Ticks on the Rise across America

Due to a milder winter and rainy spring across the United States, tick encounters and tick-borne diseases are on the rise. According to new data from the U.S. Centers for Disease Control and Prevention (CDC), emergency room visits for tick bites are currently at their highest level since 2019, and tick populations are up 30%-40% compared to last year. Most people who visit emergency rooms for a tick bite report fever and chills, headaches, fatigue, and muscle aches. 

Identifying a tick bite isn't always easy; ticks typically don't cause pain or itchiness when they bite, but over 24-48 hours local swelling, redness, fever, bullseye rash, or blistering can develop. Infections often occur in warm, creased areas like the groin, armpits, behind the knees, behind the ears, and waistband (areas where clothing presses skin together) and on children's heads and necks. According to Dr. Bobbi Pritt from the Mayo Clinic, "Frequent tick checks are important because they help prevent infections... which can cause serious long-term health issues if not caught early." Fortunately, getting a tick bite doesn't necessarily mean you will get sick. Most tick bites don't lead to disease, and the majority of tick-borne diseases can be prevented by early removal of the tick. "If you remove a tick within 24 hours of attachment, it is fairly unlikely that you will get infected," said Dr. Sam Telford, an infectious diseases expert at Tufts University.

Protecting yourself from ticks requires a layered approach. Experts recommend wearing light-colored, long-sleeved shirts and long pants tucked into socks, using EPA-registered repellents like DEET, picaridin, or oil of lemon eucalyptus, and treating clothing and gear with 0.5% permethrin. The CDC advises avoiding wooded and brushy areas with high grass and leaf litter, and staying in the center of trails when hiking. Outdoor medicine specialists emphasize regular tick checks - especially during spring and summer months - and removing ticks promptly. Remember, too, that ticks are not only found in the wild. "Most persons who acquire tick-borne infections acquire them close to their homes," says CDC medical epidemiologist Dr. David McCormick. "Even when you're outdoors just gardening, you need to be thinking about it."

Don't forget to pay attention to outdoor pets. While medications can prevent fleas and ticks from attaching to a pet's skin, it's still a good idea to check their fur after being outside. "Wherever pets can't easily groom themselves, that's where the ticks will be - on the ears, around the muzzle area, under the collar, between the toes," said Dr. Saravanan Thangamani, who studies tick-borne diseases at SUNY Upstate Medical University. Dogs and cats roaming outdoors can also bring ticks into the house. "If pets bring ticks in, a tick can live in the house for months until it finds its next blood meal," which could be another household member, he said. 

If you find an attached tick, use fine-tipped tweezers to grasp the tick as close to the skin as possible, pull straight out from the head without twisting, and clean the area with soap, water, or alcohol - never use home remedies like matches or petroleum jelly. If you don't have tweezers handy, you can also use your fingernails, the edge of a credit card, or any semi-sharp object. After removal, monitor symptoms for several weeks, and keep a record of the bite's timing and location. In high-risk regions, some doctors may prescribe a prophylactic dose of a broad-spectrum antibiotic within 72 hours to prevent Lyme disease (although this is reserved for specific cases since many bites don't result in infection).

The consequences of tick bites can range from mild local irritation to severe systemic illness. Lyme disease remains the most common tick-borne illness, with the CDC reporting that it afflicts about 40,000 Americans each year. According to the Environmental Protection Agency (EPA), over the past three decades, Lyme disease incidence rose from about 3.2 cases per 100,000 in 1993 to a peak of 18.8 per 100,000 in 2022. Most cases are concentrated in the Northeast, Mid-Atlantic, and Upper Midwest, although warming climates are pushing ticks into new territories. Lyme disease, if untreated, can lead to long-term issues such as facial palsy, arthritis, heart problems, and post-treatment syndrome, which entails chronic fatigue or cognitive issues in 5%-20% of cases. The health and financial costs are substantial: Lyme disease adds up to hundreds of millions of dollars annually in extra healthcare and lost productivity.

Ticks also transmit other serious diseases, including alpha-gal syndrome. The CDC estimates that nearly half a million people in the U.S. have alpha-gal syndrome, an illness transmitted by the bite of a tick that has recently taken a blood meal from a deer. Deer, like all mammals except for humans, carry a sugar called alpha-gal in their bodies, and the tick stores microscopic traces of the sugar in its salivary glands. When it bites a person, the tick injects alpha gal into its victim, which can cause an allergy to red meats and even dairy products.

Another tick-borne illness is ehrlichiosis, which can cause fever, headaches, organ failure, and even death, with incidence increasing from around 200 cases in 2000 to over 2,000 cases in 2019. Rocky Mountain spotted fever carries a death rate of about 0.5% and can lead to hearing loss or limb amputation. Anaplasmosis and babesiosis are both transmitted through some blacklegged ticks. Anaplasmosis can lead to respiratory failure, bleeding problems, and organ damage. While many people experience only mild, flu-like symptoms, babesiosis can be especially severe, especially in individuals with weakened immune systems or without a spleen. Powassan virus can cause confusion, loss of coordination, difficulty speaking, encephalitis (inflammation of the brain), meningitis (inflammation of the membranes around the brain and spinal cord), and seizures. Several of these diseases have no cure; you can only treat the symptoms.

Ticks and their bites are posing a growing public health challenge across the United States. Given the risks, an ounce of prevention truly is worth a pound of cure. By understanding where ticks thrive, recognizing bite symptoms, embracing personal protection strategies, and seeking early medical intervention when necessary, you can significantly reduce your risk. As tick seasons lengthen and expand, vigilance and preventive habits become vital.