Tick-bite diseases: A guide

Advice for avoiding the scourge

Wednesday, January 23 2013

If you plan to visit the Free State, Northern Cape, Eastern Cape or Kruger National Park this year for business or leisure, be aware of the health risks posed by ticks in these endemic areas.

Dr Pete Vincent of the Netcare Travel Clinics and Medicross Family Medical and Dental Centres warns of the dangers of tick-borne diseases namely Crimean-Congo Haemorrhagic Fever (CCHF), spotted fever rickettsiosis, otherwise known as tick bite fever.

Although CCHF has been widely publicised following two recent cases in Bloemfontein, Dr Vincent says the risk of travellers getting the fever is extremely low. Infections are generally only seen in people who come into regular contact with livestock in endemic areas, as well as in healthcare workers that serve those areas.

“While the occurrence of CCHF in South Africa is rare, the same can unfortunately not be said of tick bite fever,” states Dr Vincent.

“Over ten cases of tick bite fever have been reported to Geosentinel travel clinics by travellers who holidayed in South Africa in the past two months,” reveals Dr Vincent.

“In an unpublished paper that analysed over 40 000 travellers who returned ill from their travels around the world, 26% became ill following a trip to sub-Saharan Africa. Six percent of these had tick bite fever as a result of travelling in South Africa. The most commonly listed endemic areas were the Eastern Cape and Kruger National Park where diseased ticks are found in undergrowth, forest fringes and grasslands, and can brush on to your clothing or skin,” says Dr Vincent.

Avoiding tick bites
To avoid the tick bite scourge, Dr Vincent recommends that travellers take the following precautionary measures:

  • Check whether the area and place you are visiting has a high prevalence of tick bite diseases.
  • Wear long trousers that can be tucked into long socks or boots.
  • Wear closed shoes.
  • For added protection spray fabric insecticides, such as Permethrin on to your clothing.
  • Inspect your clothes and body for ticks immediately after potential exposure.
  • Extract any spotted ticks as soon as possible, using tweezers. The tweezers should be placed as close as possible to the skin, over the tick’s mouthparts. The tick should be pulled slowly, straight up and out, with care not to squeeze its stomach contents into the bite site.

Symptoms of tick-bite infections
CCHF is caused by becoming infected with a RNA virus of the Nairovirus genus transmitted by Hyalomma ticks. Human infection occurs after a bite, crushing of an infected tick, or contact with infected animal blood. The fatality rate is 20 to 35%, says Dr Vincent. Although rare, human-to-human transmission can occur via contact with infected blood or other bodily fluids. The disease was first identified in the Crimea in 1944 and called Crimean haemorrhagic fever. In 1969 it was diagnosed in patients in the Congo, thus resulting in the current name.

The onset of CCHF is sudden. Patients may have a range of flu-like symptoms including headaches, high fever, muscle pain, lower back pain, cold shivers and hot sweats. As the illness progresses, severe bruising and nosebleeds could occur.

With tick-bite fever there is an eight-day incubation period. “The bite site will develop black scabs which can result in open wounds and swelling of lymph glands close to the bite site could become visible. At day eight one usually gets onset fever, muscle pain and a headache. Three days later patients can present a macular or skin rash that appears as small, flat red spots,” says Dr Vincent.

Should symptoms show, seek treatment immediately, says Dr Vincent: “Supportive and antibiotic treatments with tetracycline are imperative for a cure. In South Africa tick bite fever is generally mild.”

Contact details for your nearest travel clinic

Netcare Travel Clinics



Netcare Travel Clinic Boksburg (Johannesburg)

(011) 898-6509

Netcare Travel Clinic Jakaranda (Pretoria)

(012) 421-6805

Netcare Travel Clinic Linksfield (Johannesburg)

(011) 026-4157

Netcare Travel Clinic Rivonia (Johannesburg)

(011) 802-0059

Netcare Travel Clinic Cape Town

(021) 419-3172



Travel clinics situated within Medicross Family Medical
and Dental Centres


Medicross Benoni (Johannesburg)

(011) 425-9100


(051) 406-0200

Bluff (Durban)

(031) 466-5030

Carlswald (Johannesburg)

(011) 318-0634

Fish Hoek (Cape Town)

(021) 782-3506

Gatemax (Durban)

(031) 582-5300

Hayfields (Pietermaritzburg)

(033) 386-9208

Kenilworth (Cape Town)

(021) 683-5867

Langeberg (Cape Town)

(021) 987-1690

Malvern (Durban)

(031) 463-2055

Pinelands (Cape Town)

(021) 511-2672

Pinetown (Durban)

(031) 709-3070


(018) 293-7800


(012) 565-6091

Quintamed (Free State)

(051) 422-4911

Randburg (Johannesburg)

(011) 796-1400

Roodepoort (Johannesburg)

(011) 764-1919

Saxby (Pretoria)

(012) 660-2355

Tokai (Cape Town)

(021) 715-7063

Walmer (Port Elizabeth)

(041) 396-4800



Issued by : Martina Nicholson Associates (MNA) on behalf of Netcells Cryogenics
Contact : Martina Nicholson or Graeme Swinney or Clemmy Eccles
Telephone : (011) 469 3016
Email:, or