View source for Tick-borne disease

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'''Tick-borne diseases''', which afflict humans and other animals, are caused by infectious agents [[Vector (epidemiology)|transmitted by]] [[tick]] bites.<ref name="NYT-20210611">{{cite news | vauthors = Wenner M |title=Let's Do a Tick Check - These pervasive bloodsuckers can give you more than just Lyme disease. Here's how to protect yourself. (Interactive) |url=https://www.nytimes.com/interactive/2021/06/11/well/tick-disease-lyme.html |date=11 June 2021 |work=[[The New York Times]] |access-date=19 June 2021 }}</ref> They are caused by infection with a variety of [[pathogen]]s, including [[rickettsia]] and other types of [[bacterium|bacteria]], [[virus]]es, and [[protozoa]].<ref name="Kumar"/>
The economic impact of tick-borne diseases is considered to be substantial in humans,<ref name="Mac">{{cite journal |last1=Mac |first1=Stephen |last2=da Silva |first2=Sara R. |last3=Sander |first3=Beate |title=The economic burden of Lyme disease and the cost-effectiveness of Lyme disease interventions: A scoping review |journal=PLOS ONE |date=4 January 2019 |volume=14 |issue=1 |article-number=e0210280 |doi=10.1371/journal.pone.0210280 |pmid=30608986 |pmc=6319811 |issn=1932-6203|doi-access=free |bibcode=2019PLoSO..1410280M }}</ref> and tick-borne diseases are estimated to affect ~80 % of [[cattle]] worldwide.<ref name="Rochlin">{{cite journal |last1=Rochlin |first1=Ilia |last2=Toledo |first2=Alvaro |title=Emerging tick-borne pathogens of public health importance: a mini-review |journal=Journal of Medical Microbiology |date=1 June 2020 |volume=69 |issue=6 |pages=781–791 |doi=10.1099/jmm.0.001206 |pmid=32478654 |pmc=7451033 |language=en |issn=0022-2615}}</ref> Most of these pathogens require passage through vertebrate hosts as part of their life cycle. Tick-borne infections in humans, farm animals, and companion animals are primarily associated with wildlife animal reservoirs.<ref name=":0">{{Cite journal |last=Baneth |first=Gad |date=1 August 2014 |title=Tick-borne infections of animals and humans: a common ground |url=https://linkinghub.elsevier.com/retrieve/pii/S0020751914000964 |journal=International Journal for Parasitology |language=en |volume=44 |issue=9 |pages=591–596 |doi=10.1016/j.ijpara.2014.03.011|pmid=24846527 |url-access=subscription }}</ref> Many tick-borne infections in humans involve a complex cycle between wildlife animal reservoirs and tick vectors.<ref name=":0" /> The survival and transmission of these tick-borne viruses are closely linked to their interactions with tick vectors and host cells. These viruses are classified into different families, including [[Asfarviridae]], [[Reoviridae]], [[Rhabdoviridae]], [[Orthomyxoviridae]], [[Bunyavirales|Bunyaviridae]], and [[Flaviviridae]].<ref>{{Cite journal |last1=Brites-Neto |first1=José |last2=Duarte |first2=Keila Maria Roncato |last3=Martins |first3=Thiago Fernandes |date=12 March 2015 |title=Tick-borne infections in human and animal population worldwide |url=http://www.veterinaryworld.org/Vol.8/March-2015/9.html |journal=Veterinary World |volume=8 |issue=3 |pages=301–315 |doi=10.14202/vetworld.2015.301-315 |pmc=4774835 |pmid=27047089}}</ref>

The occurrence of ticks and tick-borne illnesses in humans is increasing.<ref name="CDC">{{cite web |title=Lyme and Other Tickborne Diseases Increasing |url=https://www.cdc.gov/ncezid/dvbd/media/lyme-tickborne-diseases-increasing.html |website=Centers for Disease Control |access-date=4 March 2022 |language=en-us |date=21 October 2021}}</ref> Tick populations are spreading into new areas, in part [[Climate change and infectious diseases#Tick borne disease|due to climate change]].<ref name="Chrobak"/><ref name="Gilbert">{{cite journal |last1=Gilbert |first1=Lucy |title=The Impacts of Climate Change on Ticks and Tick-Borne Disease Risk |journal=Annual Review of Entomology |date=7 January 2021 |volume=66 |issue=1 |pages=373–388 |doi=10.1146/annurev-ento-052720-094533 |pmid=33417823 |s2cid=231300522 |issn=0066-4170|doi-access=free }}</ref> Tick populations are also affected by changes in the populations of their hosts (e.g. deer, cattle, mice, lizards) and those hosts' predators (e.g. foxes).  Diversity and availability of hosts and predators can be affected by [[deforestation]] and [[habitat fragmentation]].<ref name="Chrobak"/>

