Wild animals usually avoid people. They might attack, however, if they feel threatened, are sick, or are protecting their young or territory. Attacks by pets are more common. Animal bites rarely are life-threatening, but if they become infected, you can develop serious medical problems.

To prevent animal bites and complications from bites

• Never pet, handle, or feed unknown animals
• Leave snakes alone
• Watch your children closely around animals
• Vaccinate your cats, ferrets, and dogs against rabies
• Spay or neuter your dog to make it less aggressive
• Get a tetanus booster if you have not had one recently
• Wear boots and long pants when you are in areas with venomous snakes

If an animal bites you, clean the wound with soap and water as soon as possible. Get medical attention if necessary.

Dogs give us comfort, companionship, exercise, entertainment, and unconditional love. But it’s important to remember that any dog can bite, even trusted family pets. Not only can dog bites hurt, but they can also become infected and spread diseases. Nearly 1 in 5 people who are bitten by a dog require medical attention.

Learn the signs to watch for

Any dog can bite, especially when scared, nervous, eating, or when playing or protecting toys or puppies. Dogs may also bite when they aren’t feeling well and want to be left alone. Don’t approach a dog that seems angry, scared, or sick.

Responsible pet ownership, including socializing your dog, avoiding rough play, and using a leash in public, can help prevent dog bites.

Children are most at risk

Children are the most common victims of dog bites. Most dog bites affecting young children occur during everyday activities with familiar dogs. Always supervise kids around dogs, even familiar pets. Teaching kids how to interact properly with dogs can help keep them safe.

If an unfamiliar dog approaches you:

• Stay still and be calm.
• Avoid direct eye contact with the dog.
• Do not panic, make loud noises, or run.
• Say “no” or “go home” in a firm, deep voice and stand with the side of your body facing the dog.
• Slowly raise your hands to your neck with your elbows in and wait for the dog to pass or slowly back away.

Animal diseases that people can catch are called zoonoses. Many diseases affecting humans can be traced to animals or animal products. You can get a disease directly from an animal, or indirectly, through the environment.

Farm animals can carry diseases. If you touch them or things they have touched, like fencing or buckets, wash your hands thoroughly. Adults should make sure children who visit farms or petting zoos wash up as well.

Though they may be cute and cuddly, wild animals may carry germs, viruses, and parasites. Deer and deer mice carry ticks that cause Lyme disease. Some wild animals may carry rabies. Enjoy wildlife from a distance.

Pets can also make you sick. Reptiles pose a particular risk. Turtles, snakes and iguanas can transmit Salmonella bacteria to their owners. You can get rabies from an infected dog or toxoplasmosis from handling kitty litter of an infected cat. The chance that your dog or cat will make you sick is small. You can reduce the risk by practicing good hygiene, keeping pet areas clean and keeping your pets' shots up-to-date.

Cat scratch disease (CSD) is an illness caused by the bacterium Bartonella henselae. Almost half of all cats carry the infection at some point. The infection does not make cats sick. However, the scratch or bite of an infected cat can cause symptoms in people, including

• Swollen lymph nodes, especially around the head, neck, and upper limbs
• Fever
• Headache
• Fatigue
• Poor appetite

For people with weak immune systems, CSD may cause more serious problems. The best way to avoid CSD is to avoid rough play with cats that could lead to scratches or bites. If you do get a scratch or bite, wash it well with soap and water. If the bite or scratch gets infected or if you have symptoms of CSD, call your doctor.

Cat scratch disease (CSD) is a bacterial infection that primarily affects the lymph nodes. It is typically caused by the bacteria bartonella (Bartonella henselae). It is usually transmitted by being scratched or bitten by a cat, but rarely, no scratch or bite is involved. Symptoms frequently include the formation of a small bump at the site of the scratch or bite, followed by fever and swollen lymph nodes (lymphadenopathy) within 1-3 weeks. Lymphadenopathy commonly resolves on its own within a few months, but in some cases it may persist for up to 2 years. People with weakened immune systems (and less commonly, people with healthy immune systems) may develop more widespread disease and additional symptoms or neurological complications, which can be severe. In most cases, particularly in children and adolescents, having CSD once means that it cannot occur again. The recurrence of symptoms months after disease onset has been reported in a few adults with CSD.

Treatment in mild or moderate cases typically involves medicines or strategies to improve symptoms, such as using fever reducers, pain relievers, or local heat over the affected lymph node(s). In more severe or systemic cases, management may involve lymph node aspiration and/or antibiotics.

