Emergency department visits for tick bites were up more than 25% in April 2026 compared to the same month last year, according to CDC data. Weekly ED visit rates hit 118 per 100,000 by late June, the highest for that time of year since 2017. Tick season is here, and every summer of the past decade has been slightly worse than the last, driven by longer warm seasons, expanded tick ranges, and higher deer populations feeding the cycle.
Here’s what’s rising, why it matters, and what to actually do about it.
The Big Picture in Numbers
Lyme disease is the most common tick-borne illness in the United States. About 476,000 Americans are diagnosed and treated for Lyme each year, though only about 89,000 cases were reported to the CDC in 2023 (the most recent year with published totals). The gap between those numbers reflects widespread underreporting, especially in endemic areas.
Alpha-gal syndrome, a delayed red-meat allergy triggered by lone star tick bites, now affects an estimated 450,000 to 500,000 Americans. It’s rising fast enough that the CDC and HHS announced a coordinated response plan in May 29, 2026.
Powassan virus is rare (roughly 60 cases a year nationally), but the number matters less than the severity: about half of documented cases result in evidence of long-term neurological problems, and the mortality rate is around 10%. Powassan is also worth knowing about because, unlike Lyme, transmission can happen within 15 minutes of tick attachment.
What Ticks Carry What
Different tick species carry different diseases, which is one reason saving the tick after removal matters.
The blacklegged tick (deer tick), found across the eastern US and Upper Midwest, carries the bacteria that cause Lyme disease, plus anaplasmosis, babesiosis, hard tick relapsing fever, and Powassan virus.
The lone star tick, common across the Southeast and increasingly moving north, carries ehrlichiosis, Heartland virus, Bourbon virus, and tularemia. It’s also the primary trigger for alpha-gal syndrome.
The American dog tick, common in most of the eastern US, transmits Rocky Mountain spotted fever and tularemia. About 60% of Rocky Mountain spotted fever cases occur in five states: North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri.
The Western blacklegged tick carries a similar profile to its eastern cousin (Lyme, anaplasmosis) and is the main tick to worry about on the West Coast.
The Diseases Worth Knowing
Lyme disease starts with a bullseye rash in about 70 to 80% of cases, often expanding to five centimeters or more. Fever, fatigue, joint and muscle aches often come with it. Left untreated, Lyme can progress to arthritis, heart problems, and neurologic issues, including facial palsy, brain fog, and nerve pain. Treatment with doxycycline is highly effective in the early stages.
Anaplasmosis and ehrlichiosis are bacterial infections that cause fever, headache, muscle aches, and fatigue within a week or two of the bite. Both are treatable with doxycycline. Both can become severe if untreated.
Babesiosis is a parasitic infection of red blood cells, causing fever, fatigue, and sometimes hemolytic anemia. More severe in older adults and immunocompromised patients. Treatment is a combination of antimalarial and antibiotic medications.
Rocky Mountain spotted fever starts as fever, headache, and rash. The rash often appears on wrists, ankles, and palms before spreading. RMSF can become life-threatening within days if untreated, so early diagnosis and doxycycline treatment matter.
Powassan virus disease is rare but serious. Most infected people don’t develop symptoms, but those who do can develop meningitis or encephalitis within 1 to 4 weeks of the bite. No specific treatment exists beyond supportive care.
Alpha-gal syndrome is different from the others. It’s not an infection. It’s an immune response triggered by lone star tick saliva that causes the body to react to alpha-gal, a sugar found in red meat and some dairy products. Reactions typically show up 2 to 6 hours after eating red meat, and can range from hives and stomach cramps to anaphylaxis in severe cases.
Heartland and Bourbon viruses are newer to the list. Both are transmitted by lone star ticks in the central and southeastern US. Both can cause serious illness. No specific treatments exist yet.
What to Watch For After a Bite
Most tick bites result in nothing more than a small red bump. The signs that something more is going on typically show up in the 3-to-30-day window after the bite: an expanding rash (especially a bullseye), fever, chills, headache, unusual fatigue, muscle and joint aches, or a spotted rash on wrists and ankles.
For alpha-gal, symptoms won’t show up as a reaction to the bite itself. They’ll show up hours after your next red-meat meal, sometimes weeks or months later.
For Powassan, the accelerated transmission window (as short as 15 minutes) means the usual “36 hours to worry about disease” rule doesn’t apply. Anyone with fever, severe headache, or neurological symptoms after a known blacklegged tick bite in a Powassan-endemic area should be seen promptly.
For our full walkthrough of what to do right after a tick bite, see our companion piece on the first 10 minutes.
What actually Prevents Bites
Prevention still works better than treatment. EPA-registered insect repellents (DEET, picaridin, or oil of lemon eucalyptus) on skin. Permethrin-treated clothing, which repels and kills ticks and stays effective through multiple washes. Long sleeves and long pants tucked into socks when in high-risk areas. Full-body tick checks within a few hours of coming inside, paying attention to the protected spots ticks favor: behind knees, in armpits, at the waistband, in the groin, behind the ears, and in the hairline.
Showering within two hours of being outdoors reduces the odds of a tick becoming attached.
Where ChatRx Fits
ChatRx treats tick bite prophylaxis as part of our 39 acute conditions. If you’ve removed a tick within the past 72 hours and meet the criteria for preventive antibiotics, our doctors in Indiana, Illinois, and Michigan can review and prescribe. Chat-based, $25 flat.
For any suspected tick-borne illness (Lyme, RMSF, anaplasmosis, and others) where symptoms have already started, in-person care is the right move. Those need lab work and longer treatment courses than a virtual visit can handle. For alpha-gal syndrome, an allergist is typically the right specialist. Our doctors will steer you where you need to go.
The free symptom checker can also help you sort whether what you’re feeling needs urgent attention. No account required.
Quick Take
Tick season 2026 is bigger than usual. Lyme disease continues to expand its range. Alpha-gal syndrome is rising fast, driven by the lone star tick moving north. Powassan is rare but severe, and can transmit within minutes. Most tick bites still result in nothing serious, but knowing what to watch for and when to act shortens the treatment path considerably. Prevention still beats treatment. The good news is that a Lyme disease vaccine finished Phase 3 trials this year, so the tools available for prevention may improve in the near future.
Frequently Asked Questions
No. Ticks need to be attached and feeding for disease transmission to occur (with Powassan being the fastest, at around 15 minutes). A tick that brushed off or was removed before attaching hasn’t had the chance to transmit anything.
Can you develop alpha-gal syndrome from a tick bite that happened years ago?
Sensitization can happen at any point, including from a bite long in the past, but repeat tick bites are what typically maintain or worsen the allergic reaction over time.
Disclaimer
This information is provided for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment through ChatRx. If you have questions about a medical condition, talk with a qualified healthcare provider. Services like ChatRx can help connect you with licensed physicians.
