Other Tick-Borne Diseases

NOTE: One Tick Can Spread Multiple Diseases (Co-infections)

Worldwide, ticks can carry pathogens that cause disease in humans (& other mammals & animals).  Note that all ticks are not infected.  Ticks are only the disease vectors, & spread disease after getting infected, themselves, from the original host on which they feed (usually mice & other rodents). A single tick bite may spread multiple diseases at one time.


Since many of these tick-borne diseases have overlapping symptoms with Lyme disease, & serological testing for some of the pathogens is inconsistent at best, many of the more complicated cases of Lyme disease are likely to involve one or more co-infections.  Given the state of serological testing, obtaining a proper diagnosis for the co-infections may be even more difficult than identifying a case of Lyme disease. Below, we discuss these diseases & the ticks which spread them in their primary locations within the U.S.A.



Anaplasmosis - caused by a bacterium, Anaplasma phagacytophilum


NOTE: Co-infection with Lyme can cause more severe symptoms. Death can result.


SYMPTOMS: fever, malaise, headaches, chills, severe muscle aches, vomiting, anemia, lung infection, decreased white blood cells & platelets, elevated liver enzymes, seizures, encephalopathy, meningitis, confusion, ataxia & cranial nerve palsy.


VECTOR: blacklegged tick/deer tick (Ixodes scapularis), western blacklegged tick (Ixodes pacificus).




Babesiosis (Babesia) - Malaria-like illness caused by multiple parasite species: Babesia microti, B. duncani, B. divergens, MO-1


NOTE: sometimes fatal in the elderly or those with no spleen.  Babesiosis may be more severe in patients with co-existing Lyme disease.  Babesiosis has also been transmitted to humans through blood transfusions. Death can result.


SYMPTOMS: fever, chills, fatigue, headache, muscle pain, sweats and anemia.


VECTOR: blacklegged tick/deer tick (Ixodes scapularis), western blacklegged tick (Ixodes pacificus).


CASES: Cases linked to Babesia duncani, which were originally identified on the West Coast, have been more recently spreading to other parts of North America.  Babesia divergens has been found only rarely as a cause of human infections in the U.S.




Bartonellosis (Bartonella) - caused by several bacterial species transmitted either by a flea or a tick bite, cat scratch or lice. (Bartonella Henselae &/or perhaps other spp.)


NOTE: There are several case studies of severe complications in patients co-infected with Bartonella henselae, & other Bartonella strains, along with Borrelia burgdorferi (the causative agent of Lyme disease). Studies have shown dogs, coyote, & fox can also transmit strains of the bacteria.  Death can result.


SYMPTOMS: (when tick-borne) visual problems, headaches, significant lymph node enlargement, resistant neurological deficits & the new onset of a seizure disorder.


Bartonella henselae is associated with heartburn, abdominal pain, skin rash, mesenteric adenitis, gastritis & duodentis in children and adolescents.


VECTOR: blacklegged tick/deer tick (Ixodes scapularis), western blacklegged tick (Ixodes pacificus).




Borrelia mayonii - caused by new bacteria species & is the only species besides B. burgdorferi known to cause Lyme disease in North America


SYMPTOMS: all Lyme disease symptoms.


VECTOR: blacklegged tick (Ixodes scapularis).




Borrelia miyamotoi - caused by bacteria in the relapsing fever group of Borrelia


NOTE: Although not closely related to the Lyme disease bacteria, it can cause a Lyme-like-illness.  Borrelia miyamotoi was identified in 1995 in ticks from Japan.


SYMPTOMS: fever, headaches, muscle aches & chills.


VECTOR: blacklegged tick/deer tick (Ixodes scapularis), western blacklegged tick (Ixodes pacificus).




Bourbon Virus - caused by a virus, Thogotovirus


NOTE: NO TREATMENT, NO TESTS.  Five cases of the Bourbon virus have been confirmed since it was first discovered in Bourbon County, Kansas, U.S.A, in 2014.  Identified in both the Midwest & southern United States. At this time, it is unknown if the virus might be found in other areas of the United States.


SYMPTOMS: fever, headache, tiredness, rash, other body aches, nausea, vomiting, leukopenia, thrombocytopenia.  May cause death due to acute illness.


VECTOR: tick, perhaps biting insects.




Colorado tick fever (CTF) - caused by a virus, Coltivirus


NOTE: Only 5-15% of cases have a rash occur.  50% of patients have single recurrence of fever (“saddleback” fever).  Some cases of transmission through blood transfusion have been reported. Causes illness from the western Black Hills to the West Coast in the U.S.A.


SYMPTOMS: begin 3-5 days after the bite with an abrupt onset of fever & any of these: headaches, chills, malaise, photophobia, myalgias, nausea, vomiting, diarrhea and abdominal pain.  Neurologic complications may occur.  Death can result.


VECTOR: Rocky Mt. wood tick (Dermacentor andersoni).




Ehrlichiosis - caused by a bacterium, Ehrlichia chaffeensis


NOTE: Co-infection with Lyme can cause more severe symptoms. Death can result. 


SYMPTOMS: fever, malaise, headaches, chills, severe muscle aches, vomiting, anemia, lung infection, decreased white blood cells & platelets, elevated liver enzymes, seizures, encephalopathy, meningitis, confusion, ataxia & cranial nerve palsy.


VECTOR: Lone Star tick (Amblyomma americanum), American dog tick (Dermacentor variabilis).  Blacklegged tick/deer tick & western blacklegged tick have both been shown to carry the Ehrlichiosis bacterium but, to date, transmission is still in question.




