Lyme Disease Risk Map
Lyme disease risk map Image courtesy: Maria Diuk-Wasser/ Yale School of Public Health

By Rose Hoban

Ticks carrying Lyme Disease are not that big a deal in North Carolina… yet.

A study published today by Yale entomology researcher Maria Duik-Wasser generated a map of tick populations along the Eastern seaboard. She aggregated the efforts of dozens of entomologists in 37 states who wander through fields dragging pieces of cloth behind them. Young ticks, called nymphs, grab onto the cloth. From there, the scientists pick them off, grind them up and analyze what bacteria the ticks are carrying around.

A field scientist drags a cloth across the ground to gather ticks
A field assistant samples the leaf litter for ticks in a Tennessee forest. Photo Courtesy: Graham J. Hickling, University of Tennessee

From there, Duik-Wasser was able to see how many ticks in any given area are infected with Borrelia burgdorferi, the bacteria that causes Lyme disease. And Southern states weren’t that affected.

“The real concentration is in the Northeast, also near the western Great Lakes,” she said.

Ticks in North Carolina

Lyme is carried by little ticks called Ixodes scapularis, more commonly known as the black legged tick. Duik-Wasser and her co-authors concluded that in addition to being rare in North Carolina, the Ixodes scapularis living in here are just not into biting humans.

“They feed more on skinks, lizards and other reptiles,” Duik-Wasser said. “And they don’t tend to bite people as much.’

“It’s highly variable,” said Charles Apperson, professor of public health entomology at NC State University in Raleigh. “We do have nymphs in NC that are infected with Borrelia burgdorferi.”

Ixodes scapularis nymph, the tick that carries Lyme Disease
Nymphal stage Ixodes scapularis tick. Photo Courtesy: Anne Gatewood-Hoen/ Yale School of Public Health

Apperson said there are some cases of Lyme Disease in North Carolina, but it’s not like the number of cases in the Northeast, were a total of about 28,000 cases in New England and the Mid-Atlantic states in 2009 (the most recent year for available statistics). North Carolina had 417 cases in 2010 (the most recent year statistics are available).

Ixodes scapularis are just not as common as other ticks, like the lone star tick, that carries Rocky Mountain Spotted Fever, Apperson said. He’s currently involved in a study looking at forestry workers in Western NC where he collected samples from the clothes of about 140 workers last year.

“Ninety-nine percent of the samples we got were of lone star ticks,” Apperson said.

On the move

There is evidence the Ixodes scapularis are headed south, said Duik-Wasser. Most of her data come from between 2004-07. Since then, researchers at the University of Richmond, in Virginia, have found more human-biting black legged ticks.

“You could consider the map we’ve produced to be a baseline map, but at the edges they’re expanding” she said. “The front is probably expanding in several places, including in Virginia, and could eventually get to North Carolina.”

“The map should create an interest in doing more research and surveillance at those areas,” Duik-Wasser said.

Lyme Disease Risk Map
Lyme disease risk map Image courtesy: Maria Diuk-Wasser/ Yale School of Public Health

North Carolina used to have a tick-disease surveillance program, but it was eliminated in the last state budget.

Duik-Wasser also said that wherever she found populations of infected Ixodes scapularis, about 20 percent of the ticks were infected wtih B. burgdorferi. That’s the threshold cited by the Infectious Disease Society of America, which recommends doctors prophylactically treat for Lyme Disease when patients living in areas that have populations of I. scapularis arrive complaining of a tick bite.

“Now we know that most areas with Ixodes will have more than 20 percent of them carrying B. burgdorferi,” said Duik-Wasser. “It’s just that no one went out and collected the ticks and tested them before.”

Tips for avoiding tick bite:

  • be aware when out in the woods or in areas with lots of leaf litter
  • tuck in your clothes when in a tick affected area, especially tuck pants into your socks
  • use insect repellant on clothing and on exposed skin
  • check skin carefully after being outside, especially in skin creases, such as underarms and between legs

(Note, the headline for this story was changed to better reflect that Lyme Disease, while present in North Carolina, is not as likely as in other, more heavily affected states.)

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Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...

