15 Facts You Must Know About Ticks and Tick-Borne Illness

We get it: No one wants to think about ticks. They're creepy, gross-looking, and can spread disease. But that's exactly why you should start paying attention to them.

In the United States, ticks are responsible for spreading potentially life-threatening infectious diseases, some of which can trigger chills, nausea, fever, neurological problems, and even death. The most infamous of these infections is Lyme disease—according to the Centers for Disease Control and Prevention (CDC), it's the most commonly reported vector-borne illness in the United States. (A "vector" is any living thing that can transfer diseases.)

Other more common tick-borne illnesses in the U.S., according to the CDC, include:

• Babesiosis
• Ehrlichiosis
• Rocky Mountain spotted fever (RMSF)
• Anaplasmosis
• Southern tick-associated rash illness (STARI)
• Tick-borne relapsing fever (TBRF)
• Tularemia

So when it comes to ticks, ignorance is the opposite of bliss. Start reading up on what ticks look like, where they camp out, and what to do if one latches onto you. Developing an action plan can potentially better defend you from tick-borne illness.

Ticks Are Not Insects

Surprised? It's true. Ticks are actually arachnids, which means they're more closely related to spiders than they are to flies or mosquitos. Ticks even look a lot like spiders: They have four pairs of legs, no antennae, and—importantly—don't fly or jump, either. Instead, when ticks are ready to feed, they usually camp out on blades of grass or other foliage, where they wait for a human or animal to come to them. It's a strategy the CDC calls "questing." By using their third and fourth pairs of legs for stability, ticks stretch out their first set of legs and latch onto the unsuspecting host; from there, some ticks might crawl around until they find a thin area of skin near a small blood vessel, where it's easier to extract blood.

Only a Few Types of Ticks Spread Diseases in the U.S.

Scientists have identified thousands of tick species across the world, but only a handful or so really cause us trouble in the U.S. The blacklegged tick (or "deer tick") is most commonly found in the Northeast and parts of the Midwest, according to the CDC's tick population distribution maps.

You may be familiar with the deer tick because it's known for spreading Lyme disease, an infection that can eventually cause joint pain, inflammation of the brain, and more. The Rocky Mountain wood tick is another dangerous critter that gets its name from its natural habitat; it, along with the American dog tick and brown dog tick (both found across the country), can infect people with a potentially fatal disease called Rocky Mountain spotted fever.

If a Tick Bites You, It'll Probably Stick Around for a Few Days

"It's not like a mosquito, which stays on you for a few minutes," said Peter Krause, MD, a senior research scientist in epidemiology and microbial diseases at the Yale School of Public Health.

The first thing the tick will likely do is look for a good spot to set up its proverbial picnic basket. Then it starts meal prep, sometimes for as long as two hours. Since some ticks are relatively small (the larva can be smaller than a millimeter), there's a good chance you won't notice one's on you.

The CDC notes how ticks tend to choose "hard-to-see areas" like your scalp, groin, or armpit. Once there, the tick burrows its head into your skin, unpacks its feeding tube, and spits out a cocktail of blood-thinning, skin-numbing, human-immune-system-fighting saliva. Then it'll likely feed for about two to three days. If it's a female, it can swell up to nearly double its normal size—which is useful when it needs to lay eggs.

Ticks Don't Start Transmitting Diseases Right Away

Transmission rates vary by the disease and the tick species, but generally, it's not instantaneous. Certain ticks might begin to transmit a disease called anaplasmosis within eight hours, Dr. Krause told Health, but others take longer. In fact, the CDC says if you can remove a tick within 24 hours, your chances of getting Lyme disease are pretty low. In most cases, it takes 36 to 48 hours before the bacteria that causes Lyme disease can infect you.

Ticks Can Spread Multiple Diseases at Once

Let's back up: Humans aren't ticks' primary meals. Ticks also like to feed on dogs, mice, birds, rabbits, and deer. And as they climb from mammal to mammal, they infect their hosts with certain pathogens and pick up disease-causing bacteria. "It's not unheard of for ticks to be carrying three different diseases at one time," Dr. Krause said. For example, the CDC notes that the blacklegged deer tick can spread Lyme disease, anaplasmosis, and another illness called babesiosis in one bite.

Most Internet Home Remedies Don't Work

A clinical review published in the British Medical Journal (BMJ) in December 2013 analyzed the effectiveness of several internet-recommended ways to remove ticks. Suggestions included rubbing petroleum jelly, gasoline, nail polish, or 70% isopropyl alcohol over the tick's mouthparts, ostensibly to "suffocate" it. BMJ researchers concluded none of these methods actually work—ticks can survive long periods without air. So don't try these.

Furthermore, in the 2020 Guidelines for the Prevention, Diagnosis, and Treatment of Lyme, updated in February 2021 in Neurology, the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology warned against trying to burn off a tick with matches or heating devices.

You Should Remove a Tick With a Pair of Pointy Tweezers

If you deal with ticks the same way as any unwanted bug—by freaking out and yanking it off you as fast as possible—that's a bad idea. Keep a cool head, and find a good pair of pointy tweezers; blunt tweezers may be too clunky and, as a result, break the tick apart or squeeze germs further into the bite, according to the TickEncounter Resource Center. Grasp the part of the tick closest to the skin. Then, pull upward carefully and steadily. Don't jerk or twist.

Once removed, the CDC recommends flushing the tick down the toilet; wrapping it tightly in tape; or putting it in alcohol. If you or your healthcare provider want to ID it, put it in a sealed bag. If you don't remove the entire head, don't worry; the tick itself is dead, and the mouthpiece will usually work its way out of your skin eventually, Dr. Krause said. Just be sure to clean that area of your skin with soap and water or an alcohol wipe afterward. For a demo, check out this animated tick removal video from TickEncounter Resource Center.

