Alpha-gal syndrome (AGS) is a serious and potentially life-threatening allergy that can develop after a tick bite. People with AGS may experience allergic reactions after eating mammalian meat, such as beef, pork, lamb, or venison, or after exposure to certain dairy products, gelatin, medications, or other products containing alpha-gal. The CDC estimates 450,000 people in the United States have AGS, which is likely underestimated. 

AGS is common in Virginia and is associated with the Lone Star tick across the state. In a study of lab results from 2017-2022, Bedford County had the second-highest number of AGS in the nation, with over 1500 people. In October 2019, Lynchburg and Richmond made the top 10 locations represented by members in the two primary Facebook AGS support groups with a combined 11,000+ members.  Symptoms vary from gastrointestinal symptoms and hives to anaphylaxis. Learn more about AGS at Alpha-gal Information.

Lyme disease is the most common vector-borne disease in the United States and has been reported in all 50 states in the United States.  The CDC estimates nearly half a million new cases of Lyme each year in the United States and Virginia ranked the tenth for highest number of cases in 2024.  

Early signs and symptoms include fever, joint pain, body aches and pains, and other flu-like symptoms. Potentially, up to 20% of people will continue on to have persistant or chronic lyme. Early treatment is key. When left untreated, Lyme disease can affect the nervous and cardiovascular systems and cause serious long-term health problems. Check out LymeDisease.org or CDC for more information on Lyme disease. 

Spotted fever rickettsioses are bacterial diseases transmitted by ticks. They include Rocky Mountain spotted fever (RMSF), a serious illness caused by Rickettsia rickettsii, and other infections such as Rickettsia parkeri rickettsiosis. In Virginia, the American dog tick is the primary vector associated with RMSF, while the Gulf Coast tick can transmit R. parkeri.

RMSF may begin with fever, severe headache, muscle pain, nausea, vomiting, stomach pain, or loss of appetite. A rash often develops several days after fever begins, but some people never develop a rash or do not develop one early in the illness. RMSF can rapidly become life-threatening if treatment is delayed, especially for children.

RMSF has been described as one of the deadliest tick-borne diseases in the Americas, if left untreated.

Anaplasmosis has been steadily increasing since it first became reportable in 2000.  The black-legged tick, which also transmits Lyme disease, transmits the disease, which has a low fatality rate of less than 1%.  The upper midwestern and northeastern regions of the United States have the highest numbers, and Virginia experiences higher numbers than many states. Early signs and symptoms are fever, chills, severe headache, muscle aches, nausea, vomiting, diarrhea, and loss of appetite.  Learn more about Anaplasmosis from the CDC. 

Babesiosis has been spreading and increasing across the United States and was reported in 40 states in 2019.  Although yet to be considered endemic in Virginia, in 2019, the Food and Drug Administration included Virginia as one of the 15 states recommended to start screening blood donations for babesiosis. Some people will not have symptoms, whereas others will experience flu-like symptoms, including fever, chills, headache, body aches, joint pain, nausea, fatigue, or loss of appetite. Learn more about Babesiosis from the CDC.  

Ehrlichiosis is most frequently reported in the southeastern and south-central regions of the United States, which includes Virginia.  The state also has some of the highest rates of ehrlichiosis in dogs in the United States.  Early signs and symptoms include fever, chills, headaches, gastrointestinal symptoms, confusion or an altered mental status, and in children, sometimes a rash. CDC warns that antibiotics should not be delayed in patients with suggestive clinical presentation. Learn more about Ehrlichiosis from the CDC.