Cat scratch disease (CSD) is a bacterial infection spread by cats. The disease spreads when an infected cat licks a person’s open wound, or bites or scratches a person hard enough to break the surface of the skin. About three to 14 days after the skin is broken, a mild infection can occur at the site of the scratch or bite. The infected area may appear swollen and red with round, raised lesions and can have pus. A person with CSD may also have a fever, headache, poor appetite, and exhaustion. Later, the person’s lymph nodes near the original scratch or bite can become swollen, tender, or painful.

Wash cat bites and scratches well with soap and running water. Do not allow cats to lick your wounds. Contact your doctor if you develop any symptoms of cat scratch disease or infection.

CSD is caused by a bacterium called Bartonella henselae. About 40% of cats carry B. henselae at some time in their lives, although most cats with this infection show NO signs of illness. Kittens younger than 1 year are more likely to have B. henselae infection and to spread the germ to people. Kittens are also more likely to scratch and bite while they play and learn how to attack prey.

How cats and people become infected

Cats can get infected with B. henselae from flea bites and flea dirt (droppings) getting into their wounds. By scratching and biting at the fleas, cats pick up the infected flea dirt under their nails and between their teeth. Cats can also become infected by fighting with other cats that are infected. The germ spreads to people when infected cats bite or scratch a person hard enough to break their skin. The germ can also spread when infected cats lick at wounds or scabs that you may have.

Serious but rare complications

People

Although rare, CSD can cause people to have serious complications. CSD can affect the brain, eyes, heart, or other internal organs. These rare complications, which may require intensive treatment, are more likely to occur in children 5-14 years of age and people with weakened immune systems.

Cats

Most cats with B. henselae infection show NO signs of illness, but on rare occasions this disease can cause inflammation of the heart—making cats very sick with labored breathing. B. henselae infection may also develop in the mouth, urinary system, or eyes. Your veterinarian may find that some of your cat’s other organs may be inflamed.

What is cat scratch disease (CSD)?

Cat scratch disease is a bacterial infection caused by Bartonella henselae bacteria. Most infections usually occur after scratches from domestic or feral cats, especially kittens. CSD occurs wherever cats and fleas are found. The most common symptoms include fever; enlarged, tender lymph nodes that develop 1–3 weeks after exposure; and a scab or pustule at the scratch site. In the United States, most cases occur in the fall and winter and illness is most common in children less than 15 years old.

My cat is completely healthy. How can it carry an infection?

Cats become infected with Bartonella (the bacteria that cause cat scratch disease) through flea bites or, less commonly, fights with other infected cats or feline blood transfusions. While some cats become ill, most simply carry the bacteria in their blood without getting sick. Some studies have found the Bartonella bacteria in the blood of up to 1/3 of healthy cats, particularly kittens.

Should I get my pet treated for Bartonella, just to be safe?

Treatment is not recommended unless your pet becomes sick. Treating Bartonella with antibiotics can take a long time and it’s considered safer and more practical to let the pet handle the infection naturally. For cats that do become sick, the illness usually consists of fever for 2-3 days, with the cat recovering on its own. Symptoms requiring veterinary care include fever, vomiting, lethargy, red eyes, swollen lymph nodes or decreased appetite.

My daughter got scratched by the neighbor’s kitten and now my husband is worried about “cat scratch disease.” How worried should we be?

Most cat scratches do not result in cat scratch disease, and short of cleaning the wound with soap and water, there is no particular action to take. If your child develops a fever; enlarged, tender lymph nodes that develop 1–3 weeks after being scratched; or a pustule at the scratch site, please take her to your health care provider. Treatment with antibiotics is usually not necessary but may help reduce lymph node swelling.

I have a medical condition that affects my immune system. Should I give my cat away?

If you’re HIV-positive, are being treated for cancer, or have any other condition that might disrupt your immune system, you can keep your cat. Just keep the following points in mind:

• Keep the cat indoors.
• Avoid rough play with cats and situations in which scratches are likely. Declawing is not recommended to prevent cat scratch disease.
• Promptly wash any cat scratches or bites with soap and water.
• Avoid contact with fleas.
• Treat the cat with a flea control product recommended by your veterinarian.
• It’s not necessary to test or treat a healthy cat for Bartonella.
• If you are getting a cat, make sure it’s at least a year old, in good health, and free of fleas. Avoid stray cats and cats with flea infestations.

Most insect bites are harmless, though they sometimes cause discomfort. Bee, wasp, and hornet stings and fire ant bites usually hurt. Mosquito and flea bites usually itch. Insects can also spread diseases. In the United States, some mosquitoes spread West Nile virus. Travelers outside the United States may be at risk for malaria and other infections.

