By Erin Jester
Summer has arrived in Florida — it’s time for backyard barbecues and strolls in state parks.
But a tiny threat might be lurking in the grass, and its bite can cause big problems.
This tick season is shaping up to be the worst in almost a decade, which means increased risk of tickborne illnesses like Lyme disease, Rocky Mountain spotted fever and alpha-gal syndrome.
“Ticks are notorious vectors of disease,” said Michael von Fricken, Ph.D., M.P.H., associate professor in the University of Florida College of Public Health and Health Professions’ Department of Environmental and Global Health and director of UF’s One Health Center of Excellence. In the United States, ticks are responsible for about 90% of illnesses caused by bloodsucking bugs — far more than those pesky mosquitoes.
So should Floridians be worried?
Yes and no, said von Fricken, who has been studying and surveilling tickborne pathogens at home and abroad since 2015.
Ticks to watch out for
Ticks are active year-round in Florida’s warm subtropical climate, particularly in wooded areas where wildlife are present. Activity peaks between April and August, when adults are searching for hosts. They tend to pick up pathogens from small host animals they feed on during their early life stages, then transmit those pathogens to humans and other animals when the mature ticks go looking for a bigger blood meal.
About 30 tick species call the Sunshine State home, although only a handful pose a threat to humans.
Lone star ticks are the most common human-biting species in Florida, easily recognized by the single dot on females’ backs. They’re the culprit for alpha-gal syndrome, a serious allergic reaction to red meat and dairy triggered when a tick transfers a specific sugar molecule into a human’s bloodstream.
From 2017 to 2022, most reports of alpha-gal syndrome occurred in a continuous band from the eastern plains states to Virginia and North Carolina, per the Centers for Disease Control and Prevention. More recent data showed an explosion of suspected and diagnosed cases in the Northeast and Midwest, owing in part to increased awareness about the condition and the ability to test for it.
“There’s a lot more tick awareness now,” von Fricken said, in part due to the publicity around alpha-gal. “People are more prone to mention it to a doctor, who will then put the pieces together.”
The ticks themselves are on the move, though. As host animals expand out of their usual habitat due to climate, deforestation or other factors, the ticks go with them.
The Florida Department of Health doesn’t track alpha-gal, so it’s hard to pinpoint how many people acquired the allergy in-state as opposed to cases associated with travel. The Florida Lyme Disease Association says most counties in Florida have an estimated infection rate of 11 or fewer cases of alpha-gal syndrome per 1 million people, although north Florida carries a higher risk. The widespread distribution of lone star ticks in Florida makes alpha-gal syndrome a growing concern statewide.
“They’re really adaptable to different environments,” von Fricken said. “And pathogens have evolved to survive in ticks.”
Other than alpha-gal, lone star ticks are responsible for the transmission of the rare but potentially deadly Bourbon and Heartland viruses; ehrlichiosis, a serious bacterial infection; Southern tick-associated rash illness, or STARI, which causes a rash and symptoms similar to Lyme disease; and tularemia, a bacterial infection that can range from mild to life-threatening.
Black-legged ticks, also known as deer ticks, are the primary vector of Lyme disease, the most common tickborne disease in the U.S. Lyme is a bacterial infection that causes flu-like symptoms and a distinctive bull’s-eye rash. Treatment with antibiotics is most effective early in infection, and most patients recover fully in a few weeks. If left untreated, Lyme can cause chronic pain and cognitive issues or even life-threatening heart arrhythmia.
Lyme disease is the most-reported tickborne illness in Florida, although the risk of transmission in the state is incredibly low. Of the 89,468 confirmed cases of Lyme in the U.S. in 2023, the most recent year for which CDC data is available, Florida represented only 271. It remains unknown how many cases of Lyme disease are acquired in other states and diagnosed in Florida and how many are locally acquired.
Brown dog ticks and American dog ticks are vectors of Rocky Mountain spotted fever, a serious, potentially fatal bacterial disease. It’s rare in Florida, with only about a dozen cases reported each year. Gulf coast ticks, more prevalent along the coast, carry a less severe relative of Rocky Mountain spotted fever.
The bottom line
The good news is that while you can get bitten any time of the year, the risk of all tickborne illnesses is significantly lower in Florida than it is in the Northeast and the Midwest.
Rather than seeing a spike in new-to-Florida tickborne diseases this summer, von Fricken said it’s more likely that the state will see an increase in reports of diseases that already exist here, like ehrlichiosis and STARI.
If the thought of disease-carrying creepy crawlies is making you reconsider your outdoor plans this summer, don’t panic. Here are a few tips to help you survive tick season:
- Prevention is the best protection. If you’re going into wooded areas, where ticks tend to congregate, use DEET or picaridin spray to repel ticks and other biting insects. Clothing can be treated with an insecticide called permethrin (but don’t spray permethrin on your skin as it causes irritation). Wear long sleeves, tuck in your shirt and tuck your pants into your socks. “It doesn’t look stylish, but it is effective,” von Fricken said.
- Don’t forget your furry friends. Pets can carry ticks in from outside, increasing disease risk for you and for them. Many tickborne pathogens that affect humans can sicken or kill dogs and cats. Protect your pets by keeping them up to date on flea and tick prevention. Check their fur if they’ve been in known tick territory.
- Check yourself thoroughly. Ticks love warm, moist parts of the body — think armpits, bellybutton and groin. If possible, get someone to check spots you can’t see yourself, like the scalp and behind and inside ears.
- If you find a tick, remove it immediately. The longer a tick feeds, the likelier it is to transmit disease. “If you remove the tick quickly, it’s usually not an issue,” von Fricken said. Use tweezers to grasp the tick by the head, as close as possible to your skin, and pull straight up with steady pressure. Don’t twist or squeeze the tick, which could leave mouthparts embedded in the skin or force infected fluid into your body. Clean the bite area and check yourself thoroughly for other ticks.
- Don’t ignore symptoms. If a rash, redness, itching, warmth or other signs of infection develop around the bite, or if you start to experience unusual symptoms such as fever, fatigue or muscle pain, seek medical attention and tell your provider you’ve recently been bitten.
Overall, your chance of contracting a tickborne disease in Florida is low, but never zero.
“Just be vigilant,” von Fricken said.