20 replies on “Lyme Disease Not As Likely in NC, But Caution Should Prevail”

  1. I HAD Lyme Disease while I lived in North Carolina. Back in 2009. It can and does happen. It took me 5 different doctors to find one who treated me properly. Duke University Health Care refused to give me more than two weeks of antibiotics, because, I later found out, insurance companies won’t PAY for more than two weeks. And doctors at Duke didn’t believe I had Lyme Disease, even though I had the blood test results to prove it!
    Standard treatment is ONE FULL MONTH of antibiotics. So I kept getting Lyme Disease back and feeling bad again. And I was one of the lucky ones: I tested positive for Lyme, and was eventually able to find a doctor before the disease was able to cause irreversible damage. Thanks so much to Dr. John Kihm of Durham North Carolina for spotting the trouble as to why I wasn’t getting better, and for giving me proper treatment when Duke University Heath System failed miserably.

  2. This supposed “new” report they just released is using old data (perviously published). In fact, the most recent collecting of ticks was done over 5 years ago. So please…

    Make no mistake. North Carolina DOES have Lyme disease, a lot of it. What we don’t have are accurate tests, a reliable reporting system, a health department that wants to admit Lyme is there, a cure for those who contract it, and a medical board that will prosecute doctors who treat sick patients outside the NC set standard of care that was discredited years ago.

    Keep in mind…. Lyme wasn’t reported in many other states after it was first discovered in Connecticut. At least not until the problems were so bad they had to admit it was there. By then countless people were suffering, becoming chronically ill and dying.

    Don’t let this be the trend in NC. Know the facts. And know that NC has some of the highest rates for RMSF. NC also has other tick-borne diseases, some than can be deadly.

    1. Well said AfterTheBite! Just lately 2 political figures in SOUTH Carolina have been diagnosed with Lyme Disease, Dulk-Wasser would be better off doing her research online. If Lyme Disease is in South Carolina it is most definetly in NORTH Carolina, IT IS IN NORTH CAROLINA! I`ve had Lyme and co-infections of for years, I know of many others here in North Carolina that are infected and cannot get the treatment they deserve because of the corruption on the part of the IDSA, CDC, the NIH and all the insurance companies. Lyme is a very political disease in which the rich get richer and the infected are left to suffer and die. There is no Lyme controversy, only corruption. Comes around goes around, they will all get theirs in the end! POP

      1. I have a friend who was diagnosed with Lyme disease which was acquired in the northwest corner of NC and which resulted in the person having not only the “bull’s-eye” skin manifestation but also pretty severe arthritis-like symptoms.

      2. Turn to criminal activity and make it public to all! I had a doctor in concord that knew what I had from day one and I mentioned it about 5 times after the first visit. she was using me as a revenue generator and now I am doubtful that I will ever see healthy again as long as I live! Dr. Jennifer Perry at winecoff family practice is guilty of neglect and I want legal help to put here in her place!

  3. There are a number of concerns about the study that this article discusses, however, I am only addressing the headline that was used. The headline of this article is confusing, dangerous and misleading. It is confusing since the it declares “Lyme disease not likely in NC” but the article quotes Dr. Apperson as stating that we do have cases here. The state has previously declared Wake County endemic for Lyme disease and a number of other counties have had at least one case meeting stringent state and CDC requirements for a locally acquired case of Lyme disease. Numbers appear to be increasing. The article is dangerous because it may cause harm to infected people. If citizens and medical providers think people cannot acquire Lyme disease here, they are unlikely to get properly diagnosed and treated. Untreated Lyme disease can have very serious consequences including severe disability and even death. This article does a disservice to the people of North Carolina.

    1. Good point about the headline, Marcia.
      Indeed, Lyme is present in NC, and the article states it. However, it’s not *as* likely as in other states. I’ll change the headline to reflect that.

      1. Can you point a good lawyer for neglect my way of are you just full of yourself like the bad doctor that I got, if this doctor did it to me then she is doing it to others including children! Tony @ 980-21-5851 ASAP!

  4. Lyme is “not that big a deal” in North Carolina?? Come to my house in Western NC where I’ve been sick for months with lyme disease. So sick that most days I can’t even get out of bed. The ever mounting medical bills and the 1000 miles a month that I have to drive for treatment might convince you that it IS a big deal.

    Shame on all of you for covering this epidemic up with these ridiculous reports.

  5. So Rose, what about the Lone Star ticks? Seems to me that Rocky Mountain Spotted Fever is pretty bad on its own. What are the statistics on the prevalence of those ticks and that disease in NC?

  6. What bull! It is very easy to get Lyme here in NC and this is just here to help the doctors pad their pockets!

  7. I was just diagnosed with Lyme Disease and have the typical “bull’s eye” rash indicative of Lyme on my ankle. I got it two weeks ago in Durham, NC. Maybe this article gives a false sense of security? Go to the doctor if you suspect anything!

