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Tickborne Diseases

A tickborne disease is a disease that is transmitted to a person from the bite of an infected tick. Several tickborne diseases can be found in Alabama. Some of these are under public health surveillance. Alabama's most commonly reported tickborne diseases under surveillance are spotted fever rickettsiosis (including Rocky Mountain spotted fever), Lyme disease, ehrlichiosis, and anaplasmosis.

Alpha-gal Syndrome

Another possible condition of public health concern is the Alpha-gal Syndrome. It is not a reportable condition in Alabama, but a healthcare provider might report it as a case of public health importance (CPHI). Additional resources are provided below.


You can lower your risk of getting a tickborne disease while outdoors by:

  • Avoiding wooded and brushy areas where ticks tend to live
  • Walking in the center of trails
  • Using repellent that contains at least 20% DEET, picaridin, or IR3535 on exposed skin
  • Treating clothes with 0.5% permethrin
  • Finding and removing ticks from your body and clothing within 2 hours of coming indoors

To safely remove a tick attached to your skin:

  • Use tweezers to grasp the tick as close to the skin's surface as possible.
  • Pull upward on the tick with steady, even pressure. Do not twist or jerk the tick.
  • Dispose of a live tick by submerging it in alcohol, placing it in a sealed container, or flushing it down the toilet.
  • Clean the bite area and your hands with soap and water, rubbing alcohol, or an iodine scrub after removing the tick.


Early symptoms of tickborne diseases can be variable but often include fever, muscle aches, headaches, fatigue, and/or rash.1 An expanding, circular rash known as erythema migrans (EM) develops in most people infected with Lyme disease 3 to 30 days after being bitten by a tick.1,2

Irritation and allergic reactions may also occur with tick bites. Although these sometimes look like EM rashes, they have some key differences: they typically appear within 2 days of the tick bite and are often itchy.2,3

Sometimes, tickborne diseases may become severe or even life-threatening if not treated. For example, untreated spotted fever rickettsiosis may lead to encephalitis, shock, seizures, gangrene, and/or acute respiratory or renal failure within a week of becoming sick.4 Untreated Lyme disease may cause arthritis as well as various neurologic and cardiac problems days to months after first becoming ill.2,5


If you think you may have a tickborne disease, see your doctor immediately. He or she will evaluate your symptoms, exposure history, and test results to determine the best treatment course for you. Most tickborne diseases are easily treated with antibiotics, and early treatment can help you avoid serious complications.1

Tickborne Disease Cases* in Alabama by Year

Table: 1988-2022

Maps: 20222021, 2020, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011, 2010, 2009, 2008, 2007

*Include cases reported to Public Health that met CDC’s case definitions. Case counts and maps are based on residence and do not necessarily show where the disease was acquired.

Find a Tick?

If you find a tick on a person or pet while outside, the tick can be sent to the University of South Alabama for tick identification. Find more information on how and where to send the tick at The Great Alabama Tick Survey.


1. CDC: Symptoms of Tickborne Illness

2. CDC: Lyme Disease Signs and Symptoms

3. CDC: Lyme Disease Rashes and Rash Look-alikes

4. CDC: Rocky Mountain Spotted Fever, Information for Healthcare Providers

5. CDC: Tickborne Diseases, Lyme

Additional Resources

Healthcare Provider Resources

To report a patient with a tickborne disease, please complete the Communicable Disease REPORT Card.

For CDC guidance on Lyme disease testing, see the Two-Tier Testing Decision Tree.

CDC: Tickborne Diseases of the United States: A Reference Manual for Healthcare Providers (6.8 MB)

For more in-depth education, see the CDC's Toolkit for Healthcare Providers. The toolkit provides the following helpful elements:

Page last updated: September 5, 2023