Because individual ticks can harbor more than one disease-causing agent, patients can be infected with more than one pathogen at the same time, compounding the difficulty in diagnosis and treatment.<ref name="Kumar">{{cite journal |last1=Kumar |first1=Manish |last2=Sharma |first2=Aniket |last3=Grover |first3=Prashant |title=Triple Tick Attack |journal=Cureus |date=13 February 2019 | volume = 11 | issue = 2 | article-number = e4064  | pmid = 31016091 | pmc = 6464285 | doi = 10.7759/cureus.4064 |doi-access=free }}</ref> As the incidence of tick-borne illnesses increases and the geographic areas in which they are found expand, health workers increasingly must be able to distinguish the diverse, and often overlapping, clinical presentations of these diseases.<ref name="Congress"/>

{{As of|2020}},  18 tick-borne pathogens have been identified in the United States according to the [[Centers for Disease Control and Prevention]]<ref name="Congress">{{cite book |title=Tick-Borne Disease Working Group. 2020 Report to Congress |date=2020 |publisher=U.S. Department of Health and Human Services |location=Washington, D.C. |url=https://www.hhs.gov/sites/default/files/tbdwg-2020-report_to-ongress-final.pdf |access-date=4 March 2022}}</ref> and at least 27 are known globally.<ref name="Chrobak">{{cite journal |last1=Chrobak |first1=Ula |title=Lyme and other tick-borne diseases are on the rise. But why? |journal=Knowable Magazine |date=3 February 2022 |doi=10.1146/knowable-020222-1 |doi-access=free |url=https://knowablemagazine.org/article/health-disease/2022/lyme-other-tickborne-diseases-rise |access-date=4 March 2022|url-access=subscription }}</ref><ref name="Paddock">{{cite book |last1=Paddock |first1=Christopher D. |last2=Lane |first2=Robert S. |last3=Staples |first3=J. Erin |last4=Labruna |first4=Marcelo B. |title=Changing paradigms for tick-borne diseases in the Americas |date=21 September 2016 |publisher=National Academies Press (US) |url=https://www.ncbi.nlm.nih.gov/books/NBK390439/ |access-date=4 March 2022 |language=en}}</ref><ref name="Zhao">{{cite journal |last1=Zhao |first1=Guo-Ping |last2=Wang |first2=Yi-Xing |last3=Fan |first3=Zheng-Wei |last4=Ji |first4=Yang |last5=Liu |first5=Ming-jin |last6=Zhang |first6=Wen-Hui |last7=Li |first7=Xin-Lou |last8=Zhou |first8=Shi-Xia |last9=Li |first9=Hao |last10=Liang |first10=Song |last11=Liu |first11=Wei |last12=Yang |first12=Yang |last13=Fang |first13=Li-Qun |title=Mapping ticks and tick-borne pathogens in China |journal=Nature Communications |date=17 February 2021 |volume=12 |issue=1 |page=1075 |doi=10.1038/s41467-021-21375-1 |pmid=33597544 |pmc=7889899 |bibcode=2021NatCo..12.1075Z |language=en |issn=2041-1723}}</ref> New tick-borne diseases have been discovered in the 21st century, due in part to the use of [[Molecular diagnostics|molecular assays]] and [[next-generation sequencing]].<ref name="Tokarz">{{cite journal |last1=Tokarz |first1=Rafal |last2=Lipkin |first2=W. Ian |title=Discovery and Surveillance of Tick-Borne Pathogens |journal=Journal of Medical Entomology |date=1 July 2021 |volume=58 |issue=4 |pages=1525–1535 |doi=10.1093/jme/tjaa269 |pmid=33313662 |pmc=8285023 |issn=0022-2585}}</ref>