To prevent insect bites and their complications

• Don't bother insects
• Use insect repellant
• Wear protective clothing
• Be careful when you eat outside because food attracts insects
• If you know you have severe allergic reactions to insect bites and stings (such as anaphylaxis), carry an emergency epinephrine kit

What is mpox?

Mpox, which used to be called monkeypox, is a rare disease caused by infection with the mpox virus. The mpox virus is in the same family of viruses as the smallpox virus. But mpox is less contagious than smallpox. And its disease causes milder symptoms and is usually not fatal.

In the past, most of the people who got mpox lived in certain parts of central and western Africa, had traveled there, or had been exposed to infected animals imported from there. During the recent outbreak, the disease has been found in people who live in other countries, including the United States.

How does mpox spread?

Mpox spreads in different ways:

• Through close, personal, often skin-to-skin contact with someone who has the virus:
  • Through direct contact with their rash, scabs, or body fluids.
  • By breathing in the virus during prolonged, face-to-face contact.
  • During intimate physical contact such as kissing, cuddling, hugging, massage or sex.
• During pregnancy, from the pregnant person to the baby.
• From touching items (such as clothes, bedding, or towels) that were used by someone who has the virus. The risk of getting mpox this way is low.
• From infected animals:
  • By being scratched or bitten by the animal.
  • By preparing or eating meat or using products from the animal.

Someone who has mpox can spread it from the time their symptoms start until their rash has fully healed, all scabs have fallen off, and a fresh layer of skin has formed. This usually takes 2-4 weeks.

What are the symptoms of mpox?

The symptoms of mpox usually start within 3 weeks from the time you were exposed to the virus. The symptoms may include:

• A rash with sores that can look like pimples or blisters. It could be on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus. It goes through different stages, including scabs, before healing. This can take 2-4 weeks.
• Fever.
• Chills.
• Swollen lymph nodes ("swollen glands").
• Exhaustion.
• Headache.
• Muscle aches and backache.
• Respiratory symptoms, such as a sore throat, nasal congestion, or cough.

You may have all or only a few symptoms:

• You may get a rash first, followed by other symptoms
• You may have flu-like symptoms and then develop a rash 1-4 days later
• You may only get a rash

How is mpox diagnosed?

To find out if you have mpox, your provider:

• Will ask about your symptoms and health history.
• Will look at your rash.
• Will take a sample of tissue from one of the sores so it can be tested for mpox virus.
• May do blood tests to check for mpox virus or for antibodies to the virus. Antibodies are proteins that your immune system makes to fight foreign substances, such as viruses and bacteria.

What are the treatments for mpox?

There are no treatments specifically for mpox, but many people get better on their own.

Since mpox and smallpox are similar, antiviral medicines that protect against smallpox may also help treat mpox. Antiviral medicines may be recommended for people who are more likely to get severely ill, such as patients who have weakened immune systems.

Can mpox be prevented?

There are steps you can take to help prevent mpox:

• Avoid close, skin-to-skin contact with the mpox rash. So, while a person is sick with mpox:
  • Do not touch their rash or scabs.
  • Do not kiss, hug, cuddle, or have sex with them.
  • Do not share eating utensils or cups with them.
• Do not touch the bedding, towels, or clothing of a person who has mpox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially after contact with sick people.
• In Central and West Africa, avoid contact with animals that can spread mpox virus, such as rodents and primates. Also, avoid sick or dead animals, as well as any bedding or other materials they have touched.

If you are sick with mpox it is recommended that you stay home while you are sick, if possible. If you have an active rash or other symptoms, it would be best to stay in a separate room from your family members and pets if you can.

The U.S. government has two vaccines in the U.S. to protect against mpox. One was approved for smallpox and mpox (JYNNEOS), and the other was approved for smallpox (ACAM2000):

• JYNNEOS is the preferred vaccine to protect against mpox. It is a two-dose vaccine.
• ACAM2000 may be an alternative to JYNNEOS. ACAM2000 is a single-dose vaccine. But it has the potential for more side effects and adverse events than JYNNEOS. And it is not recommended for people who are pregnant, are under 12 months old, have severely weakened immune systems, or have certain medical conditions.

The U. S. Centers for Disease Control and Prevention (CDC) recommends vaccination for people who have been exposed to mpox or who are more likely to get mpox.

What is mpox?

Mpox is a rare disease caused by infection with the mpox virus. Mpox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Mpox symptoms are similar to smallpox symptoms, but milder, and mpox is rarely fatal.

When should someone get tested for mpox?

People who think they have mpox or have had close personal contact with someone who has mpox should visit a healthcare provider to help them decide if they need to be tested for mpox. If they decide that you should be tested, they will work with you to collect the specimens and send them to a laboratory for testing.

