Tick Bite Symptoms: What to Watch For

You’ve been spending a lot of time outdoors lately, and you find a tick embedded deeply in your skin. From the looks of things, you suspect it’s been there a while. You’ve read that tick bites can transmit diseases between two and 50 hours after attachment, depending on the species, and that most ticks take up to 72 hours to finish their meal. So, you’re probably in the red zone. You remove the tiny repulsive creature with a pair of tweezers and start to worry about tick bite symptoms.

There are 90 species of ticks in the United States, but only 10 transmit diseases to humans. Still, tick-borne diseases occur in every state except Hawaii, and each disease has a distinct range of symptoms. So which tick bite symptoms should you be looking for?

Odds of Experiencing Tick Bite Symptoms

Hang on, though. Just because you’ve been bitten doesn’t mean you’ll get sick. Not all ticks that can carry diseases do. Even for Lyme disease, by far the most common tick borne illness in the U.S., scientists estimate that only 1 to 3 percent of bites end up transmitting the disease, even in areas where Lyme is common. In your case, though, as you think there’s been enough time for transmission, the percentage can rise to as high as 50 percent if you were bitten by a black-legged tick (also known as a deer tick), and if you were bitten in a high-Lyme region. Still, even if your chances are low, you should always be on the lookout for common tick bite symptoms after removing a tick.

The Most Common Tick Bite Symptoms

Bacteria cause most tick-borne diseases in the United States, with Lyme disease representing 82 percent of reported cases. If your tick has transmitted unfriendly bacteria into your bloodstream, you can expect to experience fever and chills. In most cases, you will also feel fatigue and aches and pains and you may have a rash. Even in tick-borne diseases caused by viruses and parasites, you may experience these common symptoms:

• Fever/chills
• Headache
• Fatigue
• Muscle or joint pain   

If you know that the tick you removed was black-legged or deer tick (see this guide for identifying tick species) or if you live in a high-Lyme region, you should be looking for this range of symptoms specifically, which include the ones listed above, plus several others, such as the telltale bulls-eye rash, known as erythema migrans.

Tick Species, Where They Live, and the Diseases They Carry

The symptoms above are the most common, but there are many others you might experience, and, for those, the devil is the details. They depend on the particular tick-borne illness you have contracted, which, in turn, depends on the species of tick that has bitten you, which, in turn, may depend on the geographic location of the tick bite. Here’s a rundown of vector species, their geographic range, and the disease(s) they can transmit:

Tick Bite Symptoms for a Dozen Diseases and Conditions

So, you’ve identified the tick species that has bitten you and which disease or diseases it might carry. Here’s a rundown of the tick bite symptoms that each disease or condition can cause.

Lyme Disease Symptoms

• Fever, chills, bullseye rash (in 70-80 percent of cases), muscle pain, joint pain, headache. If untreated: Additional rashes, facial palsy, severe arthritis and joint swelling, intermittent pain in tendons, muscles, joints and bones, heart palpitations or irregular heartbeat, episodes of dizziness or shortness of breath, inflammation of the brain and spinal cord, nerve pain, shooting pains, numbness or tingling in the hands of feet
• Type: Bacterial
• Prevalance: 82 percent of all tick-borne cases. About 30,000 cases are reported yearly, but the CDC expects the actual number to be 10-12 times higher

Babesiosis Symptoms

• Many people experience no symptoms. Others have  flu-like symptoms, such as fever, chills, sweats, headache, body aches, loss of appetite, nausea, or fatigue. Can cause hemolytic anemia, which can lead to jaundice, dark urine, low and unstable blood pressure, blood clots and bleeding, malfunction of vital organs, or even death
• Type: Parasitic
• Prevalence: About 2,000 cases per year

Ehrlichiosis Symptoms

• Tick bite symptoms for Ehrlichiosis include fever, chills, severe headache, muscle aches, nausea, vomiting, diarrhea, loss of appetite, confusion, rash (more common in children). If untreated: Inflammation of the brain and surrounding tissue, respiratory failure, uncontrolled bleeding, organ failure, death
• Type: Bacterial
• Prevalence: 2,000+ cases per year