==Prevention==
{{Further|Tick-Borne Disease Alliance}}

===Exposure===
[[File:Tick on human head.jpg|thumb|right|A tick crawling on a human head in a wooded area near [[LeRoy, Michigan]]]]
Ticks tend to be more active during warmer months, though this varies by geographic region and climate. Areas with woods, bushes, high grass, or leaf litter are likely to have more ticks. Those bitten commonly experience symptoms such as body aches, [[fever]], [[fatigue (medical)|fatigue]], [[joint pain]], or [[rash]]es. People can limit their exposure to tick bites by wearing light-colored clothing (including pants and long sleeves), using [[insect repellent]] with 20%–30% [[DEET|N,N-Diethyl-3-methylbenzamide (DEET)]], tucking their pants legs into their socks, checking for ticks frequently, and washing and drying their clothing in a hot dryer.<ref>{{cite web |url= https://www.cdc.gov/niosh/topics/tick-borne/ |title= Tick-Borne Diseases |website= cdc.gov |publisher= [[Centers for Disease Control and Prevention]]: [[National Institute for Occupational Safety and Health]] |access-date= May 21, 2009}}</ref><ref>{{cite journal | vauthors = Rahlenbeck S, Fingerle V, Doggett S | title = Prevention of tick-borne diseases: an overview | journal = The British Journal of General Practice | volume = 66 | issue = 650 | pages = 492–494 | date = September 2016 | pmid = 27563139 | pmc = 5198687 | doi = 10.3399/bjgp16X687013 }}</ref>

According to the [[World Health Organization]], tick-to-animal transmission is difficult to prevent because animals do not show visible symptoms; the only effective prevention relies on killing ticks on the livestock production facility.<ref name="who-CCHF">{{cite web |title=Crimean-Congo haemorrhagic fever |url=https://www.who.int/news-room/fact-sheets/detail/crimean-congo-haemorrhagic-fever |website=www.who.int |access-date=13 September 2021 |language=en}}</ref>

===Signs and symptoms===

Ticks also have the potential to induce a motor illness characterized by acute, ascending flaccid paralysis. This condition can be fatal if not treated promptly, affecting both humans and animals. It is mainly associated with certain species of ticks. Symptoms typically range from fatigue, numbness in the legs, muscle aches, and, in some cases, paralysis and other severe neurological manifestations.<ref>{{cite journal |last1=Brites-Neto |first1=José |last2=Duarte |first2=Keila Maria Roncato |last3=Martins |first3=Thiago Fernandes |title=Tick-borne infections in human and animal population worldwide |journal=Veterinary World |date=12 March 2015 |volume=8 |issue=3 |pages=301–305 |doi=10.14202/vetworld.2015.301-315 |pmid=27047089|doi-access=free |pmc=4774835 }}</ref>

Tick-borne diseases (TBD) are a major health threat in the US. The number of pathogens and the burden of disease have been increasing over the last couple of decades. With improved diagnostics and surveillance, new pathogens are regularly identified, bettering our understanding of TBDs. Unfortunately, diagnosis of these illnesses remains a challenge, with many TBDs presenting with similar nonspecific symptoms and diagnosis requiring a battery of assays to assess patients adequately. New advanced molecular diagnostic methods, including next-generation sequencing and metagenomics analysis, promise improved detection of novel and emerging pathogens with the ability to detect a litany of potential pathogens with a single assay.<ref>{{Cite journal |last1=Rodino |first1=Kyle G |last2=Theel |first2=Elitza S |last3=Pritt |first3=Bobbi S |date=2020-04-01 |title=Tick-Borne Diseases in the United States |url=https://academic.oup.com/clinchem/article/66/4/537/5814095 |journal=Clinical Chemistry |language=en |volume=66 |issue=4 |pages=537–548 |doi=10.1093/clinchem/hvaa040 |issn=0009-9147|doi-access=free |pmid=32232463 |url-access=subscription }}</ref>

===Tick removal===

Ticks should be removed safely as soon as possible once discovered. They can be removed either by grasping tweezers as close to the mouth as possible and pulling without rotation; some companies market grooved tools that rotate the [[hypostome (tick)|hypostome]] to facilitate removal. Chemical methods to make the tick self-detach, or trying to pull the tick out with one's fingers, are not efficient methods.<ref name="eurosur" /> In Australia and New Zealand, where tick-borne infections are less common than tick reactions, the [[Australasian Society of Clinical Immunology and Allergy]] recommends seeking medical assistance or killing ticks [[In situ|in-situ]] by freezing and then leaving them to fall out to prevent allergic/anaphylactic reactions.<ref>{{cite web |title=New Animation - How to Safely Remove Ticks |url=https://www.allergy.org.au/about-ascia/info-updates/how-to-safely-remove-ticks-animation |website=www.allergy.org.au |publisher=Australasian Society of Clinical Immunology and Allergy (ASCIA) |archive-url=https://web.archive.org/web/20230327131921/https://www.allergy.org.au/about-ascia/info-updates/how-to-safely-remove-ticks-animation |archive-date=27 March 2023 |date=13 April 2021 |url-status=live}}</ref><ref name="allergy">{{cite web |title=Tick Allergy |url=https://www.allergy.org.au/images/pcc/ASCIA_PCC_Tick_Allergy_2019.pdf |website=Australasian Society of Clinical Immunology and Allergy |access-date=17 July 2023 |date=21 May 2019}}</ref>

