CO-INFECTIONS:
Other Tick-Borne Illnesses
The Centers for Disease Control and Prevention (CDC) reports that “a single tick can transmit multiple pathogens, including bacteria, viruses, and parasites that can result in patients developing Lyme disease related “co-infections.”
Beyond Just Lyme Disease … PA Ticks Carry Other Infections
Besides Lyme disease, having other tick-borne infections can lead to more severe outcomes and patients can get sicker, and stay sicker longer. Standard Lyme disease tests may not detect these other infections, but there are specialized tests that can detect the organisms. Early diagnosis and treatment are important to avoid future complications. Knowing the type of tick that bit you can help your health care practitioner with making a better diagnosis.
Pennsylvania ticks carry Lyme disease as well as 12 other co-infections. It’s not surprising, then, that people with Lyme disease and other tick-borne diseases experience a wide range of reactions after being bitten by an infected tick.
A Lymedisease.org survey stated the majority of patients with Chronic Lyme disease report at least one coinfection, and 30% report two or more. In Pennsylvania, current research shows that 45% of ticks tested are infected with at least one pathogen, 32% are co-infected with two or more, 9% carry three or more, and 3% of the ticks tested carry four or more infectious agents (stats updated weekly at TickCheck).
As new information is discovered, diagnosing and treating these infections continues to change. That is why patients need to educate themselves and become advocates for effective health care.
The list of co-infections below details rashes and symptoms for tick-borne diseases being detected in Pennsylvania. For Lyme disease specific symptoms, visit our What is Lyme Disease page.
Tick-Borne Infection Symptoms
Initial symptoms of tick-borne infections may occur within a day or a week, and often people think they just have the flu or virus. But some patients may present with only neurological symptoms. “Summer flu” is highly unusual – and healthcare practitioners are informed to consider Lyme and Tick-borne diseases when patients experience a “summer flu-like illness.” The checklist of Lyme & Co-Infection symptoms below is quite extensive or keep scrolling for the most common symptoms of co-infections found in ticks in Pennsylvania.
Alpha-Gal
(red meat allergy)
Lone Star tick
Rash & Symptoms: Runny nose/congestion, diarrhea, nausea, sneezing, hives, asthma, anaphylaxis (allergic reaction/inability to breathe) after consuming red meat (beef, pork, lamb) or products like gelatins/dairy products.
Anaplasmosis,
including Human granulocytic anaplasmosis (HGA)
Blacklegged tick
Rash & Symptoms: Similar to Ehrlichiosis, severe headaches, low blood platelets
Babesiosis
Blacklegged tick
Symptoms: High fevers, anemia, sweats (particularly at night), chills, severe headaches, fatigue, sleep disturbances, air hunger
Bartonellosis
Blacklegged tick**
Rash: Stretch mark-like appearance, run diagonal to the skin planes
Symptoms: Swollen glands, fatigue, headaches, arthritis, general aches and pains, anxiety, seizures, neurological disorders, dementia, eye infections/vision loss, sole pain
**known to carry, but human transmission not yet been proven
Borrelia miyamotoi disease
Blacklegged tick
Rash: Bulls-eye rashes rarely seen
Symptoms: Relapsing symptoms similar to Lyme including: fever, headache, fatigue, joint and muscle pain, loss of appetite, disorientation/memory loss, lack of coordination, severe neurological conditions
Ehrlichiosis
American Dog tick, Blacklegged tick, Lone Star tick & Asian Long Horned tick*
Rash: Smaller than Lyme with raised areas or no rash at all
Symptoms: High fevers, chills, headaches, fatigue, general achiness. Later symptoms: nausea, diarrhea or constipation, loss of appetite, cough, stiff neck, confusion and weight loss
*www.ticklab.org
**recently found to carry this co-infection
Heartland virus
Lone Star tick
Symptoms: flu-like symptoms, which can be severe, including fever, fatigue, decreased appetite, headache, nausea, diarrhea, and muscle or joint pain
Mycoplasmosis
Blacklegged tick**
Rash & Symptoms: Severe fatigue, headache, muscle/joint pain and swelling, nausea, diarrhea, abdominal bloating, bronchitis and sometimes neuropsychiatric issues such as anxiety, insomnia, emotional volatility, memory loss, and lack of concentration
**known to carry, but human transmission not yet been proven
Powassan Virus,
including Deer Tick Virus (DTV)
Blacklegged tick & Groundhog Tick
Rash & Symptoms: Infects the central nervous system, Encephalitis (brain inflammation), Meningitis, fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, seizures
Q Fever
Rash & Symptoms: Relapsing fevers, headaches, chills or sweats, fatigue, muscle aches, nausea, diarrhea, chest pain, stomach pain, weight loss, non-productive cough, Q Fever Endocarditis (Q Fever is no longer considered by the CDC to be tick-borne, www.cdc.gov/qfever/transmission/index.html)
Rocky Mountain Spotted Fever American Dog tick, Brown Dog tick, Lone Star tick* & Rocky Mt Wood tick
Rash: Spreading reddish rash starting around the wrists and ankles and on the palms and soles and other body parts
Symptoms: High fever, headache, achiness (left untreated: permanent neurological problem, can be fatal)
Southern Tick-Associated Rash Illness (STARI)
Lone Star tick
Rash & Symptoms: A rash that resembles the "bull's-eye" rash of Lyme disease, but it's caused by a different tick-borne illness transmitted by the lone star tick. Symptoms include a circular or expanding red rash at the bite site, often with a clearing center, and may be accompanied by fever, headache, fatigue, and muscle or joint pain
Tick-Borne Relapsing Fever
(B. Hermsii, B. Turicatae, B.Parkeri) Soft bodied ticks
Rash & Symptoms: Main symptoms include high fever (e.g., 103° F), headache, muscle and joint aches. Symptoms can reoccur, producing a telltale pattern of fever lasting roughly 3 days, followed by 7 days without fever, followed by another 3 days of fever. Without antibiotic treatment, this process can repeat several times.
Tularemia
American Dog tick
Rash: Skin ulcer at the site of a bite (not frequent)
Symptoms: Swollen lymph nodes near the skin ulcer (most often in the armpit or groin), severe headaches, fever, chills, fatigue, headaches