Clinical & Educational Resources
For Professionals
Technical resources for clinicians, educators, and public health professionals working on tick-borne disease in North Carolina.
Clinician Resources
Clinical Guidance for Healthcare Providers
Critical clinical context for diagnosing and treating tick-borne disease in NC.
Note: This information is for educational purposes only and is not a substitute for clinical judgment, diagnosis, treatment guidance, or current public health recommendations.
Key Clinical Considerations
40% of patients do not recall a tick bite
Absence of a recalled bite should never rule out tick-borne disease in a symptomatic NC patient.
A bull’s-eye rash is not required
The rash may be solid red, oval, or non-visible. Some patients with RMSF and Lyme never develop a rash at all.
Lab tests are unreliable in the acute phase
Serology for Lyme disease is particularly unreliable early. Clinical diagnosis based on history and signs is essential.
Untreated RMSF can kill up to 20% of patients
Even with prompt treatment, RMSF mortality may be ~5%. Ehrlichiosis may also be fatal. Early empiric treatment is appropriate.
Co-infections change the clinical picture
Babesiosis and bartonella can alter presentation and require concurrent treatment.
STARI — Southern Tick Associated Rash Illness
Transmitted by Lone Star tick. Should be treated as Lyme-like disease until further research clarifies etiology.
NC Tick Species and Disease Associations
Lone Star Tick (Amblyomma americanum) — Ehrlichiosis, STARI, Tularemia, Tick Paralysis; possibly Lyme, Babesiosis
American Dog Tick (Dermacentor variabilis) — Rocky Mountain Spotted Fever, Tick Paralysis, Tularemia
Brown Dog Tick (Rhipicephalus sanguineus) — Ehrlichiosis, Babesiosis; possibly RMSF
Blacklegged / Deer Tick (Ixodes scapularis) — Lyme Disease, Babesiosis, Ehrlichiosis, Bartonella; possibly Powassan Encephalitis
Gulf Coast Tick (Amblyomma maculatum) — Rickettsia parkeri rickettsiosis
Treatment Considerations
- Doxycycline is first-line for RMSF, Ehrlichiosis, and Anaplasmosis
- For Lyme: some clinicians recommend 4–6 weeks vs. standard 2–3, especially when treatment is delayed
- Co-infections (babesiosis, bartonella) must be treated concurrently
- Do not wait for serology before initiating empiric treatment in high-suspicion cases
- STARI: treat as Lyme-like disease
School Resources
For Educators & School Nurses
Downloadable materials, slide shows, and protocols for tick safety education.
Bilingual Tick Safety Handout
English/Spanish two-sided reference card covering NC tick species, proper removal, and symptoms.
NC Tick Foundation Booklet
Comprehensive printed guide covering tick biology, diseases, prevention, and what to do after a bite.
Latest Newsletter
Our most recent newsletter for classroom updates and tick safety awareness.
School Nurse Protocol
TIC-NC helped develop a protocol for school nurses treating students with an attached tick:
- Use fine-tipped tweezers — do not burn, twist, or use petroleum jelly
- Clean the bite area with alcohol and wash hands
- Document the date, body location, and tick type if possible
- Send the tick home in a sealed bag with the student
- Notify parents in writing about symptoms to watch for over 30 days
- Refer to a physician if fever, rash, or fatigue develops within 30 days
Additional Professional Resources
Trusted organizations and data sources for tick-borne disease guidance, surveillance, reporting, and research.
NC & Government Resources
NC DHHS Tick-Borne Disease Information
State public health information about tick-borne diseases in North Carolina.
NC Communicable Disease Manual
North Carolina guidance for disease reporting and public health response.
NC State Vector-Borne Disease Diagnostic Lab
Veterinary and research resources related to vector-borne disease testing.
National & Research Resources
CDC Tick-Borne Disease Resources
National guidance on tick-borne diseases, symptoms, prevention, and data.
CDC Tick Data and Surveillance
Maps, statistics, and disease data from national public health sources.
Search for EPA-registered repellents for ticks and other biting insects.
Professional Collaboration
Questions or Partnership Inquiries?
TIC-NC welcomes outreach from clinicians, educators, researchers, public health professionals, and community partners.
Contact us to ask about resources, education materials, presentations, or collaboration opportunities.