What are the symptoms of mpox?

Symptoms of monkeypox can include:

• Fever
• Headache
• Muscle aches and backache
• Swollen lymph nodes
• Chills
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
  • The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.

Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

What should I do if I have symptoms?

• See a healthcare provider if you notice a new or unexplained rash or other mpox symptoms.
• Remind the healthcare provider that mpox is present in the United States.
• Avoid close contact (including intimate physical contact) with others until you see a healthcare provider.
• Avoid close contact with pets or other animals until you see a healthcare provider.
• If you’re waiting for test results, follow the same precautions.
• If your test result is positive, stay isolated and observe other prevention practices until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed.
• Remain isolated if you have a fever, sore throat, nasal congestion, or cough. Only go out to see a healthcare provider or for an emergency. Avoid public transportation.
• If you must leave isolation, cover the rash and wear a well-fitting mask.

How does mpox spread?

Mpox can spread from person to person through direct contact with the infectious rash, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex.

A person with mpox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. Some people have been found to have infection but no symptoms. To date, however, there is no evidence that mpox spreads from people with no symptoms. CDC will continue to monitor for new or changing information about transmission.

Is mpox a sexually transmitted infection (STI)?

Mpox can more accurately be described as “sexually transmissible.” In other words, sex is just one of the ways that mpox can be spread. In the past, mpox outbreaks have been linked to direct exposure to infected animals and animal products, with limited person-to-person spread. In the current mpox outbreak, the virus is spreading primarily through close personal contact. This may include contact with infectious lesions or respiratory secretions via close, sustained skin-to-skin contact that occurs during sex. However, any close, sustained skin-to-skin contact with someone who has mpox can spread the virus. The contact does not have to be exclusively intimate or sexual.

Can mpox spread through water in pools, hot tubs, or splash pads?

No studies have found a clear link between mpox and water in pools, hot tubs, or splash pads. The mpox virus is killed in water at the chlorine levels recommended for disinfection in recreational water venues by CDC and required by U.S. jurisdictions.

However, it is possible to spread mpox to others through close, skin-to-skin contact. It can also be spread by sharing objects that a person with mpox used, such as towels, kickboards, pool toys, or clothing.

How can mpox be prevented?

• Avoid close, skin-to-skin contact with people who have a rash that looks like mpox.
• Avoid contact with objects and materials that a person with mpox has used.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

Should people be concerned about going to crowded events?

People can get mpox if they have close, skin-to-skin contact with someone who has mpox. Early indications are that events with activities in which people engage in close, sustained skin-to-skin contact have resulted in cases of mpox. If you plan to attend an event, consider how much close, personal, skin-to-skin contact is likely to occur there.

What treatments are available for mpox?

There are no treatments specifically for mpox virus infections. However, because of genetic similarities in the viruses, antiviral drugs used to treat smallpox may be used to treat mpox infections.

Is there a vaccine to prevent mpox?

Because mpox and smallpox viruses are genetically similar, vaccines developed to protect against smallpox viruses may be used to prevent mpox infections.

The U.S. government has two stockpiled vaccines—JYNNEOS and ACAM2000—that can prevent mpox in people who are exposed to the virus.

Who should get vaccinated?

CDC recommends vaccination for people who have been exposed to mpox and people who may be more likely to get mpox, including:

• People who have been identified by public health officials as a contact of someone with mpox
• People who know one of their sexual partners in the past 2 weeks has been diagnosed with mpox
• People who had multiple sexual partners in the past 2 weeks in an area with known mpox

Where can you find out if you’re eligible for a vaccine?

If you think you may be eligible for vaccination, contact a healthcare provider or your local health department. They can help you determine if you should get vaccinated.

If I am a man and have had multiple male sexual partners recently, does that automatically make me eligible for the vaccine?

No. Having multiple sexual partners is one consideration, but there are others, such as whether you live in an area with ongoing spread of mpox or if one of your partners has recently been infected with mpox. If you think you have mpox or might be at risk for infection, contact a healthcare provider.

Could my pet get mpox?

Mpox is zoonotic, meaning it can spread between animals and people. However, CDC does not currently believe that mpox poses a high risk to pets. We are continuing to monitor the situation closely.

Rabies is a deadly animal disease caused by a virus. It can happen in wild animals, including raccoons, skunks, bats and foxes, or in dogs, cats or farm animals. People get it from the bite of an infected animal.

In people, symptoms of rabies include fever, headache and fatigue, then confusion, hallucinations and paralysis. Once the symptoms begin, the disease is usually fatal. A series of shots can prevent rabies in people exposed to the virus. You need to get them right away. If an animal bites you, wash the wound well; then get medical care.

