The "tick belt," which runs from Virginia to Georgia and west to Oklahoma, is awash in insect s searching for a meal of blood in each of their three life cycle phases -- larva, nymph and adult.
"We'll have multiple outbreaks of Rocky Mountain Spotted Fever over the spring through the fall," said Dr. David Weber, an epidemiologist at the University of North Carolina.
About half of all people who have been bitten by a tick aren't aware a tick was on their body, Weber said. A tick needs to be in place 12 to 24 hours before it can infect anyone, he said, but symptoms of a tick-borne illness might not appear for up to 14 days after the bite -- and the tick is likely long gone by then.
Deer ticks, which are about the size of a pencil point, can spread Lyme disease, but it's not very common in North Carolina, Weber said. The biggest threat from ticks in this area is Rocky Mountain spotted fever, which is transmitted by dog ticks, which are the size of a pencil eraser.
"Although it's called Rocky Mountain spotted fever, it's really much more common in our part of the country," he said, adding that one in five infected people die from the disease unless it's treated.
The initial symptoms are a high fever, a headache, muscle aches and fatigue. After a day or two, those symptoms become more severe, and nausea and vomiting set in. People also might develop a rash on the forearms and legs, which can spread and become tiny blood blisters.
Weber said there is no good early lab test for Rocky Mountain spotted fever, but the fever and two of the other symptoms are a red flag for him.
He recommended people check themselves and their children twice a day if they're in tick-infested areas, such as places with tall grass. Keeping a yard well manicured can eliminate the problem.
Anyone in a high-grass area, like the rough of a golf course, should wear light-colored clothing to see a tick more easily. They also can tuck their pant legs into their socks to keep ticks off their skin.
Ticks look for a place like the groin area, under arms or the nape of a neck on to attach. If a tick burrows into the skin, Weber said tweezers are the best way to remove them. Grab them at the head and gently pull straight out, he said. Don't crush the tick because that could lead to infection, he said, adding they can be flushed down a toilet.