Tick Bite Fever in South Africa: What Every Family Should Know

What Is African Tick Bite Fever?

African Tick Bite Fever (ATBF) is caused by the bacterium Rickettsia africae, transmitted primarily by the bite of the African tick (Amblyomma hebraeum and Amblyomma variegatum). It is one of the most common travel-related and outdoor-exposure infections in sub-Saharan Africa, including South Africa. The disease is not typically fatal in otherwise healthy adults, but it causes significant illness and can be serious in children, the elderly, and immunocompromised individuals. It is frequently misdiagnosed as flu, particularly in its early stages.

Where and When Are You Most at Risk?

In South Africa, ATBF risk is highest in bushveld areas — Limpopo, Mpumalanga, the Kruger National Park surrounds, KwaZulu-Natal, and the Eastern Cape. However, suburban gardens in Gauteng, the Western Cape, and other provinces with wildlife corridors, parks, or domestic animals (especially dogs) also carry risk. Ticks are most active in summer and spring (October to April) when humidity and temperatures are higher, though in warmer coastal regions they present year-round.

Symptoms to Watch For

• ✓ A dark, crusted sore (eschar) at the bite site — this is the most diagnostic sign of ATBF.
• ✓ Fever (often sudden onset, 38–40°C) appearing 5–10 days after the bite.
• ✓ Severe headache, muscle pain, and fatigue.
• ✓ Swollen lymph nodes near the bite site.
• ✓ A rash of small red spots or bumps spreading from the trunk outward (appears in 40–50% of cases).
• ✓ If you develop fever after being outdoors or in a rural area, always tell your doctor to consider ATBF.

How to Remove a Tick Safely

The correct removal of a tick is critical — incorrect technique increases the risk of disease transmission and secondary infection.

• ✓ Use fine-tipped tweezers or a tick removal tool — never your fingers.
• ✓ Grasp the tick as close to the skin surface as possible.
• ✓ Pull upward with steady, even pressure — do not twist or jerk.
• ✓ Never crush, squeeze, burn, or apply Vaseline to a tick — this causes it to regurgitate into the wound.
• ✓ After removal, clean the bite site with 70% alcohol or soap and water.
• ✓ Keep the tick in a sealed bag or container — your doctor may want to identify the species.
• ✓ Monitor the bite site and your health for 10–14 days.

Protecting Your Family From Ticks

• ✓ Apply a DEET-containing repellent (20–30% DEET) to exposed skin before outdoor activities.
• ✓ Treat clothing and gear with permethrin-based products — highly effective and long-lasting.
• ✓ Wear long sleeves and long pants tucked into socks when walking in bush or long grass.
• ✓ Stick to the centre of paths and avoid brushing against vegetation.
• ✓ Perform a full-body tick check on all family members (including under arms, behind knees, in hair) after outdoor activities.
• ✓ Check pets thoroughly after they've been outside — dogs are a major vector for bringing ticks into the home.

Tick Control on Your Property

If your garden borders bush, has long grass, or you have wildlife (or pets) moving through it, professional tick treatment significantly reduces the tick population on your property. Perimeter sprays with a residual acaricide applied to lawn edges, garden beds, and shaded areas under shrubs are effective. Treating your pets monthly with a veterinary-recommended tick preventative is equally important — dogs and cats carry ticks inside and onto furniture, carpets, and beds.