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NIOSH Safety and Health Topic:

Tick-Borne Diseases

 
Lone star tick Western blacklegged tick American dog tick
 

Overview

Tick-borne pathogens can be passed to humans by the bite of infected ticks. Ticks can be infected with bacteria, viruses, or parasites. Some of the most common tick-borne diseases in the United States include: Lyme disease, babesiosis, ehrlichiosis, Rocky Mountain Spotted Fever, anaplasmosis, Southern Tick-Associated Rash Illness, Tick-Borne Relapsing Fever, and tularemia. Other tick-borne diseases in the United States include: Colorado tick fever, Powassan encephalitis, and Q fever. Lyme disease is the most commonly reported tick-borne disease in the United States. In 2005, more than 23,000 cases of Lyme disease were reported to the Centers for Disease Control and Prevention (CDC).

Outdoor workers are at risk of exposure to tick-borne diseases if they work at sites with ticks. Worksites with woods, bushes, high grass, or leaf litter are likely to have more ticks. Outdoor workers in most regions of the United States should be extra careful to protect themselves in the spring, summer, and fall when ticks are most active. Ticks may be active all year in some regions with warmer weather.

Frequently Asked Questions


Which workers are at risk of infection?

All outdoor workers should check with their supervisor if they have questions about possible exposure to ticks. Workers at risk of tick-borne diseases include, but are not limited to, those working in the following:

  • Construction
  • Landscaping
  • Forestry
  • Brush clearing
  • Land surveying
  • Farming
  • Railroad work
  • Oil field work
  • Utility line work
  • Park or wildlife management
  • Other outdoor work

What diseases are transmitted by ticks in the United States?

Diseases caused by tick-borne pathogens in the United States include:

  • Lyme disease
  • Babesiosis
  • Ehrlichiosis
  • Rocky Mountain Spotted Fever
  • Southern Tick-Associated Rash Illness
  • Tick-Borne Relapsing Fever
  • Tularemia
  • Anaplasmosis
  • Colorado tick fever
  • Powassan encephalitis
  • Q fever

Where are infected ticks found in the United States?

Tick-Borne Disease

Common US Regions

Lyme disease

Northeast, North Central, Pacific Coast

Babesiosis

Northeast, Midwest, Northwest

Ehrlichiosis

East, Southeast, Central

Rocky Mountain Spotted Fever

Southeast, Atlantic Coast

Southern Tick-Associated Rash Illness

Southeast, Atlantic Coast

Tick-Borne Relapsing Fever

Rocky Mountains, Pacific Coast

Tularemia

All States except Hawaii

Anaplasmosis Northeast, North Central, Pacific Coast
Colorado Tick Fever Northwest, Rocky Mountains
Powassan Encephalitis Northeast
Q fever Throughout the United States

When are workers at risk of infection?

Ticks are usually more active in the months of April through October and peak in the summer months of June through August. The time of year when ticks are active may vary with the geographic region and climate. Outdoor workers should be extra careful to protect themselves in the late spring and summer when immature ticks are most active.

What are the symptoms of infection with a tick-borne disease?

There are many symptoms associated with tick-borne diseases. Infected workers may not have all of these symptoms and many of these symptoms can occur with other diseases as well. Some common symptoms of infection with tick-borne diseases include:

  • Body/muscle aches
  • Fever
  • Headaches
  • Fatigue
  • Joint pain
  • Rash
  • Stiff neck
  • Facial paralysis

What is the diagnosis and treatment for tick-borne diseases?

Tick-borne diseases are diagnosed based on symptoms and the possibility that the worker has been exposed to infected ticks.

Most cases can be successfully treated with specific types of antibiotics, especially if treatment is started early. However, some workers may have symptoms such as arthritis, muscle and joint pain, or fatigue for an extended period of time.

Recommendations for Employers

Employers should protect their workers from tick-borne diseases by taking these steps:

  • Provide training for workers that includes information about the following:
    • How tick-borne diseases are spread
    • The risks of exposure and infection
    • How workers can protect themselves from ticks
    • The importance of the timely reporting of workplace illnesses and injuries
  • Recommend that workers wear light-colored long-sleeved shirts, long pants, socks, and hat when possible.
    • If worker uniforms are provided, provide long-sleeved shirts and long pants as options.
  • Provide workers with repellents (containing 20% to 30% DEET) to use on their skin and clothing for protection against tick bites.
  • Provide workers with repellents (such as Permethrin) to provide greater protection. Permethrin kills ticks on contact. It can be used on clothing but not skin.
  • When possible, have workers avoid working at sites with woods, bushes, tall grass, and leaf litter.
  • When avoiding these sites is not possible, personal protective measures are of particular importance. If work in these higher-risk sites must occur, take the following steps to reduce tick populations:
    • Remove leaf litter.
    • Remove, mow, or cut back tall grass and brush.
    • Discourage deer activity.
image of spraying deet on clothing image of tweezers extracting a tick image of long pants tucked into socks
Images courtesy of CDC Public Health Image Library, CDC Division of Viral and Rickettsial Diseases and the CDC Division of Vector-Borne Infectious Diseases