==Diagnosis==
Diagnosing tick-borne diseases involves a dual approach. Some diagnoses rely on clinical observations and symptom analysis, while others are confirmed through laboratory tests. Ticks can transmit a wide range of viruses, many of which are [[arbovirus]]es. In general, specific laboratory tests are not available for the rapid diagnosis of tick-borne diseases. Due to their seriousness, [[antibiotic]] treatment is often justified based on clinical presentation alone.

Diagnosing Lyme borreliosis relies on clinical criteria, with a history of a tick bite and associated symptoms being crucial. Laboratory diagnosis follows a 'two-tiered diagnostic protocol,' involving detecting specific antibodies using methods such as immunoenzymatic assays and Western blot tests, preferably with recombinant antigens. While ELISA and Western blot have similar sensitivity, Western blot is more specific due to the identification of specific immunoreactive bands. Seroconversion typically occurs around two weeks after symptom onset, but false-positive ELISA results can be linked to poorly reactive antibodies against specific antigens, especially in patients with other infectious and non-infectious diseases.<ref>{{Cite journal |last1=Czupryna |first1=Piotr |last2=Tarasow |first2=Eugeniusz |last3=Moniuszko-Malinowska |first3=Anna |last4=Pancewicz |first4=Sławomir |last5=Zajkowska |first5=Olga |last6=Targoński |first6=Arkadiusz |last7=Chorąży |first7=Monika |last8=Rutkowski |first8=Krzysztof |last9=Dunaj |first9=Justyna |last10=Grygorczuk |first10=Sambor |last11=Kondrusik |first11=Maciej |last12=Zajkowska |first12=Joanna |date=2016-01-02 |title=MRI and planimetric CT follow-up study of patients with severe tick-borne encephalitis |url=https://www.tandfonline.com/doi/full/10.3109/23744235.2015.1083119 |journal=Infectious Diseases |language=en |volume=48 |issue=1 |pages=74–81 |doi=10.3109/23744235.2015.1083119 |pmid=26414745 |s2cid=24319392 |issn=2374-4235|url-access=subscription }}</ref>

[[Tick-borne encephalitis virus|Tick-borne encephalitis]] (TBE) presents non-specific clinical features, making laboratory diagnosis crucial. The diagnostic process typically involves identifying specific IgM- and IgG-serum antibodies through enzyme-linked immunosorbent assay (ELISA) since these antibodies are detectable in most cases upon hospitalization.<ref>{{Cite journal |last=Holzmann |first=Heidemarie |date=1 April 2003 |title=Diagnosis of tick-borne encephalitis |url=https://linkinghub.elsevier.com/retrieve/pii/S0264410X02008198 |journal=Vaccine |language=en |volume=21 |pages=S36–S40 |doi=10.1016/S0264-410X(02)00819-8|pmid=12628812 |url-access=subscription }}</ref>

== Treatment ==
Patients with Lyme disease who are treated with appropriate antibiotics usually recover rapidly and completely. Antibiotics commonly used include doxycycline, amoxicillin, or cefuroxime axetil. For [[Anaplasmosis]], [[ehrlichiosis]], and [[Rocky Mountain Spotted Fever]], Doxycycline is the first-line treatment for adults and children of all ages. For babesiosis, a combination therapy with atovaquone and azithromycin is most commonly recommended for the treatment of mild to moderate babesiosis. Treatment is usually continued for 7 to 10 days. A combination regimen of oral clindamycin and quinine has also been proven effective, but the rate of adverse reactions is significantly higher with this combination. For the Powassan virus, there are no medications for treating Powassan virus infections. Medications, however, can help to relieve symptoms and prevent complications. People with severe disease are typically treated in a hospital where they may be given intravenous fluids, fever-reducing medications, breathing support, and other therapies as needed.<ref>{{Cite web |title=Tick-Borne Illnesses |url=https://www.yalemedicine.org/conditions/tick-borne-illnesses |access-date=2023-11-02 |website=Yale Medicine |language=en}}</ref>