  8. This is a very irresponsible and misleading article regarding Lyme Disease and the possibilty of contracting it in NC. Those of us who suffer with Lyme have enough trouble getting proper medical treatment without the false information contained in the article. I am sorry the author did not research further and interview actual Lyme patients and the doctors who will or will not treat the disease. The result would most likely have been that there are far more Lyme patients in NC than doctors who will follow new guidelines in diagnosing and treating the illness. Even if you have a tick bite and develop the characteristic “bulls eye” rash, you are dismissed as not having Lyme. We need help not misinformation. We need information distributed about how to get a tick or person tested and who to see for treatment.

  9. I live near Raleigh and while looking for recent articles on Lyme, discovered this one. I know six people with Lyme disease in the right now. One of them is my 24-year old son. For three years we saw specialists – a Raleigh neurologist, a Greensboro cardiologist, a supposedly expert diagnostian at Duke and others – and they never mentioned Lyme. It was only after other people we know with Lyme heard of it that we insisted on a Lyme test. It was positive and he is now receiving treatment by an out of town specialist. A Duke infectious disease practice acted like they had never heard of it when we started seeking treatment. This disease is disabling, even to the young. I cringe to read articles minimizing it.

  10. Go to and watch Under Our Skin. You will learn everything you need to know about Lyme and why doctors don’t want to treat patients in NC. My daughter was bite 5 years ago never thought anything of it cause she had eczema and was always broke out in a rash but then she was diagnosed with Psoratic Arthritis and took harmful meds then her dermatologist told me he didn’t believe she had PA and we saw a special on Lyme she had all the symptoms so talked to her Rheumatologist about it and he quickly shut it down. Now I am in a fight to save her from this horrible disease and I work in the medical field. I will not stop plan on starting a foundation. Saying Lyme does not exist in NC is like saying the common cold does not exist. We have woods, we have deer, we have ticks and people travel everyday. No one has a clue what is being passed from state to state, country to country. West Nile is in Texas but a person in NC got it. It is time for the CDC, IDAS, and the doctors to wake up and start fighting for human life. A doctor takes a vow to save lives but when it comes to Lyme you are sentencing your patient to a life of pain and suffering. My daughter was a softball player now she does nothing and it is not because she tries. She is 14 and has been sentenced to a life of misery because doctors are scared to loss their license. A doctor should have the freedom to practice medicine but doctors hands are tied because of so many that use the system and now people who really need medical attention can not be taking seriously. Email me if you have any info

  11. Lyme disease was denied and misdiagnosed for years although I knew I had classic symptoms and a rash. Drs do not seem to know they are NOT supposed to rely on the alleged Lyme test, it only looks for a small sample of Many strains, and there are other reasons it is not very accurate. Then, there are also the coinfections. Deer, or insects that bite them, do not travel on other animals across state lines? I got horribly ill, and when I mentioned it to others, have been surprised to find out how MANY other bad cases I’ve heard about in Wake County, with people now on disability from it. Another relative is now going through a horrible case of it, with milder undiagnosed symptoms years ago. Drs are afraid to acknowledge it and treat it due to what happened to Dr Jemsek? I think patients should take legal action against Drs who do NOT diagnose and treat it. Once you have had it for a while, it’s throughout the body and needs much more than a month of antibiotics. “Under Our Skin” documentary, and have the real truth. It can look like many other conditions (including others diagnosed withOUT a test), I knew something else was wrong and it has cost me so much.

  12. I know I have it and I live in Lexington, nc… it’s probably late stage now bc I was led to believe your bs on here that lyme doesn’t exist in nc. I refuse to see any more regular docs…I ain’t paying them no more for nothing. I will however see dr. jemsek when I get up the money.

  13. I often think someone is getting paid to write these less than accurate articles concerning Lyme disease. Years ago when I drove from Virginia to North Carolina to see my Lyme-literate doctor, parts of NC were already epidemic to Lyme disease. There are an estimated 300,000 new cases being reported yearly. I cannot believe in 2013 how much Lyme ignorance there still is amongst medical professionals. I had one doctor recently send me a packet of articles entitled the “Myth of Lyme Disease.” It’s too bad the doubters could not experience Lyme symptoms for one week. Wonder how much more empathetic they would be after that experience ?

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