A growing health problem in the United States

© Neil Burton

The Chief of the Bacterial Diseases Branch, Division of Vector-Borne Diseases of the Centers for Disease Control & Prevention walks us through a growing US health problem, tick-borne diseases

Ticks are a significant and growing health threat in the United States. They transmit a variety of pathogens, including viruses, bacteria, and parasites, which cause illnesses ranging from mild to life-threatening. Although tick-borne diseases are present in the United States, the specific diseases, the ticks that spread them, and the risk of infection vary widely from region to region. It is important to know the early signs of a tick-borne disease and how to protect yourself and your family.

How can tick-borne pathogens be transmitted to humans through the bite of infected ticks?

Ticks transmit pathogens when they feed. Once a tick has found a suitable place on a human or animal host, it inserts its mouthparts into the skin and injects small amounts of saliva to aid in the feeding process. If the tick contains a pathogen, it can be injected into the host and cause infection. Often an attached tick goes unnoticed and feeds slowly for several days. The time required to transmit the infection varies from a few minutes to several days, depending on the pathogen.

Tell us about some of the most common tick-borne diseases in the United States

Lyme disease is the most common, with approximately 476,000 Americans diagnosed and treated each year. It most commonly occurs in the upper Midwest, mid-Atlantic, and northeastern United States. Lyme disease is caused by bacteria Borrelia burgdorferi or occasionally by a second species, Borrelia mayoni, in areas of the upper Midwest. Both of these pathogens are spread by blacklegged or “deer” ticks. These ticks also transmit the pathogens responsible for anaplasmosis, babesiosis and Powassan virus disease. Lyme disease also occurs in areas along the Pacific coast, where it is spread by the western blacklegged tick.

Other important tick-borne diseases include ehrlichiosis, Rocky Mountain spotted fever (RMSF), and tularemia, which are commonly spread by the lone star tick. Amblyomma americanumor the American dog tick, Variable Dermacentor. More than 75% of spotted fever rickettsiosis cases (including RMSF) occur in seven states: Arkansas, Missouri, North Carolina, Oklahoma, Virginia, Alabama, and Tennessee. Although uncommon,
tularemia is present in all states except Hawaii. A growing body of evidence suggests that alpha-gal syndrome, or red meat allergy, can be triggered by the bite of solitary ticks and possibly other tick species.

How likely are outdoor workers to be exposed to tick-borne diseases if they work at sites with ticks?

Anyone who spends a lot of time outdoors is at risk for tick-borne diseases. Infection rates may be higher among forestry workers and other people working outdoors; However, it is important to remember that many exposures occur around the house during hobbies or gardening work. Since so many people are bitten by ticks and get sick every year, it’s important to take steps to protect yourself.

The best way to prevent tick-borne diseases is to prevent tick bites. Preventing tick bites can take place before and after spending time outdoors.

Before going outside, use EPA-registered insect repellents, treat clothing and equipment with products containing 0.5% permethrin, and talk to your veterinarian about the best tick prevention products for your dog. . If possible, avoid wooded, brushy areas with tall grass and leaf litter where ticks can live when spending time outdoors. After spending time outdoors, check your body for ticks, take a shower within two hours, and check your clothes, gear, and pets for ticks that may have entered your home.

You can also consider using landscaping methods to prevent ticks in the yard.

Veterinarian removing a tick from Cocker Spaniel dog
© Andrianocz

What are the symptoms associated with tick-borne diseases?

The most common symptoms of tick-related illnesses include fever and chills, body aches and rashes. Lyme disease, Southern tick-associated rash disease (STARI), RMSF, ehrlichiosis, and tularemia can cause distinct rashes.

If you are bitten by a tick and develop symptoms within days or weeks, see your health care provider. Tell your healthcare provider about your recent tick bite, when the bite happened, and where you likely picked up the tick.

How to diagnose and treat tick-borne diseases?

In general, healthcare providers will consider symptoms, history of tick exposure, geographic region where an individual was exposed, and laboratory tests, if any, before making a diagnosis and deciding of a treatment plan.

Many tick-borne diseases, such as Lyme disease, anaplasmosis, and RMSF, can be treated with a short course of antibiotics. Others, such as Powassan virus disease and Heartland virus disease, are caused by viruses and require supportive clinical care to manage symptoms.

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