The Symptoms From Tick-Borne Illnesses Can Show Up Within a Few Days

Most tick-borne diseases can trigger a fever, headache, fatigue, and muscle aches; some also trigger a telltale bulls-eye rash (called an erythema migrans, or EM, for short).

People who develop Rocky Mountain spotted fever usually have a fever first, the CDC reports. Then, a small, flat, pink rash tends to show up two to four days later. The CDC suggests beginning treatment as soon as possible; if after five to six days of illness, petechiae (red-to-purple spots) appear, this means the disease has become severe.

With Lyme disease, the characteristic bulls-eye rash might appear anywhere from three days to one month after the bite, and it usually arrives before the fever.

One thing we should mention: If a red ring shows up around the tick bite (and it's under 5 centimeters, doesn't grow any bigger, and disappears in a few days), that's probably just a normal allergic reaction, not a sign of Lyme disease.

Not Everyone With Lyme Disease Will Get a Rash

The CDC estimates that about 20% of people with Lyme disease won't exhibit that bulls-eye rash. But that doesn't mean a person won't develop other symptoms, like arthritis in the joints, muscle pain, and even meningitis or encephalitis, further down the road.

Just Because a Tick Can Transmit a Disease Doesn't Mean It Will

There's a good chance you won't come down with an illness even if an infected tick bites you.

A July 2017 study review published in PLoS One found that the risk of getting Lyme disease after a tick bites you is about 2.6%. If you save the tick, you can try to ID it with the Tick Identification Chart at Tick Encounter Resource Center and see which diseases it might carry; or you can bring the tick to your healthcare provider, who can tell you if it's a deer tick.

If a deer tick has bitten you and it has been on you for about 36 hours (it'll be pretty engorged by this point), your healthcare provider might want you to take doxycycline, an antibiotic that can treat infections, Dr. Krause said. (Pregnant people shouldn't take it, however.) And remember: If you start exhibiting flu-like symptoms in the days (or weeks) after you were bitten, tell your healthcare provider—that's another sign you may have a tick-borne illness.

Lyme Disease Rates Have Been Climbing Steadily

Since the CDC started keeping records in 1991, Lyme disease infection rates have trended upward. Though the CDC previously reported an estimated 300,000 Americans were diagnosed with and treated for Lyme disease each year, a 2010-2018 review of insurance claims approximated that number is closer to 476,000. This may be an overestimation because patients are sometimes treated for Lyme disease when they are not infected.

In 2019, the CDC's National Notifiable Disease Surveillance System (NNDSS) showed an increase in Lyme disease's geographic distribution; states with the most reported cases of Lyme disease are Pennsylvania, New York, New Jersey, Maine, Wisconsin, New Hampshire, Minnesota, Maryland, Connecticut, Virginia, Vermont, West Virginia, Delaware, and Rhode Island.

One possible reason for the geographical trend, said Dr. Krause, is its relative concentration of wooded areas. "As the agriculture moved into the Midwest, the forest returned to the Northeast," Dr. Krause explained. "The deer returned too, only today, they don't have nearly as many predators." More deer means more ticks.

There's No Lyme Disease Vaccine for Humans, but There's One for Dogs

Dogs can get Lyme disease from a tick bite, too. And although there are some dog vaccines available, it's not clear how protective they are. In a statement updated in March 2018 in the Journal of Veterinary Internal Medicine, authors did not reach a consensus on using Lyme vaccines or booster shots on dogs. As Dr. Krause pointed out, testing is a lot less stringent in animals than in humans.

There used to be a vaccine for people in 1998 called LYMErix, but it was discontinued in 2002—the CDC warns that if you received this vaccine before 2002, it is likely no longer protecting you from Lyme disease.

In March 2021, a vaccine called VLA15, developed by Valneva and Pfizer, entered phase two of human trials, according to the NIH. The CDC reports VLA15 is designed to protect against "North American and European strains of Lyme disease."

You're Most at Risk for a Tick Bite in the Summer

Although ticks don't exactly have an off-season, the summer is peak Lyme disease season in the Northeastern part of the U.S. That's mainly because the "nymphs," or non-adult ticks, are in full swing, according to a 2014 study in the Journal of Autoimmunity. But the deer tick is also active year-round, including the winter, as long as the temperatures are above freezing.

You Can Protect Yourself Against Ticks

Ticks often reside on the foliage that borders meadows. Deer like to graze in the open grassy areas, said Dr. Krause, but also linger in the surrounding wooded outskirts so they can run away if a predator suddenly appears. As for the ticks? They're following the deer.

When you're in tick territory, tuck your jeans into your boots or socks, slap on an insecticide (it can work against ticks), or wear clothing that's been treated with permethrin, an insect repellant. The CDC recommends people use an Environmental Protection Agency (EPA)- registered insect repellant that contains at least 20% DEET. You can treat your clothing with a product like Cutter's Backwoods Insect Repellent Pump or find insect-repellent clothing from manufacturers like LL Bean or Rei.

You Should Do Tick Checks Every 2 to 3 Hours

If you spot a tick fast enough, the worst thing it'll do is creep you out. One of the best ways to spot one is by checking your skin, particularly your scalp, belly button, armpits, ears, the back of your knees, and between your legs. A January 2013 review in the BMJ recommends scanning yourself every two to three hours, even if you're still outdoors. And remember, some of these bugs can be really small, so if you've just finished a hike and notice, say, a new freckle on your arm, it's worth a second glance.

To be thorough, the CDC also recommends checking your clothes for ticks. If you find one, remove and dispose of it; then, tumble dry your clothes on high heat for 10 minutes. You should also shower within two hours of being indoors (it's the perfect place to do an extra tick check).