Lyme disease isn't the only reason to watch out for ticks. The bite of these tiny pests can infect you with other diseases as well. One you may not know about is Hard Tick Relapsing Fever (HTRF) (formerly called Borrelia miyamotoi Disease) due to infection with the germ Borrelia miyamotoi.

HTRF is caused by infection with Borrelia miyamotoi, a type of bacteria. They can lurk inside certain species of ticks. In the U.S., they are the black-legged tick (or deer tick) and the western black-legged tick.

If you are bitten by a tick that carries Borrelia miyamotoi, you may develop HTRF. Most cases in the U.S. have occurred in Northeastern states and California. But experts believe HTRF is a threat wherever black-legged ticks roam. They can be found along the Pacific Coast, in the Northeast, and in the upper Midwest.

A person with HTRF may first suspect the flu. The disease often strikes with a fever, chills, and a severe headache. An infected person may also suffer from an upset stomach and muscle and joint pain. In about 1 out of 10 people the fever may go down and then go up again. There may be abnormal results in liver tests and low platelet counts. Long-lasting fatigue is common, too.

HTRF may be hard to diagnose. Three types of blood tests can help find out if you may be infected with Borrelia miyamotoi. Your doctor will ask about your symptoms and any history of a tick bite. If they suspect BMD, you will need antibiotics for 10 to 21 days.

Most people who are infected with HTRF fully recover. But some may need a hospital stay. People with other health problems or a weakened immune system may suffer worse symptoms.

Like other tick-borne illnesses, HTRF can be prevented. Stay away from tick habitats. Ticks favor heavily wooded areas, high grass, and leaf litter.

Here are some other tips to fend off ticks:

• Apply insect repellant if you are going into an area where ticks may live. Repellants containing the chemicals DEET or picardin (applied to the skin), or permethrin (applied to clothing) are effective against them.
• Check all over your body for ticks after returning from tick-prone places. Ticks tend to favor areas under the arms, behind the knees, around the ears, and in the hair. You should also inspect gear and clothing.
• If you do find a tick on your body, remove it as soon as possible with a set of fine-tipped tweezers. After you have completely removed the tick, thoroughly wash the area and your hands with rubbing alcohol, iodine, or soap and water.
• Keep your yard clear of ticks. Remove leaf litter and tall grass. Place furniture and play equipment away from yard edges. You may also want to apply a pesticide at the appropriate time of the year.

More than a dozen illnesses are linked to ticks. Along with HTRF, you should also be aware of Rocky Mountain spotted fever, the Heartland virus, Ehrlichiosis, and anaplasmosis.

The symptoms of these diseases are like other tick-borne illnesses. They cause fever, muscle pain, headache, and nausea. Their nonspecific symptoms can make a diagnosis a challenge. Rocky Mountain spotted fever typically causes a fever and a red rash.

Antibiotics may work for Rocky Mountain spotted fever and anaplasmosis. But they aren't effective against the Heartland virus. Instead, treatment usually includes fluids and medicine to ease pain.