To help prevent rabies

• Vaccinate your pet. Rabies vaccines are available for dogs, cats and farm animals
• Don't let pets roam
• Don't approach stray animals. Animals with rabies might be aggressive and vicious, or tired and weak

Rabies is a preventable viral disease most often transmitted through the bite of a rabid animal. The rabies virus infects the central nervous system of mammals, ultimately causing disease in the brain and death. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals like bats, raccoons, skunks, and foxes, although any mammal can get rabies.

The Rabies Virus

Rabies virus belongs to the order Mononegavirales, viruses with a nonsegmented, negative-stranded RNA genomes. Within this group, viruses with a distinct “bullet” shape are classified in the Rhabdoviridae family, which includes at least three genera of animal viruses, Lyssavirus, Ephemerovirus, and Vesiculovirus. The genus Lyssavirus includes rabies virus, Lagos bat, Mokola virus, Duvenhage virus, European bat virus 1 & 2 and Australian bat virus.

Structure

Rhabdoviruses are approximately 180 nm long and 75 nm wide. The rabies genome encodes five proteins: nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G) and polymerase (L). All rhabdoviruses have two major structural components: a helical ribonucleoprotein core (RNP) and a surrounding envelope. In the RNP, genomic RNA is tightly encased by the nucleoprotein. Two other viral proteins, the phospoprotein and the large protein (L-protein or polymerase) are associated with the RNP.

The glycoprotein forms approximately 400 trimeric spikes which are tightly arranged on the surface of the virus. The M protein is associated both with the envelope and the RNP and may be the central protein of rhabdovirus assembly. The basic structure and composition of rabies virus is depicted in the longitudinal diagram below.

Rabies is an RNA virus. The genome encodes 5 proteins designated as N, P, M, G, and L. The order and relative size of the genes in the genome are shown in the figure below. The arrangement of these proteins and the RNA genome determine the structure of the rabies virus.

Replication

The fusion of the rabies virus envelope to the host cell membrane (adsorption) initiates the infection process. The interaction of the G protein and specific cell surface receptors may be involved.

After adsorption, the virus penetrates the host cell and enters the cytoplasm. The virions aggregate in the large endosomes (cytoplasmic vesicles). The viral membranes fuse to the endosomal membranes, causing the release of viral RNP into the cytoplasm (uncoating). Because lyssaviruses have a linear single-negative-stranded ribonucleic acid (RNA) genome, messenger RNAs (mRNAs) must be transcribed to permit virus replication.

A viral-encoded polymerase (L gene) transcribes the genomic strand of rabies RNA into leader RNA and five capped and polyadenylated mRNAs, which are translated into proteins. Translation, which involves the synthesis of the N, P, M, G and L proteins, occurs on free ribosomes in the cytoplasm. Although G protein synthesis is initiated on free ribosomes, completion of synthesis and glycosylation (processing of the glycoprotein), occurs in the endoplamsic reticulum (ER) and Golgi apparatus. The intracellular ratio of leader RNA to N protein regulates the switch from transcription to replication. When this switch is activated, replication of the viral genome begins. The first step in viral replication is synthesis of full-length copies (postive strands) of the viral genome. When the switch to replication occurs, RNA transcription becomes “non-stop” and stop codons are ignored. The viral polymerase enters a single site on the 3’ end of the genome, and proceeds to synthesize full-length copies of the genome. These positive strands of rabies RNA serve as templates for synthesis of full-length negative strands of the viral genome.

During the assembly process, the N-P-L complex encapsulates negative-stranded genomic RNA to form the RNP core, and the M protein forms a capsule, or matrix, around the RNP. The RNP-M complex migrates to an area of the plasma membrane containing glycoprotein inserts, and the M-protein initiates coiling. The M-RNP complex binds with the glycoprotein, and the completed virus buds from the plasma membrane. Within the central nervous system (CNS), there is preferential viral budding from plasma membranes. Conversely, virus in the salivary glands buds primarily from the cell membrane into the acinar lumen. Viral budding into the salivary gland and virus-induced aggressive biting-behavior in the host animal maximize chances of viral infection of a new host.

Overview

Rabies is a virus that infects wildlife, especially bats, raccoons, skunks and foxes in the US. It can spread to people and pets when they are bitten or scratched, causing fever, agitation and death. Rabies is 100% preventable with post-exposure prophylaxis (PEP) that includes rabies vaccine and medications to fight infection, as long as people get PEP before symptoms start. Understanding the risk of rabies and knowing what to do after contact with wildlife can save lives.