==Assessing risk==
For a person or pet to acquire a tick-borne disease requires that the individual gets bitten by a tick and that the tick feeds for a sufficient period of time. The feeding time required to transmit pathogens differs for different ticks and different pathogens. Transmission of the bacterium that causes [[Lyme disease]] is well understood to require a substantial feeding period.<ref>{{cite web |url=http://www.tickencounter.org/prevention/time_to_transmission |title = TickEncounter Resource Center | publisher = University of Rhode Island}}</ref> In general, soft ticks ([[Argasidae]]) transmit pathogens within minutes of attachment because they feed more frequently, whereas hard ticks ([[Ixodidae]]) take hours or days, but the latter are more common and harder to remove.<ref name="eurosur">{{cite journal | vauthors = Pitches DW | title = Removal of ticks: a review of the literature | journal = Euro Surveillance | volume = 11 | issue = 8 | pages = E060817.4 | date = August 2006 | pmid = 16966784 | doi = 10.2807/esw.11.33.03027-en | doi-access = free }}</ref>

For an individual to acquire an infection, the feeding tick must also be infected. Not all ticks are infected. In most places in the US, 30-50% of deer ticks will be infected with ''[[Borrelia burgdorferi]]'' (the agent of Lyme disease). Other pathogens are much rarer. Ticks can be tested for infection using a highly specific and sensitive qPCR procedure. Several commercial labs provide this service to individuals for a fee. The Laboratory of Medical Zoology (LMZ), a nonprofit lab at the [[University of Massachusetts]], provides a comprehensive TickReport<ref>{{cite web |title= TickReport |url= http://tickreport.com | work = Laboratory of Medical Zoology | publisher = [[University of Massachusetts]]}}</ref> for a variety of human pathogens and makes the data available to the public.<ref name="Tick-Borne Disease Network">{{cite web |title= Tick-Borne Disease Network |url= http://tickdiseases.org | work = Laboratory of Medical Zoology | publisher = [[University of Massachusetts]]}}</ref> Those wishing to know the incidence of tick-borne diseases in their town or state can search the LMZ surveillance database.<ref name="Tick-Borne Disease Network"/>

==Examples==
Major tick-borne diseases include:

