What to Do If You Think You Have a Tick-Borne Illness
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It’s no longer the height of summer tick season, but the pests can continue to bite in the fall.
And when the symptoms of a tick-borne illness such as Lyme disease develop, they can be vague, often including headache, fever, muscle aches, joint aches, and sweats, says Paul Auwaerter, MBA, M.D., a past president of the Infectious Diseases Society of America. “It seems like the flu,” he says. Plus, these nonspecific symptoms can take as long as a month to show up after a bite from an infected tick, according to the Centers for Disease Control and Prevention.
If you’re concerned you might have a tick-borne disease, what happens next? Here we’ll answer a few key questions you may have about the process of getting a diagnosis and treatment.
Can You Tell If You Have a Tick-Borne Illness?
While there’s no definitive way you can self-diagnose, if you know you’ve recently been bitten by a tick—you pulled one off of you that was attached or you noticed the target-shaped rash that shows up in 70 to 80 percent of Lyme cases—that can be a clue that any flulike symptoms you’re experiencing may be connected to a tick-borne infection.
Don’t remember a bite? You still can’t rule out the possibility that you were bitten. In a study published earlier this year in the journal Ticks and Tick-borne Diseases, only about 1 in 5 children who’d had Lyme disease in the past year remembered being bitten by a tick.
Also, don’t assume you don’t have a tick disease just because you don’t see a rash. A significant number of people infected with Lyme never develop the signature rash, and in other tick-borne diseases, such as ehrlichiosis, a rash isn’t common. In Rocky Mountain spotted fever, a rash (usually made of small dots) often doesn’t appear until after several days, when the disease becomes harder to cure.
If you experience symptoms such as fever, chills, aches, and pains, think back to your recent activity. You can pick up a tick when you’re walking your dog, hiking, camping, gardening, hunting, and more, especially if you live in or have recently traveled to an area where ticks are common. (See where various species reside.)
Should You See a Doctor?
If you have symptoms that could indicate a tick-borne illness, make an appointment with your provider and be sure to tell them about any potential recent exposure to ticks.
“What I say to my trainees and to my fellow clinicians is, if you have someone that could be exposed to ticks during the spring, summer, or fall, and you have fever, and you do not have a good explanation otherwise, you should consider them as eligible for treatment for a tick-borne disease,” Auwaerter says.
A doctor can also test you for flu, to rule out one potential alternate cause of flulike symptoms.
How Does a Doctor Test You?
If your doctor suspects you have a tick-borne illness, you may receive some sort of testing to confirm the diagnosis. But don’t be alarmed if your doctor decides to start treatment without waiting for the results of the tests.
In Lyme disease, for example, that’s because early in the course of illness, Lyme bacteria are only briefly present in your blood. And even at that early stage, they’re present only at low levels, says Alison Hinckley, Ph.D., with the CDC’s Division of Vector-Borne Diseases.
Instead, scientists must look for indirect evidence of Lyme disease, by testing for antibodies that the body produces to fight Lyme bacteria. But these antibodies can take several weeks to develop; only then will the test become accurate. If you take an antibody test for Lyme right after you develop a fever, it won’t tell you anything useful—because you won’t have any antibodies yet.
For other tick-borne diseases, testing methods vary. Rocky Mountain spotted fever, for example, is difficult to detect in blood early in the disease, so a negative result doesn't necessarily rule it out. The methods used to confirm the diagnosis take time, and because RMSF can be fatal, it’s critical to start treatment as soon as possible, without waiting for the test results.
According to Auwaerter, for other bacterial tick-borne diseases, such as anaplasmosis and ehrlichiosis (see our guide to tick-borne diseases), some testing methods are available that can be used sooner than the antibody tests used for Lyme and RMSF. Still, he says, it’s often a good idea not to wait for test results before starting treatment, because even though these illnesses may not be as severe as RMSF, they can still be highly dangerous.
If a doctor thinks you may have babesiosis, a tick-borne illness caused by a parasite instead of bacteria, lab tests can find the parasite in your blood.
How Will a Doctor Treat You?
It’s critical to see a doctor early if you think you could have a tick-borne disease. The longer you go without treatment, the more severe your symptoms can get.
With Rocky Mountain spotted fever, for example, delaying treatment can be fatal, or can lead to serious complications including amputation. And late-stage Lyme disease can cause problems such as arthritis, meningitis, nerve pain, and more.
The standard treatment for bacterial tick diseases, including Lyme and RMSF, is the antibiotic doxycycline. It’s highly effective, and so far, doctors haven’t observed tick-borne bacteria becoming resistant to it. You’ll probably take at least a week’s worth of antibiotics. In some cases, such as with Lyme disease, treatment will last up to three weeks.
There’s no need to take antibiotics for much longer than that. After being treated, about 10 to 20 percent of people who contract Lyme disease go on to experience long-term lingering symptoms of the disease. But a number of studies have shown that taking antibiotics for weeks or months for post-treatment Lyme disease syndrome, as this condition is called, isn’t effective and can lead to serious side effects.
Research shows that these lingering symptoms may be more common in people who were not treated quickly after infection. According to one recent study of people with post-treatment Lyme disease syndrome, 59 percent of them were initially misdiagnosed as having something other than Lyme disease, or their diagnosis was delayed.
Still, while early treatment is most effective for Lyme, the good news is that standard antibiotic treatment usually works well even if it’s not initiated right away.
One thing to keep in mind with bacterial tick diseases: Once you’ve had the disease, the antibodies in your blood can remain in your body for years. That means future antibody tests might not be reliable—the test wouldn’t be able to tell you whether any antibodies it detects are from the old infection or a new one. In such cases, doctors must rely on listening to patients’ symptoms and taking their travel and activity history into consideration, just as they would with any case of tick-borne disease, Hinckley says.
With babesiosis, because it is caused by a parasite, a doctor will prescribe a combination of antibiotics and antiparasitic medications.
If you have a tick-borne virus, such as Powassan or Colorado tick fever, there are no direct treatments available, though healthcare providers can give supportive treatments such as IV fluids and medications for pain and fever.
How Can You Avoid a Tick Bite?
Taking preventative measures can go a long way in keeping you safe from tick diseases. Perform a tick check at the end of every day you could have encountered a tick. A good strategy is to take a shower soon after you come in, to wash off any ticks that might be crawling on you, and to give you an opportunity to look for (and remove) any that have attached.
And use an effective insect repellent that’s labeled for use against ticks. Consumer Reports’ testing finds that repellents with 25 to 30 percent deet are highly effective against mosquitoes, and our past testing has shown that repellents that work well against mosquitoes also tend to work well against ticks. Studies show that wearing permethrin-treated clothing can also be helpful in keeping ticks away.
Here are a few of our top-rated insect repellents.
Editor's Note: A previous version of this story stated that RMSF couldn't be detected in blood. This story has been updated to reflect that RMSF is difficult to detect in blood early on in the disease.
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