Tick Bites: Symptoms, Diseases, and Prevention

Ticks are a reality of outdoor life, and while there is no surefire way to avoid being bitten, there are precautions to take to reduce your risk of a chance encounter. Ticks can spread a variety of diseases, making it important to know what they look like, how to prevent bites, how to safely remove them, and what symptoms to watch for after a bite.

What does a tick look like?

Ticks are small arachnids with eight legs. Depending on the species and life stage, they can range in size from a tiny poppy seed to about the size of a pencil eraser. Before feeding, ticks have a flat body. After feeding, they become swollen or engorged with blood.

The most common areas of the body where ticks are found are the head, neck, underarms, and groin. Because ticks can be very small, performing a thorough tick check after spending time outdoors is important.

Tick Bite Symptoms

A tick bite typically starts off as a small pimple-sized lump. It may be mildly itchy or swollen, but it differs from a mosquito bite. It may go away on its own in a few days without any associated illness.

Tick-borne illness may start with a characteristic rash called “erythema migrans.” This rash begins at the bite site and spreads out in a bullseye-like fashion, beginning with a red center around the bite, followed by a white ring, and a subsequent red ring.

• The rash can grow to be 12 inches or more across.
• It may be warm to the touch, but is typically not tender or itchy.
• Other types of rashes may occur depending on the illness.
• Additional symptoms include fever, chills, joint and muscle pain, cough, headache, and diarrhea.

While tick-borne illnesses differ based on the type of tick, a common pattern of symptoms occurs days to weeks after a tick bite that indicates medical attention is needed.

Types of Ticks and the Diseases They May Carry

See the table below for the most common ticks and their associated bacterial or viral illnesses in Missouri.

Tick	Associated Bacterial/Viral Illness
American Dog Tick / Wood Tick	Tularemia, Rocky Mountain Spotted Fever
Lone Star Tick	Alpha-Gal Syndrome, Tularemia, Ehrlichiosis, STARI (Southern Tick-Associated Rash Illness), Heartland Virus
Black-leg Tick / Deer Tick	Lyme disease, Anaplasmosis, Babesosis
Brown Dog Tick	Rocky Mountain Spotted Fever

Tick-borne diseases vary depending on the type of tick involved. Some infections can be treated with antibiotics, while others are caused by viruses and require supportive care. The sooner symptoms are recognized and medical treatment is started, the better the outcome.

Alpha-Gal Syndrome

Alpha-gal syndrome is a tick-borne illness that has been in the spotlight as tick bites have increased.

“Alpha-gal” is a sugar molecule present in many non-human mammals, as well as tick saliva. When a tick bites a person, it may transfer that molecule to a human. Since humans do not naturally have this molecule, the body may see it as a foreign invader and develop an allergy to it. This may result in someone having an allergic reaction when they later eat something with alpha-gal, such as beef, lamb, or dairy products. 

In the United States, the Lone Star tick has the ability to pass along alpha-gal. However, not every bite results in alpha-gal syndrome, and some people may not know they have it. Symptoms may range from mild irritation to severe allergic reactions.

Do ticks jump or fly?

Ticks are typically found on the upper part of the body, which gives the impression that they hang out overhead and fall onto their victim by chance. However, ticks do not jump, fly, or fall from foliage above.

They find their host by “questing.” A questing tick waits in low areas of vegetation, such as brush, stems of grass, and fallen leaves, with its front legs extended, waiting for a suitable host to cross their path.

Once this happens, the tick will travel up the body in search of a place to attach where it takes its blood meal.

How To Prevent Tick Bites

Ticks are active anytime the ground is not frozen. Therefore, preventative measures need to be taken for a large part of the year.

Wearing light-colored clothing makes ticks easier to find and remove before they become attached. Tucking or even taping pant legs into your socks will help prevent a tick bite.

The best preventative measure is the consistent use of an insect repellent while outdoors. Read our helpful infographic on insect repellent tips here.

DEET is the most common ingredient found in repellents. If it sounds familiar, that’s because it is the same ingredient found in many mosquito repellents.

Another repellent that may be used is an essential oil called Oil of Lemon Eucalyptus, which has proven to provide similar or even better protection than DEET.

There is also an insecticide called permethrin that kills ticks on contact. Permethrin-based products should never be applied directly to the skin; they are intended to be applied to clothing. Clothing needs to be sprayed 2–4 hours before use to allow for drying. Once dried, the insecticide binds to the fabric and is intended to last through several washings.

What is the chance of getting a disease?

The longer a tick is attached, the greater the chance of disease transmission.

A tick must be attached for 24 hours or longer to transmit the infectious agent that causes tick-borne illness. The longer a tick is attached, the chance of disease transmission increases. In fact, after four days, when ticks are fully engorged, the transmission rate is close to 100%.

Important: Perform a “tick check” any time you have spent time outdoors. This includes adults, children, and pets.

How To Properly Remove a Tick

Ticks should be removed using a thin-tipped tweezer.

1. 1. Grasp the tick as close to the skin surface as possible.
   2. Pull straight upward with a steady pressure.
   3. The goal is to remove the entire tick, including its head and mouth.
   4. Do not jerk or twist the tick to aid in removal.
   5. Do not grab or squeeze the belly of the tick.
   6. Clean the area with soap and water, disinfect with rubbing alcohol, and apply a thin layer of topical antibiotic ointment.
   7. Mark on your calendar the day the tick was removed.

Other methods for tick removal, such as applying petroleum jelly to smother the tick or using heat and chemicals, are not effective nor recommended.

Once removed, the tick can be flushed down the toilet or saved in a plastic bag or vial for identification purposes. Do not attempt to kill the tick with your fingers or crush it using your teeth. Wearing rubber gloves while handling the tick is preferred, and be sure to wash your hands thoroughly afterward.

When should you seek medical care after a tick bite?

Observe for the common symptoms associated with tick-borne illness over the next two weeks.

Seek medical attention if you develop:

• A spreading rash
• Fever or chills
• Headache
• Joint or muscle pain
• Other flu-like symptoms

If medical attention is needed, let your provider know the date of the tick attachment and the symptoms you are currently experiencing.

Bacterial infections caused by ticks can be treated with antibiotics. The sooner treatment is started, the better the outcome.

Questions about tick bites?

If you have questions about tick bites, call the Poison Help line at 1-800-222-1222. Specially trained nurses and pharmacists are available 24/7/365. The service is free and confidential.