Tick Bite 
 
Epidemiology 
 
Clinical Manifestations 
Allergic Reactions 
Anaphylaxis  (see Anaphylaxis )
Epidemiology 
 
Associated Ticks 
Argas Reflexus  (European Pigeon Tick) 
Ixodes Holocyclus  Tick (Australian Paralysis Tick) 
Other Ixodes  Ticks 
 
 
Physiology : likely involves allergenic salivary proteins 
 
 
Allergic Reaction/Anaphylaxis Due to Tick Bite-Induced Sensitization to Alpha-Galactosidase  (see Anaphylaxis )
Physiology : tick bite sensitizes the patient to the carbohydrate, alpha-galactosidase
Alpha-Galactosidase is Found in Cetuximab (Erbitux) (see Cetuximab ) 
Alpha-Galactosidase is Found in Red Meats 
 
 
Clinical 
Alpha-Galactosidase Associated Cetuximab (Erbitux) Allergy (see Cetuximab ): may occur on first exposure and may be severe, resulting in anaphylaxis 
Alpha-Galactosidase Associated Read Meat Allergy: unusual in that it has a delayed onset (occurring 4-6 hrs after meat ingestion) 
 
 
 
 
 
 
Infectious Transmission 
Anaplasmosis (Human Granulocytic Anaplasmosis, HGA)  (see Anaplasmosis )
Organisms 
Anaplasma Phagocytophilum  
 
 
Animal Reservoir : deer, white-footed mouse 
Vectors 
Ixodes Scapularis  Tick (Blacklegged Tick): Connecticut, Maryland, Minnesota, New York, Rhode Island, and Wisconsin 
Ixodes Pacificus  Tick (Western Blacklegged Tick): Western US 
Ixodes Ricinus  Tick: Europe 
 
 
 
 
Babesiosis  (see Babesiosis )
Organisms 
Babesia Microti 
Geography: Northeastern and Upper Midwest US 
Animal Reservoir: white-tailed deer and mice 
Tick Vector: Ixodes Scapularis  (Blacklegged Tick) 
Incubation Period: 5-33 days 
 
 
Babesia Divergens 
Geography: Europe 
Animal Reservoir: cattle 
Tick Vector: Ixodes Ricinus  
 
 
Other Babesia Species  
 
 
 
 
Bourbon Virus Infection  (see Bourbon Virus )
Vector 
Amblyomma Americanum  Tick (Lone Star Tick): eastern Kansas, Missouri 
 
 
 
 
Ehrlichiosis (Human Monocytic Ehrlichiosis, HME)  (see Ehrlichiosis )
Organisms 
Ehrlichia Chafeensis : most common etiology of Ehrlichiosis 
Ehrlichia Ewingii  less common etiology of Ehrlichiosis 
Ehrlichia Muris -Like Species 
 
 
Vector 
Amblyomma Americanum  Tick (Lone Star Tick) 
 
 
 
 
Lyme Disease  (see Lyme Disease )
Epidemiology : Lyme disease is the most common tick-borne illness in the US and Europe 
Organisms 
Borrelia Burgdorferi : US, Europe 
Borrelia Mayonii : Upper Midwest US 
Borrelia Afzelii : Europe, Asia 
Borrelia Garinii : Europe, Asia 
 
 
Vectors 
Ixodes Scapularis  (Blacklegged Tick): in Eastern and North Central North America
Primary Animal Reservoir (in Northeastern US): white-footed mouse 
 
 
Ixodes Pacificus  (Western Blacklegged Tick): in Western North America (Northern California and Oregon) 
Ixodes Persculatus : in Asia 
Ixodes Ricinus : in Europe 
 
 
 
 
Relapsing Fever (Tick-Borne)  (see Relapsing Fever )
Organisms 
Borrelia Hermsii : in Mountainous Western US 
Borrelia Turicatae : in Southwest and South Central US 
Other Borrelia  Species 
 
 
Vectors 
Argasid/Soft-Bodied Ticks : usually Ornithodoros  
 
 
 
 
Rocky Mountain Spotted Fever  (see Rocky Mountain Spotted Fever )
Organism : Rickettsia Ricketsii  (see Rickettsia ) 
Vectors 
Amblyomma Aureolatum  Tick (Yellow Dog Tick): Brazil 
Amblyomma Cajennense  Tick: Central and South America 
Dermacentor Andersoni  Tick (Rocky Mountain Wood Tick): US Mountain States West of the Mississippi 
Dermacentor Variabilis  Tick (American Dog Tick): Eastern US, South Central US, Southern Canada 
Rhipicephalus Sanguineus  Tick (Brown Dog Tick): Central America, Mexico, Southwestern US 
 
 
 
 
Tick-Borne Encephalitis Virus  (see Tick-Borne Encephalitis Virus )
 
Tularemia  (see Tularemia )
Epidemiology : most common in Central and Western US 
Organisms 
Francisella Hispaniensis  
Francisella Philomiragia  
Francisella Tularensis  
Other Francisella Species  
 
 
Vector 
 
 
 
 
 
 
Diagnosis 
 
Clinical 
Rash and tick bite history are often absent 
 
 
Treatment 
Lyme Disease: Tetracycline, Ceftriaxone 
Babesiosis: Clinda + Quinine (for life-threatening illness), Atovaquone+Azithro (for non-life threatening illness 
Ehrlichiosis: Tetracycline 
Tularemia: Gentamicin 
Rocky Mountain Spotted Fever: Tetracycline, Chloramphenicol 
 
 
References 
Tick-Borne Pulmonary Disease; Chest, 1999: 116: 222-230 
The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose.  J Allergy Clin Immunol. 2011;127(5):1286. Epub 2011 Mar 31 [MEDLINE ] 
Human babesiosis.  N Engl J Med.  2012;366:2397–2407 [MEDLINE ] 
The alpha-gal story: lessons learned from connecting the dots.  J Allergy Clin Immunol. 2015;135(3):58 [MEDLINE ] 
Diagnosis, treatment and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis.  JAMA.  2016;315:1767–1777 [MEDLINE ] 
CDC Tickborne Diseases of the United States (Accessed 7/17) [LINK ] 
 
 
Property of Kenneth J. Serio, MD.    Author is not responsible for errors in content, site is for information purposes only.