• The best way to avoid rabies is to stay away from wildlife.
• Contact with infected bats is the leading cause of rabies deaths in people in the US.
• Rabid dogs outside the US are the second leading cause of rabies deaths in Americans, who are exposed during travel abroad.
• Whether in the US or abroad, seeing a healthcare provider quickly after an animal bite or scratch can ensure people get PEP if needed.

Common carriers of rabies by location in the US.

Then & Now: Changes in Rabid Animals Reported

Problem

People may not know about rabies.

• Once the leading cause of human rabies deaths in the US, dogs are no longer as much of a risk, thanks to the use of rabies vaccines. Dogs are only 1% of rabid animals reported each year.
• People might worry about rabies in animals that don’t often carry the virus, like opossums or squirrels. But these animals hardly ever have rabies.
• People may not recognize a scratch or bite from a bat, which can be smaller than the top of a pencil eraser. But these types of contact can still spread rabies!
• It’s not only in the woods – rabid animals can be found in people’s yards and homes too!

The Way Forward

Everyone Can:

• Leave all wildlife alone.
• Wash animal bites or scratches immediately with soap and water.
• If you are bitten, scratched or unsure, talk to a healthcare provider about whether you need PEP.
• Vaccinate your pets to protect them and your family.
• If you find injured wildlife, don’t touch it; contact local authorities for assistance.

Healthcare Providers Can:

• Contact local/state health departments for help with risk assessments and PEP recommendations.
• Ask patients if they had recent animal bites or scratches.

International Travelers Can:

• Get health recommendations for your destination: www.cdc.gov/travel.
• Know if rabies is present in dogs or wildlife where you are going.
• While abroad, avoid contact with all animals.
• Seek medical care ASAP if you are bitten or scratched.

Rabies prevention by the numbers

• About 55,000 Americans get post-exposure prophylaxis (PEP) each year to prevent rabies infection after being bitten or scratched by an infected or suspected infected animal.
• Each year, CDC and its public health partners respond to 175 mass bat exposures (events where more than 10 people are exposed to a potentially rabid bat).

Though many people are afraid of spiders, they rarely bite people unless threatened. Most spider bites are harmless. Occasionally, spider bites can cause allergic reactions. And bites by the venomous black widow and brown recluse spiders can be very dangerous to people.

If you are bitten by a spider, you may see a reaction similar to that of a bee sting, including redness, pain and swelling at the site. To treat a spider bite:

• Wash the area well with soap and water
• Apply an ice pack or a wet compress to the area
• Take over-the-counter pain medicine, if needed
• Consider using antihistamines for severe swelling
• Seek medical treatment for small children and adults with severe symptoms

If you spend time outdoors or have pets that go outdoors, you need to beware of ticks. Ticks are small bloodsucking parasites. Many species transmit diseases to animals and people. Some of the diseases you can get from a tick bite are Lyme disease, ehrlichiosis, Rocky Mountain spotted fever and tularemia.

Some ticks are so small that they can be difficult to see. Ticks may get on you if you walk through areas where they live, such as tall grass, leaf litter or shrubs.

Tick-borne diseases occur worldwide, including in your own backyard. To help protect yourself and your family, you should

• Use a chemical repellent with DEET, permethrin or picaridin
• Wear light-colored protective clothing
• Tuck pant legs into socks
• Avoid tick-infested areas
• Check yourself, your children and your pets daily for ticks and carefully remove any ticks you find

As people spend more time outdoors, so do many insects and pests. Among them are ticks, which are small bloodsucking parasites and arthropods.

Some diseases you can get from a tick bite are Lyme disease, ehrlichiosis, Rocky Mountain spotted fever, and tularemia.

One of the biggest things to keep in mind when thinking about the risk of tick bites is your location. Different regions in the U.S. are home to various types of ticks. The type or species of a tick determines what diseases it may carry.

NIH MedlinePlus magazine spoke with two officials at the National Institute of Allergy and Infectious Diseases (NIAID) to find out more about tick bites, how to avoid them, and new research that could increase our understanding of how to treat tick-related conditions.

Types of ticks

The deer tick (Ixodes scapulars) is found mainly in the Eastern and upper Midwestern regions of the U.S. It can cause conditions like Lyme disease and babesiosis.

The dog tick (Dermacentor variabilis) is found in the Eastern half of the U.S. and can cause diseases such as Rocky Mountain spotted fever and tularemia. There have been reports of dog ticks as far west as California.

The lone star tick (Ambylomma americanum) lives in the Northeast and Midwest regions of the U.S. It carries diseases such as ehrlichiosis and Southern tick associated rash illness.

