The dog tick, much larger than the black-legged tick, is also endemic in the Northeast. It carries microbes that cause tularemia and Rocky Mountain spotted fever. The rash associated with Rocky Mountain spotted fever typically starts on the hands and feet; early recognition and treatment with antibiotics is needed to avoid dangerous and sometimes deadly complications. Tularemia is a much rarer but serious disease characterized by fever, enlarged and painful liver and spleen, and often a skin ulcer.
The lone star tick, which until recently was primarily found in the South, has expanded its geographic range and is now also found in the Northeast. The lone star tick is an aggressive hunter, moving about 3 times faster than the black-legged tick. The lone star tick may carry the microbes that cause ehrlichiosis, which manifests most often as a viral -like illness, with fever, chills, severe headaches, nausea, confusion, and muscle pains; unlike a virus, it should be treated with the antibiotic doxycycline. The lone star tick may also carry a substance called alpha-gal that, after a bite, triggers a delayed allergic reaction to red meat (but not to chicken or fish).