Recommendations for Workers

Take the following steps to protect yourself from tick bites:

  • Wear a hat and light-colored clothing, including long-sleeved shirts and long pants tucked into boots or socks.
  • Use insect repellents that provide protection for the amount of time you will be outdoors:
    • Follow repellent label directions for use.
    • Use repellents containing 20%-30% DEET on your exposed skin and clothing to prevent tick bites.
    • Reapply repellents as needed.
  • Use repellents such as Permethrin for greater protection.
    • Permethrin kills ticks on contact.
    • Permethrin can be used on clothing but should not be used on skin.
    • One application of permethrin to pants, socks, and shoes typically stays effective through several washings.
  • Check your skin and clothes for ticks every day. The immature forms of these ticks are very small and may be hard to see.
    • Remember to check your hair, underarms, and groin for ticks.
    • Immediately remove ticks from your body using fine-tipped tweezers.
    • Grasp the tick firmly and as close to your skin as possible.
    • Pull the tick's body away from your skin with a steady motion.
    • Clean the area with soap and water.
  • Wash and dry work clothes in a hot dryer to kill any ticks present.
  • Learn the symptoms of tick-borne diseases.
  • If you develop symptoms of a tick-borne disease seek medical attention promptly. Be sure to tell your health care provider that you work outdoors in an area where ticks may be present.

CDC Resources


CDC Tick Card: Protect Yourself from Tick-borne Diseases

Provides short, concise information about tick-borne diseases, ticks, and symptoms.

Stop Ticks
Identifies several tick-borne diseases and suggests methods for protecting yourself from tick bites.

CDC Lyme Disease Home Page
Provides comprehensive information about Lyme disease prevention, transmission, diagnosis, and treatment.

NIOSH Lyme Disease
Provides work-related information about the disease, occupations at risk, and recommendations for employers and workers.

Babesiosis
Provides links to reports and articles about Babesiosis.

Ehrlichiosis
Provides information about the symptoms, questions and answers, treatment, epidemiology, and prevention of ehrlichiosis.

Rocky Mountain Spotted Fever
Provides information about the symptoms, questions and answers, treatment, epidemiology, and prevention of Rocky Mountain Spotted Fever.

Southern Tick-Associated Rash Illness
Provides information about the symptoms, treatment, and prevention of Southern Tick-Associated Rash Illness.

Tick-Borne Relapsing Fever
Provides information about the symptoms, treatments, and prevention of Tick-Borne Relapsing Fever.

Tularemia
Provides key facts about tularemia.
En Español

CDC Insect Repellent Use and Safety
Provides information about safe repellent use.

Other Resources

Occupational Safety and Health Administration (OSHA) Saw Mills eTool:  Tick-borne Illnesses
Provides information about the potential risk of tick-borne illnesses in workers with jobs in heavily wooded or grassy areas. 
External link: http://www.osha.gov/SLTC/etools/sawmills/tick_borne.html

OSHA Logging eTool: Tick-borne Disease
Provides recommendations for safe work practices to prevent and control tick-borne diseases.  Explains how to check for and remove ticks.
External link: http://www.osha.gov/SLTC/etools/logging/mechanical/firstaid/tick_disease.html

National Institute of Allergy and Infectious Diseases: Tick-borne Diseases
Provides an overview of tick-borne diseases.
External link: http://www3.niaid.nih.gov/healthscience/healthtopics/Tickborne/

U.S. Army Center of Health Promotion and Preventive Medicine (USACHPPM): Protect Yourself from Tick-borne Diseases
Provides tips for tick prevention, a chart of the tick life stages, and information about the diseases they may carry.
External link: http://usachppm.apgea.army.mil/Documents/FACT/18-028-0107-Tick-Borne_Diseases.pdf

USACHPPM: Tick Removal
Provides step-by-step instructions with diagrams for proper tick removal.
External link: http://chppm-www.apgea.army.mil/documents/FACT/Tick_Removal-April_2006.pdf

American Lyme Disease Foundation: Other Tick-Borne Diseases
Provides information about tick-borne diseases.
External link: http://www.aldf.com/majorTick.shtml
En Español 

National Pesticide Information Center
Provides information about pesticides and pesticide-related topics.
External link: http://www.aldf.com/majorTick.shtml

State and University Resources

Select State government and university Web sites that provide regional and local information about ticks and tick-borne diseases. 