===Bacterial===
* [[Lyme disease]] or borreliosis
** Organism: ''[[Lyme disease microbiology|Borrelia burgdorferi sensu lato]]'' (bacterium)
** Vectors: at least 15 species of ticks in the genus ''Ixodes'', including [[deer tick (disambiguation)|deer tick]] (''Ixodes scapularis'' (=''I. dammini''), ''I. pacificus'', ''I. ricinus'' (Europe), ''I. persulcatus'' (Asia)).<ref>{{cite journal | vauthors = Wolcott KA, Margos G, Fingerle V, Becker NS | title = Host association of Borrelia burgdorferi sensu lato: A review | journal = Ticks and Tick-Borne Diseases | volume = 12 | issue = 5 | article-number = 101766 | date = September 2021 | pmid = 34161868 | doi = 10.1016/j.ttbdis.2021.101766 }}</ref> Additionally, ''Haemaphysalis punctata.''<ref name=":1" /><ref>{{Cite journal |last=Tälleklint |first=Lars |date=1996-08-01 |title=Lyme borreliosis spirochetes in Ixodes ricinus and Haemaphysalis punctata ticks (Acari: Ixodidae) on three islands in the Baltic Sea |url=https://doi.org/10.1007/BF00053310 |journal=Experimental & Applied Acarology |language=en |volume=20 |issue=8 |pages=467–476 |doi=10.1007/BF00053310 |issn=1572-9702}}</ref> 
** Endemic to: The Americas and Eurasia
** Symptoms: [[Fever]], [[arthritis]], [[neuroborreliosis]], [[erythema migrans]], cranial nerve palsy, [[carditis]], fatigue, and influenza-like illness<ref>{{cite web |url= http://www.mayoclinic.org/diseases-conditions/lyme-disease/basics/symptoms/con-20019701 |title= Lyme disease: Symptoms |series= Diseases and Conditions |website= MayoClinic.com |author= Mayo Clinic Staff |publisher= [[Mayo Clinic]]}}</ref>
** Treatment: Antibiotics – [[amoxicillin]] in pregnant adults and children, [[doxycycline]] in other adults<ref>{{cite web |url= http://www.mayoclinic.org/diseases-conditions/lyme-disease/basics/treatment/con-20019701 |title= Lyme disease: Treatments and drugs |series= Diseases and Conditions |website= MayoClinic.com |author= Mayo Clinic Staff |publisher= [[Mayo Clinic]]}}</ref>
* [[Relapsing fever]] (tick-borne relapsing fever, different from Lyme disease due to different ''Borrelia'' species and ticks)
** Organisms: ''[[Borrelia]]'' species such as ''B. hermsii,'' ''B. parkeri'', ''B. duttoni'', ''B.  miyamotoi''
** Vector: ''[[Ornithodoros]]'' species
** Regions: Primarily in Africa, Spain, Saudi Arabia, Asia in and certain areas of Canada and the western United States
** Symptoms: Relapsing fever typically presents as recurring high fevers, flu-like symptoms, headaches, and muscular pain, with less common symptoms including [[rigors]], joint pain, altered mentation, cough, sore throat, painful urination, and rash<ref>{{Emedicine|article|227272|Relapsing fever}}.</ref>
** Treatment: Antibiotics are the treatment for relapsing fever, with doxycycline, tetracycline, or erythromycin being the treatment of choice.<ref>{{Emedicine|article|227272|Relapsing fever|treatment}}.</ref>
* [[Typhus]] Several diseases caused by ''Rickettsia'' bacteria (below)
* [[Rocky Mountain spotted fever]]
** Organism: ''Rickettsia rickettsii''
** Vector/Region:  Wood tick (''[[Dermacentor variabilis]]''), ''[[Dermacentor andersoni]]'' in USA: East, Southwest
** Vector/Region: ''[[Amblyomma sculptum]]'' (formerly ''[[Amblyomma cajennense]]'') in Brazil: [[São Paulo (state)|São Paulo]], [[Rio de Janeiro (state)|Rio de Janeiro]], [[Minas Gerais]]
** Symptoms: Fever, headache, [[altered mental status]], [[myalgia]], [[rash]], [[palsy]], and [[necrosis]]
** Treatment: [[Antibiotic]] therapy, typically consisting of doxycycline or tetracycline.
* [[Rickettsia helvetica|Helvetica spotted fever]]
** Organism: ''Rickettsia helvetica''
** Region (''R. helvetica''): Confirmed common in ticks in Sweden, Switzerland, France, and Laos<ref name=Lindblom2012>{{cite journal | vauthors = Lindblom A, Wallménius K, Nordberg M, Forsberg P, Eliasson I, Påhlson C, Nilsson K | title = Seroreactivity for spotted fever rickettsiae and co-infections with other tick-borne agents among habitants (sic) in central and southern Sweden | journal = European Journal of Clinical Microbiology & Infectious Diseases | volume = 32 | issue = 3 | pages = 317–323 | date = March 2013 | pmid = 22961007 | pmc = 3569577 | doi = 10.1007/s10096-012-1742-3 }}</ref>
** Vector/region(s): ''[[Ixodes ricinus]]'' is the main European vector.<ref name="Lindblom2012"/>
<!-- **Vector/Region(s)#2: Please add if more vectors are found.-->
** Symptoms: Most often small red spots, other symptoms are fever, muscle pain, headache, and respiratory problems<ref name="Lindblom2012" />
** Treatment: Broad-spectrum [[antibiotic]] therapy is needed, phenoxymethylpenicillin likely is sufficient.<ref name="Lindblom2012" />
* [[Human granulocytic anaplasmosis]] (formerly human granulocytic ehrlichiosis or HGE)
** Organism: ''[[Anaplasma phagocytophilum]]'' (formerly ''Ehrlichia phagocytophilum'' or ''Ehrlichia equi'')
** Vector: [[Lone star tick]] (''Amblyomma americanum''), ''I. scapularis''
** Region (US): South Atlantic, South-central
* ''[[Bartonella]]'': ''Bartonella ''transmission rates to humans via tick bite are not well established<ref>{{cite journal | vauthors = Ben Beard C, Nelson CA, Mead PS, Petersen LR | title = Bartonella spp. Bacteremia and rheumatic symptoms in patients from lyme disease-endemic region | journal = Emerging Infectious Diseases | volume = 18 | issue = 11 | pages = 1918–1919 | date = November 2012 | pmid = 23092626 | pmc = 3559143 | doi = 10.3201/eid1811.120675 }}</ref> but Bartonella is common in ticks. For example: 4.76% of 2100 ticks tested in a study in Germany<ref>{{cite journal | vauthors = Janecek E, Mietze A, Goethe R, Schnieder T, Strube C | title = Bartonella spp. infection rate and B. grahamii in ticks | journal = Emerging Infectious Diseases | volume = 18 | issue = 10 | pages = 1689–1690 | date = October 2012 | pmid = 23017501 | pmc = 3471628 | doi = 10.3201/eid1810.120390 }}</ref>
* [[Tularemia]]
** Organism: ''Francisella tularensis'', ''A. americanum''
** Vector: ''[[Dermacentor variabilis|D. variabilis]]'', ''D. andersoni''
** Region (US): Southeast, South-central, West, widespread

