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If a tick infected with ehrlichia or anaplasma bites you, the following flu-like signs and symptoms may appear within five to 14 days of the bite:

• Mild fever
• Headache
• Muscle aches
• Nausea
• Vomiting
• Diarrhea
• Cough
• Joint pain
• Confusion
• Rash — rare in adults, but more frequent in children

Some people infected with ehrlichiosis may have symptoms so mild that they never seek medical attention, and the body fights off the illness on its own. But untreated ehrlichiosis with persistent symptoms can result in an illness serious enough for hospitalization. If you experience any of the above symptoms soon after you've been in an area that you know has ticks, see your doctor.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Ehrlichiosis is caused by Ehrlichia chaffeensis bacteria and is transmitted primarily by the Lone Star tick.

Ticks feed on blood, latching onto a host and feeding until they're swollen to many times their normal size. During feeding, ticks that carry disease-producing bacteria can transmit the bacteria to a healthy host. Or they may pick up bacteria themselves if the host is infected.

To get ehrlichiosis, you must be bitten by an infected tick. The bacteria enter your skin through the bite and eventually make their way into your bloodstream. Before bacteria can be transmitted, a tick must be attached and feeding for at least 24 hours. An attached tick that has a swollen appearance may indicate that enough time has elapsed to transmit bacteria. Removing the tick as soon as possible may prevent infection.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Ehrlichiosis is spread by a bite from an infected tick, primarily the Lone Star tick. Tick-borne infections cannot spread directly from person to person. The following factors may increase your risk of getting tick-borne infections:

• Being outdoors in warm weather. Most cases of ehrlichiosis occur from May to July when populations of the Lone Star tick are at their peak and people are outside for activities such as hiking, gardening and camping.
• Living in or visiting an area with a high tick population. You are at greater risk if you are in an area with a high Lone Star tick population. In the United States, Lone Star ticks are most common in southeastern and midwestern states, particularly Arkansas, Florida, Georgia, Missouri, North Carolina, Oklahoma, Tennessee, Texas and Virginia. However, cases of ehrlichiosis have been reported in all states.
• Age. You can get ehrlichiosis at any age, but most cases of infection are in adults.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

It may take 14 days after a tick bite for you to begin showing signs and symptoms of ehrlichiosis. If you get symptoms within two weeks of a tick bite, see your doctor. Be sure to tell your doctor that you recently received a tick bite or visited an area with a high population of ticks.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Tick-borne infections are difficult to diagnose based solely on symptoms because the symptoms are similar to many other common causes of fever or body aches.

A pattern of abnormal blood tests may lead your doctor to a diagnosis. Your doctor may prescribe antibiotics after analyzing your symptoms and may have you undergo a specific diagnostic blood test. If the symptoms don't subside with your doctor's recommendations, see your doctor for a follow-up visit.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Ehrlichiosis can have serious effects on an otherwise healthy adult or child if you don't seek prompt treatment.

People with weakened immune systems are at an even higher risk of more-serious and potentially life-threatening consequences. Serious complications of untreated infection include:

• Kidney failure
• Respiratory failure
• Prolonged fever
• Seizures
• Coma

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

If it's suspected that you have ehrlichiosis, your doctor will likely give you a prescription for an antibiotic such as tetracycline or doxycycline. You'll generally take the antibiotics for seven to 10 days and should see the signs and symptoms subside. Your doctor may have you take antibiotics for a longer period if you're at risk of contracting Lyme disease as well.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

The best way to steer clear of ehrlichiosis is to avoid tick bites.

Most ticks attach themselves to your lower legs and feet as you walk or work in grassy, wooded areas or overgrown fields. After a tick attaches to your body, it usually crawls upward to find a location to burrow into your skin. Common tick bite locations include the back of your knees, groin, underarms, ears and back of your neck.

If you remove a tick in the first 24 hours after attachment, you greatly reduce your risk of infection. While you may not be able to avoid going into areas where ticks are present, the following tips can make it easier to discover and remove ticks before they attach to your skin:

• Wear light-colored clothing. Ticks are dark. Light clothing helps you and others notice ticks on your clothing before they can attach themselves to your skin.
• Avoid open-toed shoes or sandals. Ticks generally live in grassy areas or fields and can attach themselves to your feet and legs when you brush by. Wearing open-toed shoes or sandals increases the risk of a tick attaching to your bare skin and working its way under your clothes, out of sight from detection.
• Apply repellent. Products containing DEET (Off! Deep Woods, Repel) or permethrin (Repel Permanone) often repel ticks. DEET is very effective on your skin, but follow the concentration recommendations on the label and don't apply DEET to your face. A repellent with DEET may not be a good idea for children because they're more likely to get the repellent in their eyes.
• Wear long pants and a long-sleeved shirt. The less skin you expose, the less area a tick has to bite. For added protection, wear shirts, pants and socks with permethrin impregnated in the fabric.
• Tuck your shirt into your pants and your pants into your socks. By doing this, ticks will be less able to crawl onto exposed skin.
• Stay on clear trails whenever possible. Ticks prefer grassy areas and may be less common on well-beaten paths.
• Pull back long hair. Ticks may attach to dangling hair and work their way to your neck or scalp. Pulling back long hair helps you see ticks better on your neck and limits the chance of them attaching in the first place.

• Inspect your body. Do a complete visual inspection of your body. Be sure to check your head and neck because ticks will continue to climb upward until they find a suitable burrowing site. Use your hands to feel through your hair and in areas you can't see when you return from your outing or garden.

  Ticks can be as small as a strawberry seed, and they usually attach to hidden skin. Be sure to check all the possibilities. A shower alone will rarely dislodge attached ticks from your head and body.

• Inspect your clothes. Ticks may have hitched a ride on your clothes. Check your clothes, too. You can spin them in your clothes dryer for 20 minutes to kill any ticks you might have missed.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

If you find a tick on your body, don't be alarmed. If you remove the tick within 24 hours of its attachment, chances of transmission of ehrlichiosis or other tick-borne illnesses are slim. Follow these steps for safe removal of ticks:

• Use tweezers if possible. Use a pair of flat-tipped tweezers or cover your hand with a tissue or glove to remove a tick. A tick's saliva and bodily fluids can carry the same bacteria as their mouths and can enter your body through cuts or mucous membranes in your skin.

• Remove the tick slowly. Grab the tick by its mouthparts where it has attached to your skin. Pull it up and out of your skin steadily and slowly without jerking or twisting it. If you pull too quickly or grab the tick by its body, the tick will likely separate, leaving the mouthparts in your skin. If the tick's mouthparts do break off in your skin, remove them with tweezers.

  Petroleum jelly and hot matches are not effective treatments for removing ticks or tick parts from your skin. These methods may make matters worse by triggering the tick to release more of its bodily fluids that could cause further infection.

• Kill the tick. Once you have successfully removed the tick, kill it by placing it in an alcohol solution. Don't crush the tick in your hands or with your fingernails because the fluids it releases may contain infected bacteria. If you want to save the tick for testing in the event you become ill, put it in a plastic bag or a jar, date the container, and place it in the freezer.
• Clean the bite site. Wash thoroughly with hand antiseptic or soap and water.

• Monitor the bite site. In the following days and weeks, watch the bite site for a rash and pay close attention to any unusual symptoms that develop such as fever, muscle aches or joint pain.

  While ehrlichiosis generally takes seven to 14 days to develop, Lyme disease may take up to 30 days to cause a rash. If you notice anything out of the ordinary, see your doctor. If possible, bring the tick with you to your appointment.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.