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Precision Diagnosis for Tick-Borne Diseases?

Posted on by Dr. Francis Collins

Lone Star tick

Caption: Adult female Lone Star tick
Credit: National Institute of Allergy and Infectious Diseases, NIH

For many of us who enjoy roaming the great outdoors, there are some things to watch out for. Now is the peak season for “tick checks.” An estimated 90 species of these blood-sucking arachnids inhabit the continental United States, and tick-borne diseases have been on the rise over the past three decades. While not all tick bites will make you sick, the critters can transmit at least 19 types of bacteria, viruses, and protozoa known to cause Lyme disease, Rocky Mountain spotted fever, tularemia, and a host of other potentially serious illnesses [1].

If a tick becomes attached to your skin, there’s currently no quick way to determine if you’ve been exposed to a pathogen and, if so, which specific one(s). If you get sick, getting a definitive diagnosis in order to get the right treatment for your tick’s particular pathogen(s) can involve multiple tests at a cost of about $200 each. Wouldn’t it be great if there was one simple, low-cost way to test for all major tickborne diseases? Such a test is now under development by NIH-funded researchers, and it recently passed an encouraging early research milestone.

In a recent paper in Scientific Reports, the researchers describe development of a Tick-Borne Disease (TBD) Serochip that, using a single sample of blood, can simultaneously detect and distinguish among antibodies associated with exposure to eight common tick-borne pathogens [2]. Those pathogens cause: Lyme disease, Rocky Mountain spotted fever, babesiosis, human monocytic ehrlichiosis, human granulocytic anaplasmosis, Borrelia miyamotoi disease, Heartland virus disease, and Powassan virus disease.

The TBD Serochip, according to the researchers, was also able to identify whether a person had been infected by more than one tick-borne pathogen. That capacity is very important in real-world settings because an individual tick often carries more than one type of infectious agent and, in the case of deer ticks, as many as five! The next step for the team, which was co-led by Rafel Tokarz and Nischay Mishra of Columbia University’s Mailman School of Public Health, New York, is to optimize the technology further and conduct additional studies to determine the safety and efficacy of this testing approach in a clinical setting.

In the meantime, NIH’s infectious disease experts recommend that you take the following precautions to help protect yourself and your family from tick-borne diseases: Try to avoid tick-infested areas, such as areas with tall grass, leaf litter, or dense shrubs. If you plan on venturing into such places, wear long pants and tuck the legs into your socks, and spray your skin and/or your clothing with an insect repellent containing DEET, permethrin, or picaridin. And, yes, it certainly can’t hurt to check yourself, your children, and your pets for ticks on a daily basis and carefully remove any ticks that you happen to find.


[1] Tickborne diseases of the United States, Centers for Disease Control and Prevention, May 22, 2017

[2] A multiplex serologic platform for diagnosis of tick-borne diseases. Tokarz R, Mishra N, Tagliafierro T, Sameroff S, Caciula A, Chauhan L, Patel J, Sullivan E, Gucwa A, Fallon B, Golightly M, Molins C, Schriefer M, Marques A, Briese T, Lipkin WI. Sci Rep. 2018 Feb 16;8(1):3158.


Tick bites (National Library of Medicine/NIH)

Tickborne diseases (National Institute of Allergy and Infectious Diseases/NIH)

Tiny but Treacherous: Pics and Flicks Feature Disease-Bearing Ticks (NIAID)

Rafal Tokarz  (Columbia University, New York)

NIH Support: National Institute of Allergy and Infectious Diseases


  • Amiya Kumar Sarkar says:

    Multidisciplinary approach is so very essential, ’till AI takes over. Sometimes, being a ‘jack of all trades’ pays! Great going!

  • Jim Clear says:

    What great news. Under Dr. Collins leadership the NIH remains a source for Health and Hope.

  • Dolores C. says:

    A step in the right direction but still not adequate. Many with tick borne pathogens are immune compromised, so they are not able to build antibodies. This sero chip once again is looking for antibodies. How about next generation DNA sequencing so we can find the actual pathogens and not an immune response to them ? Next, there are most likely thousands of pathogens and these 8 merely scratch the surface. The next hurdle is to find someone to treat you. My child was CDC positive with both positive ELISA and Western Blot and many co infections and NOT ONE single infectious disease physician in 4 counties near me would see her. This is a crime against humanity and has got to stop and instead of researching some ineffective vaccine, we should be focusing on better detection and then figuring out ways to eradicate the pathogens and restore the broken immune system. Unless you can stop that tick from regurgitating we shall get no where with vaccine efforts. It also takes weeks for someone to build an antibody response and by that time it is simply too late. Many of the injected pathogens can segue from an acute to chronic state and that also needs to be addressed.

  • ismael says:

    That was a great article, thanks for the advice!

  • Od. Luis Marcano says:

    I´ve never heard of something like these arachnids over here in my country (Venezuela)

    It´s very interesting this subject

    And you´re right, prevention is better than having to treat some disease

    Thanks for sharing!

  • Patsy K. says:

    I live in the midwest, and I was diagnosed with RMSTF in July 2018. They are assuming I contracted it from a tick bite I got mid March. I still suffer daily from many medical issues from the damage it has caused to my body and going so long before the doctors got a diagnosis. I have seizures and mini strokes almost daily. This is something to not take lightly, listen to your body. Treat yourself when going out and treat your animals when they are out. I would have never thought a tiny little bug could change my life as much as it has.

  • Teresa C. says:

    I was diagnosed with RMSF 20 years ago. I recently had a blood work that turned up that I still have the disease. Twenty years ago, I went on an antibiotic regime of doxycycline, and currently on the same regime for three months so far. I was wondering if you could explain how the regiment works and for how long to clear up the bacteria?

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