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Other Tickborne Diseases

Other Tickborne Diseases of Public Health Concern

While there are more common tickborne diseases, there are some other tickborne diseases that are rarely reported in Alabama. Some rare tickborne diseases include Tularemia, Babesiosis, Alpha-gal syndrome, Powassan Virus, and Typhus fevers. These diseases spread to humans through an infected tick and not person to person. Alabama rarely reports cases of Tularemia and Babesiosis. In 2022, Alabama reported only three cases of Tularemia and zero cases of Babesiosis. When it comes to Alpha-gal syndrome, it is not a nationally notifiable condition. This means that it is not reported in Alabama. However, it has become a public health concern because it is a serious allergic condition that can occur after people eat red meat or are exposed to other products containing alpha-gal. Another public health concern is Typhus fevers, which is also a condition that is not reportable in Alabama. Lastly, there are currently no reported cases of the Powassan virus.


Tularemia is a zoonotic disease characterized by an acute febrile illness with various clinical manifestations depending on the route of infection. The bacteria that cause tularemia can be found naturally in rabbits, hares, voles, muskrats, beavers, and ticks. Human infection is by the bite of an infected tick or deer fly, direct contact with an infected animal, inhaling infectious aerosols, or ingestion (i.e., eating undercooked contaminated meat or drinking contaminated water). Tularemia infection is rare in Alabama and occurs more frequently in the western and southern central states.

To learn more information, visit CDC Information on Tularemia.


Babesiosis is a disease caused by a very small (microscopic) parasite that infects red blood cells. Many different species (types) of Babesia parasites have been found in animals, only a few of which have been found in people. Babesia microti—which usually infects white-footed mice and other small mammals—is the main species that have been found in people in the United States. Human infections are by the bite of infected black-legged ticks or deer ticks, receipt of a contaminated blood transfusion, or transmission from an infected mother to her baby during pregnancy or delivery. Many people who are infected with Babesia microti feel fine and do not have any symptoms. Some people develop flu-like symptoms and hemolytic anemia (from the destruction of red blood cells). Babesiosis infection is rare in Alabama and occurs more frequently in the Northeast and upper Midwest states.

To learn more information, visit CDC Information on Babesiosis.

Powassan Virus

Powassan virus is spread to people primarily by infected ticks. Ticks become infected when they feed on groundhogs, squirrels, mice, or other rodents that have the virus in their blood. Most people infected with the Powassan virus do not have symptoms. The initial symptoms can include fever, headache, vomiting, and weakness. Powassan virus can cause severe disease, including infection of the brain (encephalitis) or the membranes around the brain and spinal cord (meningitis). Powassan virus is rare in Alabama and most cases occur in the northeast and Great Lakes regions.

To learn more information, visit CDC Information on Powassan.

Alpha-gal Syndrome

Alpha-gal syndrome (AGS) is a serious, potentially life-threatening allergic condition. Other names for AGS are alpha-gal allergy, red meat allergy, or tick bite meat allergy. AGS is not caused by an infection and symptoms occur after people eat red meat or are exposed to other products containing alpha-gal. Alpha-gal can be found in meat (pork, beef, rabbit, lamb, venison, etc.) and products made from mammals (including gelatin, cow’s milk, and milk products). AGS is associated with tick bites and evidence suggests that AGS is primarily associated with the bite of a lone star tick in the United States, but other kinds of ticks have not been ruled out. More research is needed to understand the role ticks play in starting this condition, and why certain people develop AGS. Alpha-gal syndrome is rare in Alabama but can be life-threatening, so seek immediate emergency care if you are having a severe allergic reaction.

To learn more information, visit CDC Information on Alpha-gal Syndrome.

Typhus Fevers

Typhus fevers are a group of diseases caused by bacteria that are spread to humans by fleas and lice. Typhus fevers include Flea-borne (murine) typhus and epidemic typhus. Fleas spread murine typhus and body lice spread epidemic typhus. There are no reported cases of flea-borne (murine) and epidemic typhus in Alabama. In the United States, flea-borne (murine) typhus is mostly reported in southern California, Hawaii, and southern Texas. Epidemic typhus is mostly reported in several eastern states in the United States.

Flea-borne (murine) typhus is a disease spread to people through contact with infected fleas, most commonly the Oriental rat fleas and the cat flea. The fleas become infected when they bite infected animals, such as rats, cats, or opossums.

Epidemic typhus, which is also called louse-borne typhus, is an uncommon disease that is spread to people through contact with infected body lice. Cases tend to occur in areas where extreme overcrowding is common and body lice can travel from one person to another.

To learn more information, visit CDC Information on Typhus Fevers.

Page last updated: November 30, 2023