A Patient’s Story from the South

My patient from Florida looked me straight in the eye and said, “But Lyme doesn’t exist down here, right?” That’s what she’d been told—by more than one doctor.

She had a rash. Fatigue. Joint pain. Classic signs of Lyme disease. But instead of being tested or treated, she was told she had STARI—Southern Tick-Associated Rash Illness.

The problem? We still don’t know what causes STARI. And there’s no confirmed test or treatment for it.

Labeling it STARI might seem harmless. But if it’s actually Lyme—or another tick-borne infection—then that label can delay or deny the care she truly needs.

Evidence says they were wrong.

The Study That Challenges the Myth

A peer-reviewed study published in BMC Infectious Diseases investigated patients—many from the southern U.S.—who showed signs of Lyme disease, including erythema migrans-like rashes, fatigue, and joint pain.

Researchers tested blood and skin biopsy samples and found Borrelia burgdorferi sensu lato DNA, the family of bacteria responsible for Lyme disease.

These findings were linked to Lyme-like symptoms in patients from Florida, Georgia, Texas, and other southern states.

Why This Matters

For decades, many believed Lyme was confined to the Northeast and upper Midwest. But mounting research and case reports show that Lyme disease—and Lyme-like illness—can and does occur in the South.

Ticks capable of transmitting Lyme group bacteria are widely distributed across southern states. Infections may involve species other than B. burgdorferi sensu stricto, but the symptoms can be just as serious.

The Diagnostic Challenge

Southern patients often face unique barriers:

• Many doctors are not trained to recognize Lyme or related infections in southern states.
• Diagnostic tests are optimized for B. burgdorferi sensu stricto.
• Symptoms may be dismissed as anxiety, fibromyalgia, or viral illness.

What Clinicians and Patients Should Know

• Lyme disease is not a northern-only illness.
• Patients with tick exposure and Lyme-like symptoms in the South deserve thorough evaluation—including testing for multiple Borrelia species and co-infections.
• More research is needed but denying the possibility of Lyme in the South risks missing diagnoses.

Conclusion

Lyme disease—and its close relatives—do not respect state lines. It’s time we updated how we think, diagnose, and talk about tick-borne illnesses in every region of the U.S.

If your doctor says, “Lyme doesn’t happen here.” Ask them to read the research.

Reference

Clark K. et al. Detection of Borrelia burgdorferi sensu lato DNA in patients with symptoms consistent with Lyme borreliosis in the southern United States. BMC Infectious Diseases. 2013;13:299. doi:10.1186/1471-2334-13-299