Do you feel I L L after
exposure to T I C K S or tick habitats?
Ticks are commonly found in shady areas, moist ground litter, tall grass, brush, low tree branches, and along trails in the woods. They can also
be found in backyards that back up to woody areas. If you spend time outside you are at risk of getting bitten by a tick and catching a
tick-borne disease. It is easy to unknowingly be bitten by a tick because bites are usually painless. Not all ticks carry diseases, but see your
doctor at the earliest signs of any of these symptoms of tick-borne disease within one to four weeks after a tick bite or exposure to tick habitats.
Visit the NC Division of Public Health website at http://epi.publichealth.nc.gov/cd/diseases/ticks.html for more information about tick-borne diseases.

Disease

Tick

Symptoms

American dog tick

Onset of symptoms is three to 14 days
(average seven days) after tick bite.
Initial symptoms may include: high fever,
severe headache, muscle aches, nausea,
vomiting and loss of appetite.
Later symptoms: rash (two to six days after
onset of fever), abdominal pain, joint pain
and diarrhea.
Rash usually starts as small,
pink
spots that do not itch on wrists and ankles,
and then spreads.
It can lead to heart, lung or kidney failure,
swelling of the brain, and/or death.
Early treatment with antibiotics is
important.

Rocky
Mountain
spotted
fever
(RMSF)

Lone star tick
Human
monocytic
ehrlichiosis
(HME)

Black-legged tick
Lyme
disease

Onset of symptoms is
to 21 days
after tick bite.
Symptoms usually include fever,
fatigue, headache and muscle aches.
Other symptoms include nausea,
vomiting, diarrhea, cough, joint pain
and confusion.
Rash is often absent and more common
in children.
Severe disease or death occurs rarely.
Early treatment with antibiotics is
important.
Onset of symptoms is three to 30 days
after tick bite.
Early symptoms may include rash, fever,
headache, muscle aches, fatigue and joint
aches. Rash appears in 60 percent of cases.
Some people develop late symptoms,
which vary and may include: secondary
bull’s-eye shaped rashes, joint and muscle
pain with or without swelling, neurological
symptoms and heart problems.
Early treatment with antibiotics is
important to prevent late symptoms,
including those that may be chronic and
disabling.

(STARI)

Female and male
American dog tick.

Photo courtesy of Gary Alpert,
Harvard University, Bugwood.org

Lone star tick male and female

Photo courtesy of
Mat Pound, USDA Agricultural
Research Service, www.insectimages.org

Black-legged ticks male, female,
larvae and nymph with head of a
pin for size comparison.

Photo courtesy of Jim Occi,
www.Bugwood.org

Adult, nymph and larval ticks on
the ear of a deer.

Lone star tick
Southern
tickassociated
rash illness

Males are typically smaller than
the females and often mistaken
for an immature stage.

Symptoms are indistinguishable from
those of early Lyme disease and include
a bull’s-eye shaped rash, sometimes
with fever, headache, muscle pain or
fatigue.
STARI is treated with antibiotics.

Photo courtesy of Mat Pound, USDA
Agricultural Research Service,
www.insectimages.org

If you find an attached tick, remove it promptly. See your physician if you become ill within the next 30 days.
www.cdc.gov/ticks/removing_a_tick.html

N.C. Department of Health and Human Services - Divison of Public Health
www.ncdhhs.gov
www.publichealth.nc.gov
919-733-3419
N.C. DHHS is an equal opportunity employer and provider.
Adapted with permission from the Georgia Division of Public Health
9/12