===Viral===
* [[Tick-borne meningoencephalitis]]
** Organism: [[TBEV]] (FSME) virus, a [[flavivirus]] from family ''[[Flaviviridae]]''
** Vector: deer tick (''[[Ixodes scapularis]]''), ''[[Ixodes ricinus]]'' (Europe), ''[[Ixodes persulcatus]]'' (Russia + Asia))
** Endemic to: Europe (including now the UK; in 2020 Public Health England announced the first two TBE cases contracted within the country)<ref name=":1">{{Cite journal |last1=Middleton |first1=Jo |last2=Cooper |first2=Ian |last3=Rott |first3=Anja S. |date=2024-06-12 |title=Tick hazard in the South Downs National Park (UK): species, distribution, key locations for future interventions, site density, habitats |journal=PeerJ |language=en |volume=12 |article-number=e17483 |doi=10.7717/peerj.17483 |doi-access=free |issn=2167-8359 |pmc=11179636 |pmid=38881864}}</ref> and northern Asia
* [[Powassan virus]]/deer tick virus<ref>{{cite journal | vauthors = Dobler G | title = Zoonotic tick-borne flaviviruses | journal = Veterinary Microbiology | volume = 140 | issue = 3–4 | pages = 221–228 | date = January 2010 | pmid = 19765917 | doi = 10.1016/j.vetmic.2009.08.024 | series = Zoonoses: Advances and Perspectives }}</ref><ref>{{Cite web|url=https://www.cdc.gov/powassan/|title=Powassan Virus {{!}} Powassan {{!}} CDC|website=www.cdc.gov|language=en-us|access-date=2017-06-07}}</ref>
** Organism: Powassan virus (POWV), a [[flavivirus]] from family ''[[Flaviviridae]]''. Lineage 2 POWV is also known as deer tick virus (DTV)
** Vector: ''[[Ixodes cookei]]'', ''[[Ixodes scapularis|Ix. scapularis]]'', ''Ix. marxi'', ''Ix. spinipalpus''m, ''[[Dermacentor andersoni]]'', and ''[[Dermacentor variabilis|D. variabilis]]''
** Endemic to: North America and eastern Russia
* [[Colorado tick fever]]
** Organism: Colorado tick fever virus (CTF), a [[coltivirus]] from the ''[[Reoviridae]]''
** Vector: ''[[Dermacentor andersoni]]''
** Region: US (West)
* [[Crimean-Congo hemorrhagic fever]]
** Organism: [[CCHF]] virus, a [[nairovirus]], from the ''[[Bunyaviridae]]''
** Vector: ''[[Hyalomma marginatum]]'', ''[[Rhipicephalus]] bursa''
** Region: Southern part of Asia, Northern Africa, Southern Europe
* Severe febrile illness<ref>{{cite journal | vauthors = Pastula DM, Turabelidze G, Yates KF, Jones TF, Lambert AJ, Panella AJ, Kosoy OI, Velez JO, Fisher M, Staples E | display-authors = 6 | title = Notes from the field: Heartland virus disease - United States, 2012-2013 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 63 | issue = 12 | pages = 270–271 | date = March 2014 | pmid = 24670929 | pmc = 5779346 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6312a4.htm }}</ref>
** Organism: [[Heartland virus]], a [[phlebovirus]], from the ''[[Bunyaviridae]]''
** Vector: Lone star tick (''Amblyomma americanum'')
** Region: Missouri and Tennessee, United States
* Severe febrile illness, headaches, coma in 1/3 patients<ref>{{cite web | title = Chinese researchers highlight new tick-borne disease, Alongshan virus | url = http://www.cidrap.umn.edu/news-perspective/2019/05/news-scan-may-29-2019 | work = CIDRAP - Center for Infectious Disease Research and Policy | publisher = University of Minnesota | location = Minneapolis, MN | date = May 29, 2019 }}</ref>
** Organism: tentatively Alongshan virus, Jingmen virus group in the Flavivirus family
** Vector: tick (likely ''[[Ixodes persulcatus]]'', ''[[Ixodes ricinus]]''), mosquitoes
** Region: Inner Mongolia, but potentially more widespread