CALIFORNIA
California Department of Public Health: Tick-borne Diseases
External link: http://www.cdph.ca.gov/HealthInfo/discond/Pages/TickBorneDiseases.aspx

COLORADO
Colorado Department of Public Health and Environment: Tick-borne Diseases
External link: http://www.cdphe.state.co.us/dc/zoonosis/tick/index.html

Colorado State University Extension: Colorado Ticks and Tick-borne Diseases
External link: http://www.ext.colostate.edu/pubs/insect/05593.html

GEORGIA
Georgia Division of Public Health: Tick-borne Diseases
External link: http://health.state.ga.us/epi/vbd/tick.asp

IOWA
Iowa State University Extension: Ticks and Tick-borne Diseases in Iowa
External link: http://www.extension.iastate.edu/Publications/PM2036.pdf

KENTUCKY
Kentucky Department for Public Health: Tick-borne Disease
External link: http://chfs.ky.gov/dph/epi/tickborne.htm

MASSACHUSETTS
Commonwealth of Massachusetts Department of Public Health: Tick-borne Disease Website
External link: http://www.mass.gov/?pageID=eohhs2subtopic&L=7&L0=Home&L1=Provider&L2
=Guidelines+and+Resources&L3=Guidelines+for+Clinical+Treatment&L4=Diseases+%26+Conditions&L5
=Communicable+Diseases&L6=Tickborne+Diseases&sid=Eeohhs2

NEW JERSEY
New Jersey Department of Health and Senior Services: Tick-borne Diseases of New Jersey
External link: http://www.visitmonmouth.com/mosquito/pdfs/tickborn.pdf

NORTH CAROLINA
North Carolina State University Department of Entomology: Ticks and Tick-borne Diseases in North Carolina
External link: http://www.ces.ncsu.edu/depts/ent/notes/Urban/ticks.htm

RHODE ISLAND
University of Rhode Island Tick Encounter Resource Center: Protect Yourself
External link: http://www.tickencounter.org/prevention/protectyourself#userepellents

TEXAS
Texas Parks and Wildlife Department: Ticks and Tick-borne Diseases in Texas
External link: http://www.ticktexas.org/

WASHINGTON
Washington State Department of Health: Ticks and Tick-borne Diseases in Washington
External link: http://www.doh.wa.gov/ehp/ts/Zoo/WATickDiseases.htm

NIOSH Related Publications

Histoplasmosis—Protecting Workers at Risk
DHHS (NIOSH) Publication No. 2005-109 (2004)  
This revised booklet provides updated information about worker exposure to the disease-causing fungus Histoplasma capsulatum. It provides information about histoplasmosis, identifies activities that may put workers at risk, and recommends methods for preventing disease and protecting workers.
En Español

West Nile Virus: Recommendations for Protecting Outdoor Workers from Exposure
DHHS (NIOSH) Publication No. 2005-155 (2005)
This document answers questions relevant to outdoor workers and West Nile virus; it also contains recommendations for preventing the exposure of outdoor workers to West Nile virus.
En Español

Working in Hot Environments
DHHS (NIOSH) Publication No. 86-112 (April 1986, reprinted 1992, with minor changes)
This publication discusses the safety and health consequences of heat stress. From iron workers to pastry bakers, Americans work in a wide variety of hot or hot and humid environments. Being uncomfortable is not the major problem with working in high temperatures and humidities. Workers who are suddenly exposed to work in a hot environment face additional and generally avoidable hazards to their safety and health.
En Español

Related NIOSH Safety and Health Topics

Agriculture Topic Page
Provides links to publications and resources on agricultural topics including ergonomics, grain handling, injuries and deaths, machinery, and young workers.

Avian Influenza Topic Page
Provides information about avian influenza, identifies potential risks for poultry workers, and explains the potential threats associated with the virus.

Heat Stress Topic Page
Provides information about heat-induced occupational illnesses, injuries, and reduced productivity along with methods for reducing risk.

Lyme Disease Topic Page
Provides work-related information about the disease, occupations at risk, and recommendations for employers and workers.

Protective Clothing and Ensembles Topic Page
Provides information about protecting the skin from various health hazards that may be encountered at work or during a terrorist attack.

West Nile Virus Topic Page
Provides information about the West Nile virus, identifies workers at risk, and recommends methods for preventing worker exposure.

Page last updated: October 22, 2008
Page last reviewed: June 24, 2008
Content Source: National Institute for Occupational Safety and Health (NIOSH)

Tick-Borne Diseases

Lone star tick

On This Page...

Overview
 
Frequently Asked Questions
 
Recommendations for Employers
 
Recommendations for Workers
 
CDC Resources
 
Other Resources
 
State and University Resources
 
NIOSH Related Publications
 
Related NIOSH Safety and Health Topics