Rocky Mountain Spotted Fever and Other Spotted Fevers Symptoms

• Eschar (dark scab at the site of tick bite), fever, headache, and rash. With RMSF, possible nausea, vomiting, stomach pain, muscle pain and lack of appetite. Some patients with severe RMSF may require amputation of arms, legs, fingers, or toes (from damage to blood vessels), hearing loss, paralysis, or mental disability. Untreated, RMSF may result in death
• Type: Bacterial
• Prevalence: 4,000 to 6,000 cases of spotted fevers (including RMSF) reported each year

Anaplasmosis Symptoms

• Fever, chills, severe headache, nausea, vomiting, diarrhea, loss of appetite. If untreated, in rare cases, can cause respiratory failure, bleeding problems, organ failure, or death
• Type: Bacterial
• Prevalence: 6,000+ cases per year

Southern Tick-Associated Rash Illness (STARI) Symptoms

• Fatigue, headache, fever, and muscle pains
• Type: Unknown
• Prevalence: Unknown

Tick-Borne Relapsing Fever Symptoms

• High fever, chills, headache, body and joint pain, and fatigue. One in ten patients develop a rash. Telltale pattern of fever: 3 days on, 7 days off, 3 days on
• Type: Bacterial
• Prevalence: Rare

Tularemia (AKA rabbit fever) Symptoms

• Tick bite symptoms for Tularemia include fever, skin ulcer at site of tick bite, accompanied by swelling of regional lymph glands, usually in armpit or groin
• Type: Bacterial (may be transmitted by a variety of means, including tick bites)
• Prevalence: About 250 cases per year

Colorado Tick Tever Symptoms

• Fever, chills, headache, body aches, and fatigue. About half of patients have a “biphasic” fever (off and on). Some have sore throat, vomiting, abdominal pain, or skin rash. In rare cases, stiff neck and confusion.
• Type: Viral
• Prevalence: Rare: Only 59 cases reported over past decade

Powassan Virus Symptoms

• May not have any symptoms. If symptoms occur, may include fever, headache, vomiting, and weakness. Can cause severe disease, including infection of the brain (encephalitis) or the membranes around the brain and spinal cord (meningitis), which, in turn, can cause confusion, loss of coordination, difficulty speaking, and seizures. Approximately one out of ten people with severe disease die. Approximately half of the people who survive have long-term health problems such as recurring headaches, loss of muscle mass and strength, and memory problems
• Type: Viral
• Prevalence: Very rare, but on the rise

Heartland Virus Symptoms

• Tick bite symptoms for Heartland Virus include fever, fatigue, decreased appetite, headache, nausea, diarrhea, and muscle or joint pain. In some cases: lower than normal counts of white blood cells and lower than normal counts of platelets
• Type: Viral
• Prevalence: Rare (60 total reported as of 2022)

Alpha-gal syndrome (AGS), AKA Red Meat Allergy, Symptoms

• AGS is associated with Lone Star tick bites, but the allergy is not caused by infection; it is caused by eating red meat (pork, beef, rabbit, lamb, venison, etc.), and products made from mammals, like gelatin, cow’s milk, and milk products. Hives or itchy rash, nausea or vomiting, heartburn or indigestion, diarrhea, cough, shortness of breath, or difficulty breathing, drop in blood pressure, swelling of the lips, throat, tongue, or eyelids, dizziness or faintness, severe stomach pain. In some cases, can cause anaphylaxis (a potentially life-threatening reaction involving multiple organ systems) and may require urgent medical care. Symptoms may not occur until 2 to 6 hours after eating meat
• Type: Unknown
• Prevalence: 110,000 cases identified since 2010, but scientists believe this may be a vast undercount. The number is thought to be growing rapidly

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