TICK-BORNE DISEASES

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 2010, more than 22,500 confirmed and 7,500 probable 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

CDC Geographic Distribution of Ticks (includes maps)

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.

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.
  • Pre-treated clothing is available and remains protective for many (up to 70) 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.
  • Shower or bathe as soon as possible after working outdoors to wash off and check for ticks.
  • 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.
  • Removing infected ticks within 24 hours reduces your risk of being infected with the Lyme disease bacterium.
• 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 Tickborne Diseases of the U.S.

CDC Lyme disease communications tool kit

• Fact Sheet for outdoor workers
  
• Fact Sheet for outdoor workers - En Español

CDC Insect Repellent Use and Safety

Other Resources

OSHA Logging eTool: Tick-borne Disease

National Institute of Allergy and Infectious Diseases: Tick-borne Diseases

U.S. Army Public Health Command: Protect Yourself from Tick-borne Diseases

National Pesticide Information Center

NIOSH Related Publications

NIOSH Fast Facts Card: Protecting Yourself from Ticks and Mosquitoes
DHHS (NIOSH) Publication No. 2010-119
En Español

NIOSH Fast Facts Card: Heat Stress
DHHS (NIOSH) Publication No. 2010-114
En Español

NIOSH Fast Facts Card: Sun Exposure
DHHS (NIOSH) Publication No. 2010-116
En Español

NIOSH Fast Facts Card: Stinging Insects
DHHS (NIOSH) Publication No. 2010-117
En Español

NIOSH Fast Facts Card: Poisonous plants
DHHS (NIOSH) Publication No. 2010-118
En Español

NIOSH Fast Facts Card: Cold stress
DHHS (NIOSH) Publication No. 2010-115
En Español

West Nile Virus: Recommendations for Protecting Outdoor Workers from Exposure
DHHS (NIOSH) Publication No. 2005-155 (2005)

Working in Hot Environments
DHHS (NIOSH) Publication No. 86-112 (April 1986, reprinted 1992, with minor changes)
En Español