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Lyme Disease in the Southeast

Reported cases of Lyme disease (CDC 1999)
Lyme disease vector distribution (CDC 1996)
Does the Southeast have a unique form of LD? (MCG 11/2/99)
Lyme disease (Raleigh News and Observer 6/22/00)
Lyme Disease Knowledge is Critical to Preventing Spread (The State 7/14/00)
Debilitating Lyme disease hard to diagnose, defend against (The State 7/31/00)

Georgia Support Group
Georgia Lyme disease abstracts
Lyme disease in Georgia (Doherty 1999)

Mississippi Support Group
Mississippi Lyme disease abstracts
Lyme disease in Mississippi (Doherty 1999)

Tennessee Support Group
Tennessee Lyme disease abstracts
Lyme disease in Tennessee (Doherty 1999)

Analysis of Southern Borrelia
Angela James, PhD
Centers for Disease Control and Prevention
Abstract of her presentation given at the 13th International Conference on
Lyme disease and other tick-borne disorders (March, 2000 in Hartford, CN)

Lyme disease is the most common tick-borne disease reported in the United States. The majority of the cases occur in northeastern and mid-Atlantic regions. Borrelia burgdorferi sensu lato, the etiological agent, is transmitted by Ixodes spp. ticks. Borrelia burgdorferi has been isolated from several locales throughout the southern United States and these isolates appear to be genetically more diverse than isolates from the northeastern regions. Borrelia sp. isolates have been made from mammals, birds, and ticks from Georgia, Florida, North Carolina, South Carolina, Virginia, Missouri, Oklahoma, and Texas. Borrelia sp. isolates have been cultured in BSKII from Ixodes scapularis, I. affinis, I. dentatus, and I. minor. It appears that I. affinis, I. minor, and I. dentatus maintain enzootic cycles and that I. scapularis acts as a bridge vector to humans. A variety of vertebrate species serve as reservoirs of Borrelia sp., including the cotton mouse, cotton rat, eastern woodrat, and cottontail rabbit. However, few human cases have been reported from this region. This low number may be a result of ecological factors such as the variety and number of hosts, precipitation, and the one or two year life cycle of the black-legged tick (I. scapularis) in this region. Moreover, accurate diagnosis of Lyme disease and tick-associated erythemas in general may be complicated by the possibility of multiple ixodid tick/Borrelia sp. transmission cycles in the southern US. For example, B. lonestari was recently described; it was detected via PCR in the metastriate tick, Amblyomma americanum. The lone star tick (A. americanum) is the most prevalent tick species found in the southeastern United States and it frequently bites humans. The prevalence and association of Borrelia burgdorferi, B. lonestari, and other, possibly new Borrelia genospecies to human illness remains unclear in the southern United States. Thus, a reevaluation of Lyme disease in the south is warranted.