Ticks are more than a warm-weather nuisance. They are tiny disease carriers that thrive in many of the same places hunters, anglers, campers and dog owners spend their free time: brushy field edges, oak flats, creek bottoms, tall grass, leaf litter and shaded trails.
Lyme disease gets the headlines, and for good reason. But it is only part of the story. In the United States, ticks can spread bacteria, viruses and parasites that cause a long list of tickborne diseases, many with overlapping symptoms that can make them hard to sort out early.
Fever, chills, headaches, muscle aches, fatigue and sometimes rash are common warning signs. If you get sick after a tick bite, or after spending time where ticks live, don’t try to tough it out. Call a healthcare provider.
Some tickborne diseases are treatable with antibiotics when caught early. Others are viral and can only be managed with supportive care. Either way, the smartest move is to prevent tick bites in the first place.
Alpha-Gal Syndrome
Alpha-gal syndrome is one of the cruelest tick-related conditions for anyone who loves venison, burgers, bacon or a good steak. The Centers for Disease Control and Prevention describes alpha-gal syndrome, or AGS, as a serious, potentially life-threatening allergy and tickborne disease that can develop after a tick bite.
Alpha-gal is a molecule found in most mammals, including cows, pigs, sheep, deer and rabbits, but not in people. It is also found in the saliva of some ticks. When a tick bite exposes the human body to alpha-gal, the immune system may identify that molecule as a threat. Later, when that person eats red meat or is exposed to other mammal-derived products, the immune system can trigger an allergic reaction.
Symptoms can include hives, nausea, vomiting, severe stomach pain, diarrhea, breathing issues, swelling, dizziness or even anaphylaxis. One of the tricky parts is that AGS reactions are often delayed, sometimes showing up hours after a meal.
That means patients with AGS may have to stop eating meat from mammals, including venison, beef, pork, lamb and rabbit. Some people also have trouble with dairy products, gelatin, certain medications or other products made from mammals.
In the United States, AGS is most often associated with the lone star tick, though a few cases have been reported after bites from blacklegged and western blacklegged ticks. Most reported U.S. cases occur in the South, East and Central states, where lone star ticks are common. Fortunately, not everyone bitten by a tick develops AGS.
Anaplasmosis
If you are not familiar with anaplasmosis, there is a fair chance you will be at some point. It is a bacterial disease spread primarily through the bite of infected blacklegged and western blacklegged ticks.
Symptoms often begin one to two weeks after the bite of an infected tick, though many people never remember being bitten. Early symptoms can include fever, chills, severe headache, muscle aches, nausea, vomiting, diarrhea and loss of appetite.
Treatment typically involves antibiotics, and prompt treatment can reduce the risk of severe illness. If treatment is delayed, anaplasmosis can become serious, especially for older adults, people with weakened immune systems and those with other medical conditions.
I can personally attest that it is no fun.
I woke up in hunting camp one morning feeling achy and fatigued, but still well enough to venture afield. My condition worsened throughout the day, and once back at camp I went straight to bed, where I would spend most of the next three days.
Every joint ached, and I alternated between chills and fever, soaking through several shirts each night. Trying to stay hydrated was a challenge, and I had no interest in food.
When I nearly passed out one evening, my son insisted on taking me to the ER. Unfortunately, the doctor diagnosed it as a simple virus. A week later the whole cycle repeated, and I ended up in a different ER, where doctors eventually determined I had both anaplasmosis and Lyme disease.
Lyme Disease
Lyme disease is the tickborne disease most people know by name. It is a bacterial infection spread through the bite of infected blacklegged ticks.
Typical symptoms can include fever, headache, fatigue and a skin rash often called erythema migrans. If left untreated, Lyme disease can spread to the joints, heart and nervous system.
Most cases can be treated successfully with a course of antibiotics, especially when diagnosed early. Some patients report prolonged symptoms such as fatigue, pain or difficulty thinking even after treatment, so it is important to work with a healthcare provider if symptoms persist.
Ehrlichiosis
Ehrlichiosis is the general name for a group of bacterial diseases spread by infected ticks, especially lone star ticks and blacklegged ticks.
Like several other tickborne diseases, ehrlichiosis can show up with fever, chills, headache, muscle aches and upset stomach. Symptoms often resemble other illnesses, which can make diagnosis difficult without a good history of tick exposure.
Doxycycline is the treatment of choice for people of all ages with ehrlichiosis. The important part is not waiting too long to get checked if you develop symptoms after a tick bite or after spending time in tick country.
Powassan Virus
Powassan virus is less common than Lyme disease, but it deserves attention because it can become serious quickly. Cases remain uncommon, but reported cases have increased in recent years, and most U.S. cases occur in the Northeast and Great Lakes regions.