Location, location, location

"The east coast here in the U.S., parts of the south and Midwest, and even in California you have the major [tick-borne] disease, which is Lyme disease," said José Ribeiro, M.D., Ph.D., chief of the Vector Biology Section of the Laboratory of Malaria and Vector Research in NIAID's Division of Intramural Research. "People should be aware of ticks and where they can encounter them. In other parts of the country you have other diseases, like Rocky Mountain Spotted Fever in the Rocky Mountains, and so on."

Online maps that show tick activity in different regions of the country can be helpful in understanding the risk in your region.

Prevention is a top priority

Maliha Ilias, Ph.D., Lyme Disease Research Program Officer in NIAID's Division of Microbiology and Infectious Diseases, said it is important to prevent ticks from coming into contact with your skin.

Dr. Ilias discussed that there are ways to prevent exposure to ticks. She noted that the best way to do this is wear clothing that covers your arms and legs; tuck your pants into your socks or even put tape around openings in clothing so ticks have no access; and wear light-colored clothing to also help you see if a tick is on you. When you are in the woods, keep to the center of the trail, where ticks are less likely to be (ticks tend to stay in shrubs and bushes).

As soon as you are home, check yourself or have a family member help check you for ticks. Use a fine-tooth comb through your hair and check folds of the skin. You should also shower and wash your clothes at a high heat so any ticks on you are killed.

Stay calm

If you do find a tick on yourself or a family member, be sure to stay calm.

"I think the most important thing for folks to know is that if they find the tick on themselves, don't panic," Dr. Ilias said, noting that it typically takes 36 hours for the bacteria that causes Lyme diseases to travel from the tick gut to its salivary glands and into the host.

It is also important to remove the tick properly. "There is a lot of folklore about how to take a tick out of your skin. Some people even talk about having a lighted cigarette close by, things like that," Dr. Ribeiro said. "The most important thing is just to use appropriate forceps such as tweezers. Grab the whole tick and pull it out."

Saliva is a tick's best friend

A tick's saliva (or spit) is important in its ability to feed. A combination of compounds in a tick's saliva stops human blood from clotting while the tick feeds.

"What we're seeing now is ticks change the composition of their saliva every few days. So the cocktail that they're showing on Monday will be completely different from the cocktail that will be showing up on Friday," Dr. Ribeiro said.

Researchers at the National Institutes of Health are studying the saliva of arthropods to see if there is a way to create a vaccine that will affect the saliva. A current study is looking at a vaccine that works against the saliva of sand flies, so the parasite cannot establish itself at the site of the initial bite. This sort of vaccine will be harder to develop for ticks, as the tick is constantly changing the composition of its saliva.

Early removal is key

The sooner you remove a tick, the better. It takes time for infections to reach a person's blood stream, especially Lyme disease. A tick needs to remain attached for 36 hours before Lyme disease can be transmitted, so remove any ticks as quickly as you can.

However, you may not always know if you’ve been bitten by a tick, and therefore won’t know to keep an eye out for symptoms of tickborne disease.

Looking forward, Dr. Ilias noted the importance of a sensitive and specific diagnostic test for Lyme disease, particularly to detect it early. She added that Lyme disease can be effectively treated if it is diagnosed early.

Tick bite prevention

Tick-borne diseases occur worldwide, including in your own backyard. To help protect yourself and your family, you should:

• Use a chemical repellent with DEET, permethrin or picaridin.
• Wear light-colored protective clothing.
• Tuck pant legs into socks.
• Avoid tick-infested areas.
• Check yourself, your children, and your pets daily for ticks and carefully remove any ticks.

What do Asian longhorned ticks look like?

What we know about Asian longhorned ticks in the U.S.

• Not normally found in the Western Hemisphere, these ticks were reported for the first time in the United States in 2017.
• Asian longhorned ticks have been found on pets, livestock, wildlife, and people.
• The female ticks can lay eggs and reproduce without mating.

