United States Symptoms: Relapsing fever typically presents as recurring high fevers, flu-like symptoms, headaches, and muscular pain, with less common symptoms including rigors, joint pain, altered mentation, cough, sore throat, painful urination, and rash Treatment: Antibiotics are the treatment for relapsing fever, with doxycycline, tetracycline, or erythromycin being the treatment of choice. Typhus Several diseases caused by Rickettsia bacteria (below) Rocky Mountain spotted fever Organism: Rickettsia rickettsii Vector: Wood tick (Dermacentor variabilis), D. andersoni Region (US): East, Southwest Vector: Amblyomma cajennense Region (Brazil): São Paulo, Rio de Janeiro, Minas Gerais. Symptoms:Fever, headache, altered mental status, myalgia, and rash Treatment: Antibiotic therapy, typically consisting of doxycycline or tetracycline Helvetica spotted fever Organism: Rickettsia helvetica Region(R. helvetica): Confirmed common in ticks in Sweden, Switzerland, France, and Laos Vector/region(s)#1: Ixodes ricinus is the main European vector. Symptoms: Most often small red spots, other symptoms are fever, muscle pain, headache and respiratory problems Treatment: Broad-spectrum antibiotic therapy is needed, phenoxymethylpenicillin likely is sufficient. Human granulocytic anaplasmosis (formerly human granulocytic ehrlichiosis or HGE) Organism: Anaplasma phagocytophilum (formerly Ehrlichia phagocytophilum or Ehrlichia equi) Vector: Lone star tick (Amblyomma americanum), I. scapularis Region (US): South Atlantic, South-central Bartonella: Bartonella transmission rates to humans via tick bite are not well established but Bartonella is common in ticks. For example: 4.76% of 2100 ticks tested in a study in Germany Tularemia Organism: Francisella tularensis, A. americanum Vector: D. variabilis, D. andersoni Region (US): Southeast, South-central, West, widespread Viral Tick-borne meningoencephalitis Organism: TBEV (FSME) virus, a flavivirus from family Flaviviridae Vector: deer tick (Ixodes scapularis), Ixodes ricinus (Europe), Ixodes persulcatus (Russia + Asia)) Endemic to: Europe and northern Asia Powassan virus/deer tick virus Organism: Powassan virus (POWV), a flavivirus from family Flaviviridae. Lineage 2 POWV is also known as deer tick virus (DTV) Vector: Ixodes cookei, Ix. scapularis, Ix. marxi, Ix. spinipalpusm, Dermacentor andersoni, and D. variabilis Endemic to: North America and eastern Russia Colorado tick fever Organism: Colorado tick fever virus (CTF), a coltivirus from the Reoviridae Vector: Dermacentor andersoni Region: US (West) Crimean-Congo hemorrhagic fever Organism: CCHF virus, a nairovirus, from the Bunyaviridae Vector: Hyalomma marginatum, Rhipicephalus bursa Region: Southern part of Asia, Northern Africa, Southern Europe Severe febrile illness Organism: Heartland virus, a phlebovirus, from the Bunyaviridae Vector: Lone star tick (Amblyomma americanum) Region: Missouri and Tennessee, United States Severe febrile illness, headaches, coma in 1/3 patients Organism: tentatively Alongshan virus, jingmenvirus group in the flavivirus family