Initial symptoms can include fever, headache, vomiting and weakness. In severe cases, Powassan virus can cause inflammation of the brain or the membranes around the brain and spinal cord. That can lead to confusion, loss of coordination, difficulty speaking and seizures.
There are no vaccines or medicines to prevent or treat Powassan virus disease. Antibiotics do not treat viruses, so care is focused on managing symptoms. People with severe illness often need hospitalization.
Bourbon Virus
Bourbon virus sounds like a camp joke waiting to happen. It isn’t.
Bourbon virus is a rare disease believed to spread through the bite of infected ticks, likely lone star ticks. A limited number of cases have been reported in the Midwest, East Coast and Southern United States.
Symptoms can include fever, fatigue, rash, headache, body aches, nausea and vomiting. As with Powassan virus, there are no vaccines or medicines to prevent or treat Bourbon virus disease, and antibiotics do not work against viruses.
Mild symptoms may be managed with over-the-counter pain relievers, but some patients require hospitalization, intravenous fluids and treatment for pain or fever.
Babesiosis
Babesiosis is different from the bacterial and viral diseases above because it is caused by microscopic parasites that infect red blood cells.
In the United States, babesiosis is most often spread through the bite of infected blacklegged ticks. Some people have no symptoms at all, while others develop flu-like symptoms such as fever, chills, sweats, headache, body aches, loss of appetite, nausea and fatigue.
Because the parasite attacks red blood cells, babesiosis can become serious for some people, especially those without a spleen, people with weakened immune systems, older adults and people with serious liver or kidney disease.
The good news is that babesiosis is preventable and treatable when properly diagnosed.
Other Tickborne Diseases to Know
The list of tickborne diseases does not stop there. Depending on where you live or travel, ticks can also spread Colorado tick fever, hard tick relapsing fever, Heartland virus, Rocky Mountain spotted fever, rickettsioses, soft tick relapsing fever, Southern tick-associated rash illness, or STARI, and tularemia.
You do not need to memorize every disease name before you go hunting, fishing or camping. The important thing is recognizing the pattern: If you develop fever, rash, aches, fatigue, headache or other unusual symptoms after a tick bite or time outdoors, take it seriously and contact a healthcare provider.
The Best Defense Against Tickborne Diseases
The best defense against tickborne diseases is to avoid tick bites. That is easier said than done for hunters and anglers, but there are several practical steps that help.
Start with clothing. Wear long pants, long sleeves and closed-toe boots when you are in tick country. Light-colored clothing can make ticks easier to spot. Tuck pants into socks or boots when practical, especially when walking through grass, brush or leaf litter.
Use an EPA-registered insect repellent and follow the product label. Common active ingredients include DEET, picaridin, IR3535, Oil of Lemon Eucalyptus, PMD and 2-undecanone.
For clothing and gear, products containing 0.5% permethrin are a strong option. Permethrin can be used on boots, pants, socks, gaiters, tents and other gear. It should be used on clothing and gear, not directly on skin, and the treated items should be allowed to dry according to label directions before use. You can also buy pretreated clothing and gear.
After you come indoors, check your clothing, gear and pets. Ticks can ride into the house on packs, jackets, boots or dogs and attach later. Showering soon after coming indoors may help wash off unattached ticks and gives you a good chance to do a full-body tick check.
Check carefully around the hairline, ears, armpits, belly button, waist, between the legs, backs of knees, ankles and anywhere clothing fits tightly. Dogs should be checked, too, and pet owners should talk with a veterinarian about tick prevention products.
How to Remove a Tick
If you find a tick attached to your skin, remove it as soon as possible. Several tick-removal tools are available, but fine-tipped tweezers work well.
Use clean, fine-tipped tweezers to grab the tick as close to the skin as possible.
Pull upward with steady, even pressure. Do not twist or jerk the tick, because that can cause the mouthparts to break off and remain in the skin.
If mouthparts break off and you can remove them easily with tweezers, do so. If you cannot remove them easily, leave the area alone and let the skin heal.
After removing the tick, clean the bite area and your hands with rubbing alcohol or soap and water.
Do not crush a live tick with your fingers. Dispose of it by placing it in alcohol, sealing it in a bag or container, wrapping it tightly in tape, or flushing it down the toilet. If you want to save the tick for identification, place it in alcohol or a sealed container.
Skip the old camp tricks. Do not use petroleum jelly, nail polish, heat or other methods to try to make the tick detach. Remove it cleanly and quickly.
Then watch for symptoms. If you develop a rash, fever, fatigue, headache, muscle pain, joint swelling or other concerning symptoms after a tick bite, contact a healthcare provider.
Tickborne diseases are not something to panic over, but they are something to respect. Take prevention seriously, check yourself and your gear, and do not ignore symptoms after time in tick country.