• Thousands of ticks may be found at a time in grass or shrubs or on an animal.
• Researchers are looking for these ticks to find out where they live and if they prefer wooded or more open areas.
• As of February 7, 2020, longhorned ticks have been found in Arkansas, Connecticut, Delaware, Kentucky, Maryland, North Carolina, New Jersey, New York, Pennsylvania, Tennessee, Virginia, and West Virginia.
• Compared with well-known native ticks (such as the blacklegged tick, lone star tick and American dog tick), the Asian longhorned tick appears to be less attracted to human skin.
• In other countries, germs spread via bites from these ticks can make people and animals seriously ill.
  • With ongoing testing of ticks collected in the United States, it is likely that some ticks will be found to contain germs that can be harmful to people. However, we do not yet know if and how often these ticks are able to pass these germs along to people and make them ill. (See sidebar.)
  • One recent experimental study found that this tick is not likely to contribute to the spread of Lyme disease bacteria in the United States.
  • Another laboratory study found that this tick has the ability to carry and spread the bacteria that causes Rocky Mountain spotted fever (Rickettsia rickettsii). The germs that cause Rocky Mountain spotted fever have not yet been found in these ticks in nature.
  • Research is ongoing.
• You can protect yourself from tick bites. CDC-recommended personal protective measures such as the use of EPA-approved insect repellents and 0.5% permethrin-treated clothing are effective against Asian longhorned ticks.

What you should do if you think you have found an Asian longhorned tick

• Remove ticks from people and animals as quickly as possible.
• Save the ticks in rubbing alcohol in a jar or a ziplock bag, then:
  • Contact your health department about steps you can take to prevent tick bites and tickborne diseases.
  • Contact a veterinarian for information about how to protect pets from ticks and tick bites.
  • Contact your state agriculture department or local agricultural extension office about ticks on livestock or for tick identification.

The lifecycle of blacklegged ticks (Ixodes scapularis and Ixodes pacificus) generally lasts two years. During this time, they go through four life stages: egg, six-legged larva, eight-legged nymph, and adult. After the eggs hatch, the ticks must have a blood meal at every stage to survive.

Blacklegged ticks can feed from mammals, birds, reptiles, and amphibians. The ticks need to have a new host at each stage of their life, as shown below:

How ticks find their hosts

Ticks can't fly or jump. Instead, they wait for a host, resting on the tips of grasses and shrubs in a position known as "questing". While questing, ticks hold onto leaves and grass by their lower legs. They hold their upper pair of legs outstretched, waiting to climb onto a passing host. When a host brushes the spot where a tick is waiting, it quickly climbs aboard. It then finds a suitable place to bite its host.

How ticks spread disease

The tick feeding process makes ticks very good at transmitting infection:

• Depending on the tick species and its stage of life, preparing to feed can take from 10 minutes to 2 hours. When the tick finds a feeding spot, it grasps the skin and cuts into the surface. The tick then inserts its feeding tube. Many species also secrete a cement-like substance that keeps them firmly attached during the meal. The feeding tube can have barbs which help keep the tick in place.
• Ticks also can secrete small amounts of saliva with anesthetic properties so that the animal or person can't feel that the tick has attached itself. If the tick is in a sheltered spot, it can go unnoticed.
• A blacklegged tick will attach to its host and suck the blood slowly for several days. If the host animal has certain bloodborne infections, such as the Lyme disease agent, the tick may ingest the pathogen and become infected. If the tick later feeds on a human, that human can become infected.
• After feeding, the blacklegged tick drops off and prepares for the next life stage. At its next feeding, it can then transmit the infection to the new host. Once infected, a tick can transmit infection throughout its life.
• If you remove a tick quickly (within 24 hours) you can greatly reduce your chances of getting Lyme disease. It takes some time for the Lyme disease-causing bacteria to move from the tick to the host. The longer the tick is attached, the greater the risk of acquiring disease from it.

Workers should take these steps if a snake bites them:

• Seek medical attention as soon as possible (dial 911 or call local Emergency Medical Services [EMS]).
  • Antivenom is the treatment for serious snake envenomation. The sooner antivenom can be started, the sooner irreversible damage from venom can be stopped.
  • Driving oneself to the hospital is not advised because people with snakebites can become dizzy or pass out.
• Take a photograph of the snake from a safe distance if possible. Identifying the snake can help with treatment of the snakebite.
• Keep calm.
• Inform your supervisor.
• Apply first aid while waiting for EMS staff to get you to the hospital.
  • Lay or sit down with the bite in a neutral position of comfort.
  • Remove rings and watches before swelling starts.
  • Wash the bite with soap and water.
  • Cover the bite with a clean, dry dressing.
  • Mark the leading edge of tenderness/swelling on the skin and write the time alongside it.

Do NOT do any of the following:

• Do not pick up the snake or try to trap it. NEVER handle a venomous snake, not even a dead one or its decapitated head.
• Do not wait for symptoms to appear if bitten, get medical help right away.
• Do not apply a tourniquet.
• Do not slash the wound with a knife or cut it in any way.
• Do not try to suck out the venom.
• Do not apply ice or immerse the wound in water.
• Do not drink alcohol as a painkiller.
• Do not take pain relievers (such as aspirin, ibuprofen, naproxen).
• Do not apply electric shock or folk therapies.