Prospective health assessment of Fort Campbell, Kentucky patrons bitten by ticks.

Amblyomma americanum is an aggressive human-biting tick that transmits several known human pathogens and is associated with a Lyme disease-like illness of unknown etiology. To determine the frequency, distinguishing clinical characteristics, and etiology ofA. americanum-associated illness and identify associated risk factors, a prospective study of adult tick-bite victims was conducted at Fort Campbell from 2005-2007. Forty-two participants submitted ticks, none of which contained Borrelia lonestari or B. burgdorferi DNA. Thirty-three participants completed a follow-up health survey; 14 reported at least one symptom; two had erythema migrans-like rash; eight sought medical evaluation for their symptoms. Findings suggest that a variety of symptoms are temporally associated with tick bite but data provide no clear evidence that reported symptoms were caused by an infectious process. Removing a tick by hand or being bitten on a limb may be a risk factor for illness.