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Avoid getting “ticked” off Avoid getting “ticked” off
With spring upon us and summer rapidly approaching many people are heading to the wilderness to hike and camp. As humans invade formerly... Avoid getting “ticked” off

by Kimberly Allen R.N.

With spring upon us and summer rapidly approaching many people are heading to the wilderness to hike and camp.  As humans invade formerly uninhabited wilderness areas inhabited by ticks and their animal hosts the incidence of tick-borne diseases has increased.  Tick-borne diseases can be found throughout the US and can be caused by either bacteria, viruses, or parasites.  Ticks can carry more than one disease causing pathogen, therefore people can be infected with more than one pathogen at the same time, which increases the difficulty of diagnosis and treatment.

Ticks can carry diseases and pathogens and bites should be cleaned immediately after the tick is removed to avoid infection. See a doctor if you feel sick after a tick bite.

There are numerous tick-borne diseases in the US and as there are no specific laboratory tests available to rapidly diagnose and treat specific tick-borne diseases it’s important to recognize the many symptoms manifested by each major tick borne disease.  The major tick-borne diseases found today are classified by pathogen, ie. bacterial, viral, and protozoan.  The most common are bacterial related, however there are numerous cases involving other pathogens diagnosed every year.
Bacterial infections include:

1.  Lyme disease is transmitted by the deer tick after being attached to the host for at least 24hours.  With in 7-10 days a rash known as erythema migrans or EM appears at the bite site.  The area over the bite will be dk pink to red surrounded by a ring of clear skin then more pink skin. This rash is distinct to lyme disease and allows for immediate clinical diagnosis and initiation of treatment.

2.  Rocky Mountain Spotted Fever (RMSF) is caused by the wood tick after being attached to the host for 6-10 hours.  Symptoms appear 5-10 days after the tick bite.  Early symptoms include a fever greater than 102degrees F, headache and rash.  The rash usually begins around the wrists and ankles then spreads inward toward the trunk and face then the palms and soles.  Other symptoms include abdominal pain, diarrhea, and confusion.  If untreated symptoms can progress to respiratory failure, kidney failure, and myocarditis.

3.  Ehrlichiosis is the most recent tick-borne illness to emerge in the US.  Though this disease is similar to RMSF it is frequently not reported because it’s symptoms are milder and self-limited.  The most common symptoms are high fever and headache that develops 7-11 days after the tick bite.  A rash is seen in only 20% of patients and it is almost never on the palms or soles like RMSF.  Other common symptoms are nausea and vomiting, chills and muscle aches.  Symptoms usually last 1-2 weeks then resolve themselves.

4.  Relapsing fever is not as common as the others.  It is transmitted by the soft tick that is found almost exclusively in the mountains.  It is frequently misdiagnosed so the actual number of incidence is unknown.  Frequently a black itchy scab will develop at the bite site.  seven days after the patient will suddently develop a high fever and chills and is frequently accompanied by headache, muscle aches and joint pain.  Left untreated the fever breaks in approximately 6 days followed by drenching sweats.  The fever returns 8 days later, however it’s milder.  The average patient has 3-5 episodes of reccuring fever.

Colorado tick fever or “mountain fever” is transmitted by the rocky mountain wood tick.  Symptoms begin suddenly 6 days after the tick bite.  Symptoms include fever, chills, severe headache, abdominal pain and nausea muscle aches and photophobia.  The symptoms usually last for 7-10 days, however, frequently reoccur several days later.  The 2nd episode usually last 2-4 days.

Babesiosis is a malaria-like illness that is caused by a protozoan parasite.  It is also transmitted by the deer tick.  Frequently there are no symptoms see in Babesiosis however, 1-3 weeks after the tick bite the patient can develop a feeling of malaise, loss of appetite and fatigue,  the urine can be dark also.  Severa; days later fever, headache, drenching sweats  and myalgia develop.  This disease can range from an infection that is mild and self limited to severe hemolytic anemia, kidney failure with sewvere hypertension.

Many symptoms of tick0borne diseases overlap so it’s important to recognize the differences in the symptoms seen also knowing when and where were you when you received the tick bite to help determine the tick and the illness.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at