Tickborne Infections

Understanding Tickborne Disease

As people build homes or travel in formerly uninhabited wilderness areas where ticks and their animal hosts live, tickborne diseases caused by viruses, bacteria, and parasites, are becoming a more frequent health problem.

Tickborne diseases are becoming a more frequent health problem as people build homes or travel in formerly uninhabited wilderness areas where ticks and their animal hosts live. Ticks can be infected with bacteria, viruses or parasites.

Tickborne Diseases in the United States

  • Lyme disease, ehrlichiosis, and anaplasmosis
  • Rocky Mountain spotted fever (RMSF)
  • Babesiosis
  • Colorado tick fever (CTF)
  • Tularemia
  • Relapsing fever (Borrelia)
  • STARI
  • Deer tick virus (Powassan)
  • Heartland virus
  • Bourbon virus
  • Tick paralysis
Ticks

Tick Season

Tick season runs from April to September, with peak months being May through August.

Disease Transmittal

Tick species vary by geographical area. Only the bites of certain tick species can transmit disease to humans.


Tickborn Testing Information

Test Number Test Name Recommended use and advantages
Antigen
3000010 Relapsing Fever Borrelia Species by PCR Diagnose relapsing fever caused by various Borrelia species during the symptomatic phase of infection
2008670 Tick-Borne Disease Panel by PCR, Blood Preferred panel for diagnosing possible tick-borne disease (i.e., Anaplasmosis, Ehrlichiosis, or Babesiosis) during the acute phase of the disease. 
2007862 Ehrlichia and Anaplasma Species by Real-Time PCR Detects and speciates: Anaplasma phagocytophilum; Ehrlichia chaffeensis; E. ewingii/E. canis; E. muris-like. Rare E. ewingii and E. canis infections cannot be differentiated by this test. 
2008665 Babesia Species by PCR This PCR test detects nucleic acid from B. microti and detects but does not differentiate between B. duncani, B. divergens, strain MO-1, and strain EU-1.
0055570 Borrelia Species by PCR (Lyme Disease) Not a first-line test for Lyme disease. May be useful if strong suspicion of Lyme disease persists in spite of persistent negative serologic testing.
Antibody
0097303 Anaplasma phagocytiphilum (HGA) Antibodies, IgG and IgM Acceptable test for acute or convalescent phase of infection from Anaplasma phagocytophilium.
0097317 Anaplasma phagocytophilum (HGA) Antibody, IgG  
0097318 Anaplasma phagocytiphilum (HGA) Antibody, IgM Most useful to detect antibodies during acute phase of disease; recommend concurrent testing with IgG A. phagocyophilium. PCR testing is preferred. 
0093048 Babesia microti Antibodies, IgG and IgM by IFA Useful if Giemsa stain is negative but high suspicion of babesiosis exists. Will not detect B. duncani or strain MO-1.
0050267 Borrelia burgdorferi Antibodies, Total by ELISA with Reflex to IgG and IgM by Immunoblot (Early Disease) Preferred reflex test to detect Lyme disease in individuals with ≤4 weeks of clinical symptoms or exposure to tick. Positive/equivocal screen confirmed by Immunoblot.
0050254 Borrelia burgdorferi Antibodies, IgG and IgM by Immunoblot Do not order in the absence of a positive/equivocal ELISA screening test. IgM Immunoblot is not useful after the first 4 weeks of clinical symptoms.
0050255 Borrelia burgdorferi Antibody, IgG by Immunoblot Do not order in the absence of a positive/equivocal ELISA screening test. During first 4 weeks of clinical symptoms, order concurrent IgM Immunoblot .
0050253 Borrelia burgdorferi Antibody, IgM by Immunoblot Do not order in the absence of a positive/equivocal ELISA screening test. Useful only when ordered during first 4 weeks of clinical symptoms and concurrently with IgG Immunoblot.
0051044 Borrelia burgdorferi C6 Peptide Antibodies, Total by ELISA First-line serologic screening for suspected Lyme disease. Positive or equivocal results must be confirmed with a Immunoblot.
0051043 Borrelia burgdorferi C6 Peptide Antibodies, Total by ELISA with Reflex to IgG and IgM by Immunoblot Preferred reflex test to detect Lyme disease in individuals with ≤4 weeks of clinical symptoms or exposure to tick. Positive/equivocal screen confirmed by Immunoblot.
0051002 Ehrlichia chaffeensis Antibody, IgG and I gM by IFA Diagnose infection from Ehrlichia chaffeensis. May require acute and convalescent samples to determine presence of disease. 
0051003 Ehrlichia chaffeensis Antibody, IgM by IFA Most useful to detect antibodies during acute phase of disease; recommend concurrent testing with IgG E. chaffeensis. PCR testing is preferred. 
0051004 Ehrlichia chaffeensis Antibody, IgG by IFA Most useful to detect antibodies during convalescent phase of disease. PCR preferred.
2005350 Francisella tularensis Antibodies, IgG and IgM Cross-reactivity with Brucella and Yersinia antibodies may occur. Therefore, results should be interpreted with caution and correlated with clinical information. The best evidence for current infection is a significant change on two appropriately timed specimens, where both tests are performed in the same laboratory at the same time.
2005353 Francisella tularensis Antibody, IgG
2005354 Francisella tularensis Antibody, IgM
0050371 Rickettsia rickettsii (Rocky Mountain Spotted Fever) Antibodies, IgG and IgM by IFA The best evidence for current infection is a significant change on two appropriately-timed specimens, where both tests are done in the same laboratory at the same time. The CDC does not use IgM results for routine diagnostic testing of Rocky Mountain spotted fever as the response may not be specific for the agent (resulting in false positives), and the IgM response may be persistent from past infection.
0050369 Rickettsia rickettsii (Rocky Mountain Spotted Fever) Antibody, IgG The best evidence for current infection is a significant change on two appropriately-timed specimens, where both tests are done in the same laboratory at the same time.
0050372 Rickettsia rickettsii (Rocky Mountain Spotted Fever) Antibody, IgM The CDC does not use IgM results for routine diagnostic testing of Rocky Mountain spotted fever as the response may not be specific for the agent (resulting in false positives), and the IgM response may be persistent from past infection.

Additional Resources

ARUP Consult