===Protozoan===
* [[Babesiosis]]
** Organism: ''[[Babesia microti]]'', ''[[Theileria equi]]''
** Vector: ''[[Ixodes scapularis]]'' (deer tick), ''[[Ixodes pacificus|I. pacificus]]'' (western black-legged tick)
** Region (US): Northeast, West Coast
* [[Cytauxzoonosis]]
** Organism: ''Cytauxzoon felis''
** Vector: ''[[Amblyomma americanum]]'' (Lone star tick)
** Region (US): South, Southeast

===Toxin===
* [[Tick paralysis]]
** Cause: Toxin
** Vector (US): ''[[Dermacentor andersoni]]'' (Rocky Mountain wood tick), ''[[Dermacentor variabilis|D. variabilis]]'' (American dog tick or wood tick)
** Region (US): ''D. andersoni'': East, ''D. variabilis'': East, West coast
** Vector (Australia): ''[[Ixodes holocyclus]]'' (Australian paralysis tick)<ref>{{cite web |url= http://medent.usyd.edu.au/fact/ticks.htm |title= Ticks |website= medent.usyd.edu.au |publisher= Department of Entomology, [[University of Sydney]] and [[Westmead Hospital]]|date= November 7, 2003 }}</ref>
** Region (Australia): East

=== Allergies ===
* [[Alpha-gal allergy]] - Alpha-gal syndrome is likely caused by a hypersensitivity reaction to the Alpha-gal (Galactose-alpha-1,3-galactose) sugar molecule introduced by ticks while feeding on a human host. The immune reaction can leave people with an allergy to red meat and other mammalian-derived products.<ref>Crispell, Gary; Commins, Scott P.; Archer-Hartman, Stephanie A.; Choudhary, Shailesh; Dharmarajan, Guha; Azadi, Parastoo; Karim, Shahid (17 May 2019). "Discovery of Alpha-Gal-Containing Antigens in North American Tick Species Believed to Induce Red Meat Allergy". Frontiers in Immunology. 10: 1056. https://doi.org/10.3389/fimmu.2019.01056. PMC 6533943. PMID 31156631</ref>
* The experimental confirmation and investigation of how tick bites contribute to the development of AGS have been established and examined using a mouse model.<ref> Sharma, Surendra Raj; Choudhary, S; Vorobiov, J; Commins, SP; Shahid, Karim (7 Feb 2024). " Tick bite-induced alpha-gal syndrome and immunologic responses in an alpha-gal deficient murine model" . Frontiers in Immunology. 10: 1056. https://doi.org/10.3389/fimmu.2023.1336883. PMC NA. PMID NA</ref>

== See also ==
{{div col|colwidth=20em}}
* [[Arbovirus]]
* [[Climate change and infectious diseases]]
* [[List of diseases spread by invertebrates]]
* [[List of insect-borne diseases]]
* [[Mosquito-borne disease]]
* [[Robovirus]]
* [[Tibovirus]]
* [[Wetland virus]]
* [[Ticks of domestic animals]]
{{div col end}}

== References ==
{{Reflist}}

== External links ==

{{Wikispecies|Ixodida}}
* [https://vbdhub.org UK's ''One Health Vector-Borne Diseases Hub'']
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* [https://www.cdc.gov/niosh/topics/tick-borne/ Tick-Borne Diseases: Recommendations for Workers and Employers]—National Institute for Occupational Safety and Health
* [https://www.cdc.gov/ticks/diseases/ Tickborne Diseases]—National Center for Infectious Diseases (CDC)
* [http://www.mass.gov/dph/cdc/epii/lyme/lymehp.htm Tickborne Disease Website]—Massachusetts Department of Public Health
* [https://web.archive.org/web/20080502184949/http://chppm-www.apgea.army.mil/3d/tick/Xyber-tick.html Ixodes Scapularis]—3D animation of Deer or Blacklegged Tick from US Army site
* [https://en.wikibooks.org/wiki/Parasitic%20Insects,%20Mites%20and%20Ticks:%20Genera%20of%20Medical%20and%20Veterinary%20Importance Parasitic Insects, Mites and Ticks: Genera of Medical and Veterinary Importance] Wikibooks
* {{cite journal |title=Tick Saliva and the Alpha-Gal Syndrome: Finding a Needle in a Haystack |author1=Surendra RS |author2=Shahid Karim |journal=Frontiers in Cellular and Infection Microbiology |date=2021 |volume=11 |article-number=680264 |doi=10.3389/fcimb.2021.680264 |doi-access=free |pmc=8331069 |pmid=34354960}}

{{Tick-borne diseases}}
{{Concepts in infectious disease}}
{{Authority control}}

{{DEFAULTSORT:Tick-Borne Disease}}
[[Category:Tick-borne diseases| ]]