The ticks then seek out blood meals from human inhabitants. The responsible tick feeds at night obtaining a blood meal within 15-45 minutes. Most bites go unrecognized as the soft tick does not attach to it's host for days at a time like the more recognizable hard tick. Soft ticks can survive up to 10 years with infrequent blood meals every year or two, making certain cabins 'hot spots' for infection year after year. Due to the persistent nature of the offending ticks within structures, thorough environmental assessments accompany any disease investigation.
Rustic cabins appear to pose the highest risk for infection.
Prevention efforts should focus on the elimination of rodent access to structures and the use of an appropriate insecticide to exterminate existing ticks. Tick-borne relapsing fever should be considered with any recurring febrile illness. The recognized agents causing TSS are Staphlococcus aureus and Streptococcus pyogenes . The syndrome includes a high fever, vomiting, profuse watery diarrhea, myalgia, and hypotension which may lead to shock in severe cases. In 1980-81 an epidemiologic study revealed a strong association between TSS and the use of tampons with super absorbency, containing the chemical polyacrylate.