What You Need To Know About Lyme Disease in the Southern USA

Source: Georgia Lyme Disease Association

Borrelia burgdorferi sensu stricto?

Check.  50+ Bbss strains documented by Georgia Southern University’s Dr. Jim Oliver.

In fact, Lyme disease bacteria, Borrelia burgdorferi (Bb) have been documented in THOUSANDS of tick and animal specimens and in many humans from across the South in published studies spanning more than two decades.  More importantly, more Lyme disease bacteria species and strains have been documented in the Southeastern United States than in any other region of the country (see our website NEWS page for details).  The fact that there are more numerous and varied Bb strains in the South, suggests to scientists that Lyme disease bacteria were actually in the Southern United States first, giving the bacteria time to diversify into so many different species and strains, before moving North.

Competent Animal Reservoir in the South?

Check.  The cotton mouse, cotton rat and wood rat are all competent reservoirs for Borrelia burgdorferi.  The white-footed mouse is also found in some areas.  Gray squirrels, chipmunks and shrews are now being investigated as reservoirs, as well.  Even birds and some lizards may be reservoirs.

Infected Ixodes scapularis, black-legged “deer” ticks?

Check.  And evidence suggests these ticks moved from South to North, not that they are now “expanding their range” down to the South.

Do black-legged “deer” ticks bite humans in the South?
Check.  In fall and winter months, adult Ixodes scapularis “deer” ticks feed on humans on warmer days so humans are exposed year ’round due to our warm climate. 

And lest you believe that old myth“Only nymphal ticks are attached long enough to transmit Lyme disease because bigger ticks are more easily spotted and removed quickly”here’s an important study published in 1996:

Duration of tick bites in a Lyme disease-endemic area, Am. J. Epidemiol. 143: 187-192.
The authors (Falco, Fish, and Piesman) reported that 26.8% of I. scapularis nymphs removed from people were attached >48 hours, while 23.3% of adults were attached >48 hours.
There’s not a very significant difference between the number of nymphs and adults attached for over 48 hours, is there?  Adult ticks can easily be missed on a person’s back or scalp.

Do People in the Southern USA Test Positive for Lyme Disease?

Check.  Some Southerners do indeed test fully “CDC-reportable” positive for Lyme disease using the very strict 2-tier test methodology.  This indicates that these patients are infected with a Borrelia burgdoreri sensu stricto B31 type strain or one closely-related, known to cause Lyme disease in the Northeastern US.  These and many other strains of the species Bb sensu stricto have been documented in the Southern USA.  Additionally, other diverse Lyme Borrelia species and strains are found in the South and some are newly discovered.

As in the Northern USA, western blot lab results for some Southern patients don’t meet CDC guidelines, however, they show various positive bands, some highly specific for Borrelia burgdorferi.  That all Southern patients’ labs do not meet strict CDC guidelines meant for reporting purposes isn’t surprising in the least.  A recent Johns Hopkins study of Lyme patients proved that current tests were unreliable in detecting a huge percentage of patients tested from Maryland and Pennsylvania.  Why would Southern patients be expected to always have “CDC-reportable” lab results when Northern patients do not?

A study of southern erythema migrans (EM) rash patients published years ago concluded that Southern Bb strains are so genetically different, the South needs its own Lyme disease testing system!  We still await these tests.  Many Southern Lyme disease cases are likely missed using the current unreliable tests which are designed to detect a few strains of a single Bb species.
Until next time, please remember to do a tick check daily…even in the winter months especially in warmer climates.
-GALDA