Lyme disease is expanding into southern Appalachia, and a town in the Blue Ridge Mountains appears to be on the edge of this growing territory.
In an analysis yesterday in Morbidity and Mortality Weekly Report, 39.6% of the blacklegged (deer) ticks collected from residential properties in Biltmore Forest, North Carolina, tested positive for the bacterium—Borrelia burgdorferi—that causes Lyme disease. If left untreated, an infection can result in facial paralysis, irregular heartbeat, arthritis, and other long-term neurologic complications.
Lyme has historically been considered endemic in the Northeast and Upper Midwest. Researchers note that tick surveys in nearby South Carolina counties found a low prevalence of Lyme, which suggests that Biltmore Forest "represents the leading edge of southward expansion."
In fact, 17 Biltmore Forest residents said they've been diagnosed with the disease. They also reported cases of babesiosis and one case of ehrlichiosis, though the researchers, from both South and North Carolina, didn't find ticks carrying the bacteria that cause these diseases.
However, the researchers identified Borrelia miyamotoi in two adult ticks and two collections of pooled DNA from larval ticks. This bacterium causes hard tick relapsing fever; the most common symptom is a high temperature, though some patients experience chills or shakes, fatigue, joint pain, headache, and nausea.
Wear DEET, check your armpits
The findings show a need for public education about tick-bite prevention in this part of Appalachia, along with expanded surveillance to improve early diagnosis, said the researchers. They noted that many medical providers in the area lack experience diagnosing and managing tick-borne diseases.
To avoid these illnesses, the Centers for Disease Control and Prevention advises people to avoid areas where ticks are found and to apply DEET-containing insect repellent. After coming indoors, people should check their bodies for ticks, including less visible areas like under the arms, back of the knees, and hair.
