Nymphal black-legged ticks
These are very small (pinhead size), difficult to see, and are active during the late spring and summer months. Roughly 70-80% of human Lyme disease cases occur in the summer months.

Lyme Disease Cases in Connecticut
The majority (about 75%) of Lyme disease cases are associated with activities (play, yard or garden work) around the home and about 21% in activities away from the home. Adult black-legged ticks are active in the fall, warmer days in the winter, and in the spring when outdoor activity and exposure is more limited. They are larger, easier to see, and therefore associated with fewer cases of Lyme disease (even though infection rates may be slightly higher.)

Ticks Activity
Ticks do not jump, fly or drop from trees, but grasp passing hosts from the leaf litter, tips of grass, etc. Most ticks are probably picked up on the lower legs and then crawl up the body seeking a place to feed. Adult ticks will seek deer and other larger animals at the shrub level several feet above the ground, about or above the height of a child.

Children 5-13 years old
Children 5-13 years of age are particularly at risk for tick bites and Lyme disease as playing outdoors has been identified as a high-risk activity. Take notice of the proximity of woodland edge or mixed grassy and brushy areas from public and private recreational areas and playing fields. While ticks are unlikely to be encountered in open fields, children chasing balls off the field or cutting through woods to school may be entering a high-risk tick area.

Pets
Pets can bring ticks into the home, resulting in a tick bite without the person being outdoors. A veterinarian can suggest methods to protect your pets. Engorged black-legged ticks dropping off a pet will not survive or lay eggs in the house as it is too dry.

Lyme Disease and Other Tick-Borne Diseases
Lyme disease is an infection caused by the spirochete bacterium Borrelia burgdorferi, transmitted by the feeding of the blacklegged tick, Ixodes scapularis. Early infection is noted by an expanding red rash in 70-80% of patients within 7-14 days at the site of the tick bite. With or without the rash, non-specific "viral-like" symptoms include fatigue, muscle and joint pain and maybe a fever. Rashes vary in size, shape, and appearance. The rash is often red, but may have central clearing, or a "bull's eye" appearance. As the infection spreads it can cause arthritis, debilitating malaise and fatigue, neurologic or cardiac problems.

• Babesiosis
  Babesiosis is a malaria-like illness that is caused by a protozoan Babesia microti, found in red blood cells. Human infection can range from subclinical to mild flu-like illness, to severe lifethreatening disease in the elderly, the immunesuppressed, and people without spleens. Symptoms include fever, fatigue, chills, sweats, headache, and muscle pain. Co-infection with B. microti and B. burgdorferi can result in overlapping clinical symptoms, more severe Lyme disease, and a longer recovery than either disease alone.
• Anaplasmosis
  The bacterium Anaplasma phagocytophilum invades a type of white blood cell, forming colonies (morulae) that may be observed in a stained peripheral blood smear. Clinical symptoms are non-specific and may include fever, headache, chills, muscle aches, nausea, vomiting, and malaise. Most cases are mild, resolving without treatment within 30 days, but cases may also be moderate or severe in elderly or immunocompromised individuals.
• Hard Tick Relapsing Fever
  Borrelia miyamotoi was first found in the black-legged tick, I. scapularis, in Connecticut in 2001. The first human cases in North America were described in 2013 in patients presenting with a viral-like illness, some of whom also had Lyme disease or babesiosis. Symptomatic cases appear to be highest in people during July and August. Symptoms include fever, chills, fatigue, headache, muscle and joint pain. Fever and other symptoms may occur in cycles separated by periods of feeling better. The prevalence of B. miyamotoi in black-legged ticks appears low (1-5%). Unlike with Lyme disease, this pathogen can be transovarially transmitted (female tick to egg), raising the possibility of transmission by larval ticks feeding on people.
• Powassan Virus
  Powassan (POW) virus is a tick-borne encephalitis virus. Cases of Powassan encephalitis are relatively rare (7-12 cases reported in the US each year). The principal tick vectors are the "woodchuck tick," Ixodes cookei, and the black-legged tick. Approximately 2.0% of adult black-legged ticks carry the virus. While some people may not develop any symptoms, POW can present as meningitis or meningoencephalitis progressing to encephalitis with fever, convulsions, headache, disorientation, lethargy, with partial coma and parlysis in some patients. The disease has a fatality rate of 10% and about half of survivors will develop long-term or permanent neurological and other problems.