Tiny Ticks, Big Impact: Diana Zychowski Studies the Rise of Tick-Borne Diseases
Diana Zychowski, MD, MPH, was drawn to the field of infectious diseases because of how dynamic and interdisciplinary the field is—it sits at the intersection of microbiology, public health, informatics, epidemiology, and patient care.
After Dr. Zychowski graduated from college, she worked as a Research Technologist in an infectious disease laboratory.
“Working alongside physician-scientists, I saw firsthand how research could bridge the gap between the laboratory and patient care,” said Zychowski. “What really resonated with me was the ability to translate scientific discoveries into meaningful improvements in public health and clinical practice.”
This appreciation led her to join the Center for Infectious Disease Research (CeIDeR) team at Hennepin Healthcare Research Institute (HHRI). After completing her clinical Infectious Disease Fellowship and two years of research postdoctoral work, Dr. Zychowski was eager to return to Minnesota—a state that is a hotbed for tick-borne diseases.
“CeIDeR stood out to me because of its collaborative and mission-driven culture,” said Zychowski. “Everyone I met was incredibly talented, but also approachable and deeply committed to improving patient care. The center's focus on advancing infectious disease prevention, treatment, and implementation science made it an ideal place to continue building my research program.”
Tiny ticks, serious illness
Dr. Zychowski is a physician researcher, which means she splits her time between caring for patients and conducting research. Her research focuses on tick-borne diseases, especially emerging tick-borne viral infections, as well as other tick-associated conditions, such as Alpha-gal syndrome. She investigates these diseases through clinical epidemiology, laboratory diagnostics, and studies of the immune response to better understand how infections are detected, how they cause illness, and why some patients develop severe diseases.
Alpha-gal syndrome is a food allergy that can develop after a tick bite, causing allergic reactions to red meat, red meat byproducts, and dairy. Many tick species can cause it, but it’s most commonly developed from the bite of a lone star tick.
Dr. Zychowski studies infectious diseases through the lens of the One Health framework. This framework uses a multidisciplinary approach to explore how environmental change, climate patterns, human behavior, land use, and animal populations influence the spread of disease. By understanding these connections, researchers can better predict, prevent, and treat disease outbreaks.
There are more than 900 tick species in the United States, and while only a few transmit diseases to humans and animals, the Centers for Disease Control and Prevention (CDC) reported over 100,000 cases of tick-borne disease in 2023 (the most recent year of data available).
Ticks are scattered throughout the United States, but are most prevalent in Minnesota, Wisconsin, and the Upper New England region.
Nearly 90,000 of these reported cases were attributed to Lyme disease.
Geographic Distribution of Tickborne Disease Cases
The CDC tracks reported cases of selected tickborne diseases by county of residence in the United States.
There are hundreds of tick species worldwide, but only about a dozen are found in Minnesota. Fortunately, not all ticks transmit diseases. The three species that people are most likely to encounter in Minnesota are the blacklegged tick (also known as the deer tick), the American dog tick (or wood tick), and the lone star tick. While the invasive Asian longhorned tick has spread to many parts of the United States, it is not currently known to be established in Minnesota.
Each tick species can carry a different set of pathogens and is associated with different diseases. The blacklegged tick (Ixodes scapularis) is the tick responsible for Lyme disease and is also responsible for transmitting several other infections, including anaplasmosis, babesiosis, and Powassan virus disease. While early symptoms of Lyme disease include flu-like symptoms or a bull’s-eye rash, later symptoms can be more severe and affect the nervous system, heart, and joints.
Tick activity peaks during warmer months, but can even occur on mild winter days. In Minnesota, ticks are most active from mid-May through September, with a strong peak in June. They are more often found in wooded, brushy areas, along trails, and in the area between the woods and the border. They are less common in open areas like your yard. Ticks crawl; they don’t jump! Instead, they respond to cues like body heat, carbon dioxide, and movement. Their behavior is more about opportunity.
“They tend to migrate to warm, hidden areas of the body. So, you may find them in your scalp, behind your ears, under your arms, around your waist or the waistband of your pants, behind your knee, and towards the band of your socks,” said Dr. Zychowski.
Dr. Zychowski recommends wearing light-colored protective clothing to spot ticks more easily, tucking your socks inside your pants, doing a tick-check once you return from outdoor activities, and using an insect repellent with DEET.
The challenge with diagnosis
Zychowski explained that tick-borne viral infections are tricky to detect and are underdiagnosed because the symptoms (fever, chills, nausea, vomiting, headache) mimic so many other common illnesses like the common cold or the flu. While Lyme disease is the most recognized tick-borne illness, many emerging tick-borne viruses remain poorly understood. Awareness among clinicians may be limited, and diagnostic testing is not widely available. Adding to the challenge, some diagnostic tests must be performed within a specific timeframe after infection. If that window is missed, the infection may be more difficult to detect.
“I’m especially interested in understanding how often these emerging viruses are causing human disease but going undetected,” said Zychowski. “Many of these pathogens likely exist in our communities, but we lack the surveillance systems and diagnostic tools needed to identify them.”
To address these gaps, Zychowski is developing approaches that leverage remnant clinical specimens (samples that would otherwise be discarded after routine patient care) to create low-risk surveillance systems for emerging infectious diseases. She is also building a clinical specimen repository linked to patient data, allowing researchers to study how the immune system responds to tick-borne infections and identify previously unrecognized pathogens.
“Ultimately, my goal is to better characterize these diseases, improve our ability to diagnose them, and lay the foundation for new diagnostics, treatments, and prevention strategies,” she said.
RELATED RESOURCES
Listen to Dr. Zychowski's interview on the Healthy Matters podcast with Dr. Hilden
Season 6, Episode 3 of the Healthy Matters podcast featured special guest Dr. Diana Zychowski, an infectious diseases specialist at Hennepin Healthcare. In the episode, she discussed the basics of these bothersome bugs, the current state of ticks in Minnesota, and the many illnesses they can carry.
In the episode, she advised listeners on what to do if you happen to get bitten, and most importantly, the best tips for how to still get out and enjoy a little of the outdoors this summer.
Dr. Zychowski interviewed by MPR News
MPR News interviewed infectious disease researcher Dr. Diana Zychowski as a tick expert on the uptick in emergency rooms in Minnesota related to tick-borne diseases.