Heartland Virus - caused by a virus, Phlebovirus


NOTE: Discovered in humans in 2009 in the state of Montana, cases since have been identified in the Midwestern & southern United States.  There is no treatment.


SYMPTOMS: fever, leucopenia (decrease in the number of total white blood cells), thrombocytopenia (low platelet).  Death can result.


VECTOR: Suspected that Lone Star ticks (Amblyomma americanum) can transmit the virus.  It is unknown if the virus may be found in other areas of the U.S.A.




Meat Allergy/alpha-gal - meat allergy caused by lone star tick bite


NOTE: CAN CAUSE DEATH. The tick's saliva triggers an immune response to a carbohydrate, alpha-gal, found in red meat.


SYMPTOMS: develop 3-4 hours after exposure. Anaphylaxis.


VECTOR: Lone Star tick (Amblyomma americanum).




Pacific Coast tick fever (PCTF) - caused by a bacterium, Rickettsia philipii (type strain “Rickettsia 364D”)


NOTE: As of 2016, fourteen cases (14) cases reported (all in California); 1st case in 2008.


SYMPTOMS: fever, headache, eschar(s) - eschar is dead tissue that falls off (sheds) from healthy skin.


VECTOR: Pacific Coast tick (Dermacentor occidentalis).


The Pacific Coast tick’s range includes most of California, southern Oregon, & northern Baja California, Mexico.




Powassan Encephalitis - is caused by a flavivirus, Powassan


NOTE: Cases have been reported primarily from northeastern states & the Great Lakes region.


SYMPTOMS: headache, fever, nausea & vomiting, stiff neck, & sleepiness. Later, breathing distress, tremors, confusion, seizures, coma, paralysis.  Death can result.


VECTOR: Blacklegged/deer tick (Ixodes scapularis), woodchuck tick (Ixodes cookei), squirrel tick (Ixodes marxi).




Rickettsia parkeri - caused by a bacterium of the same name


SYMPTOMS: fever, headache, variable rash, eschar(s) - eschar is dead tissue that falls off (sheds) from healthy skin.


NOTE: Found in eastern, southern, & Gulf Coast regions of the U.S.A.


VECTOR: Gulf Coast tick (Amblyomma maculatum).




Rocky Mountain spotted fever (RMSF) - caused by a bacterium, Rickettsia rickettsii


SYMPTOMS: CAN CAUSE DEATH. Headaches, myalgia, & a characteristic rash usually beginning on wrists, ankles, palms and soles.


VECTOR: Lone Star tick (Amblyomma americanum), American dog tick (Dermacentor variabilis), Rocky Mt. wood tick (Dermacentor andersoni), brown dog tick (Rhipicephalus sangunineus) in the U.S.A.


The brown dog tick & additional tick species are associated with RMSF in Central & South America.




STARI (Southern Tick-Associated Rash illness) - causative agent of STARI is unknown; possibly the bacterium Borrellia lonestari, possibly another form of Lyme disease


NOTE: STARI is a disease that looks & acts like Lyme disease. There is no generally accepted test for STARI at this time.


SYMPTOMS: similar to Lyme disease & can include a rash that looks like the bull's-eye rash of Lyme.


VECTOR: Lone Star tick (Amblyomma americanum).


STARI can be found in the southeastern, eastern, & northern regions of the U.S.A.




Tick-borne relapsing fever (TBRF) - caused by bacterial spirochete species: Borellia hermsii, Borellia parkerii, or Borellia turicatae


NOTE: TBRF has been reported in 15 states: Arizona, California, Colorado, Idaho, Kansas, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Texas, Utah, Washington, & Wyoming & is associated with sleeping in rustic cabins & vacation homes.


SYMPTOMS: headache, myalgia, arthralgia, shaking chills, & abdominal pain.  Death can result.


VECTOR: soft tick species (Ornithodoros).




Tick paralysis - caused by a neurotoxin secreted by tick bite


NOTE: Paralysis resolves when tick is completely removed.


SYMPTOMS: begins 2-6 days after attachment & primarily involves a paralysis that begins in the feet & spreads upward.  May be fatal if respiratory muscles involved.


VECTOR: American dog tick (Dermacentor variabilis), Rocky Mt. wood tick (Dermacentor andersoni), Lone Star tick (Amblyomma americanum), blacklegged tick/deer tick (Ixodes scapularis).




Tularemia - caused by a bacterium, Francisella tularensis


SYMPTOMS: headache, chills, vomiting, aching pains, fever, swollen glands, sweating, weight loss, weakness.  Infection site develops into an ulcer.  Death can result.


VECTOR: American dog tick (Dermacentor variabilis), Rocky Mt. wood tick (Dermacentor andersoni), Lone Star tick (Amblyomma americanum), blacklegged tick/deer tick (Ixodes scapularis).


Tularemia occurs throughout the U.S.A.




Q fever - caused by a bacterium, Coxiella burnetti (Cb)


NOTE: Disease can be tick-borne, but most cases result from inhaling Cb-containing dust. Cattle, sheep, & goats are the primary reservoirs.


SYMPTOMS: high fevers up to 105°F, severe headache, malaise, myalgia, chills &/or sweats, cough, nausea, vomiting, diarrhea, abdominal pain, chest pain. Death can result.


Acute symptoms include hepatitis, pneumonia, & chronic endocarditis.


VECTOR: Lone Star tick (Amblyomma americanum), Rocky Mt. wood tick (Dermacentor andersoni).