Tick-Borne Diseases in the South: Why Travelers Remain at Risk

Tick-borne diseases in the South are increasing as tick populations expand into new regions. Although Lyme disease is often associated with the Northeast, multiple tick species in the southern United States carry a range of infections that travelers should be aware of. :contentReference[oaicite:0]{index=0}

“The recent confluence of environmental, ecological, sociological, and human demographic factors has created a near ‘perfect storm’ leading to more ticks in more places throughout North America.” [1]

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Lyme Disease Expanding Southward

Lyme disease cases have expanded significantly into southern regions, particularly Virginia and North Carolina.

The study Geographic Expansion of Lyme Disease in the Southeastern United States, 2000–2014 identified a marked increase in cases, including the emergence of a new disease cluster in southern Virginia.

Five counties in North Carolina have been considered endemic since 2009, and expansion is expected into neighboring states such as Kentucky, West Virginia, and Tennessee. [2]

These findings demonstrate a clear trend of southward expansion of Lyme disease.

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Evidence of Borrelia in Southern Ecosystems

Researchers have identified Borrelia burgdorferi in birds, rodents, ticks, and even lizards in southern and western states.

Studies have detected Borrelia DNA in wildlife across Florida, South Carolina, and Maryland, suggesting widespread environmental presence. [3]

In one study, more than 50% of sampled lizards were positive for Borrelia species, indicating a potential role in maintaining infection in the region.

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A Researcher’s Personal Experience

Entomologist Dr. Kerry Clark became ill after fieldwork in Georgia, developing headaches, fatigue, neurologic symptoms, and cognitive issues.

He tested positive for Borrelia burgdorferi and another species, Borrelia andersonii.

Although antibiotic treatment provided temporary relief, symptoms returned after discontinuation.

Clark later published evidence confirming Lyme Borrelia infections in patients from Florida and Georgia. [3]

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Tick Activity in Winter Months

Many travelers assume tick exposure is limited to warmer months. However, studies show otherwise.

A 10-year study in Mississippi found that the majority of blacklegged tick bites occurred in February. [5]

Researchers identified seven tick species, with the lone star tick responsible for more than half of reported bites.

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Multiple Tick Species, Multiple Risks

In the southern United States, several tick species can transmit disease, including:

• Lone star tick
• Gulf Coast tick
• American dog tick
• Blacklegged tick

This diversity increases the range of potential infections and complicates diagnosis.

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Why Travelers Should Be Concerned

Tick-borne diseases are not confined to traditional endemic regions.

Travelers heading south should recognize that ticks are active year-round and capable of transmitting a range of infections.

Awareness, prevention, and early recognition remain essential to reducing risk.

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References

1. Entomological Society of America Position Paper, 2015.
2. Lantos PM et al. Open Forum Infectious Diseases, 2015.
3. Clark KL et al. Int J Med Sci, 2013.
4. Discover Magazine, 2013.
5. Goddard J. Journal of Agromedicine.
6. Clark K et al. Appl Environ Microbiol, 2005.

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Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention