Alpha-gal Syndrome (AGS) is a tick-bite-induced allergy to red or mammalian meat, and people with AGS can be triggered by hundreds of mammalian meat products and byproducts (MMPBs).The American Academy of Allergy Asthma & Immunology (2019) defines Alpha-gal as a "potentially life-threatening allergy to carbohydrate molecule called galactose-alpha-1.3-galactose found in most mammals or red meat."  The CDC estimates 450,000 people in the United States have AGS, which is likely underestimated. 

AGS is common in Virginia and is transmitted by the Lone Star tick. It has also been found in Blacklegged ticks. 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 is now 1.5 times more common than the estimated number of cases of breast cancer. It has been reported in all 50 states in the United States, and Virginia is considered a high-incidence state and ranked the tenth highest in 2024..  According to Tick Check, there could be an estimated 200,000 actual cases of Lyme disease in Virginia since 2000.   The CDC estimates nearly half a million new cases of Lyme each year in the United States. 

Potentially, 20% of Lyme patients end up with long-term health problems or post-treatment Lyme Disease, and as low as 30% have a bulls-eye rash. When left untreated, Lyme disease can affect the nervous and cardiovascular systems and cause serious long-term health problems. Early signs and symptoms include fever, joint pain, body aches and pains, and other flu-like symptoms. Check out Tick Check's interactive map for state and county-level data from 2000-2020 and CDC for more information on Lyme disease. 

Rocky Mountain Spotted Fever (RMSF) cases have been reported throughout the United States, with five states accounting for over 50% of cases.  Virginia is among the states with the highest rates. The American Dog Tick transmits the disease in Virginia and is now reported under Spotted Fever Rickettsiosis (SFR).  

About 5-10% of RMSF cases are fatal, with children under 10 representing the highest number of reported deaths. Early signs and symptoms include fever and headaches, and a rash may develop within a few days after the fever begins. Nausea, vomiting, stomach pain, muscle pain, and lack of appetite may also occur. The CDC describes RMSF as "one of the deadliest tick-borne diseases in the Americas." 

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.