Migrating Ticks Make Lyme Disease Diagnosis Tougher
- Healio: How and why has the distribution of the lone star tick (Amblyomma americanum) changed, and where are they overlapping now with ticks that cause Lyme disease?
- Dattwyler: We don't know what's causing the overlapping.
- healio: How is the changing epidemiology complicating the diagnosis of Lyme disease and STARI?
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January 15, 2026
3 min read
Key takeaways:
- The FDA approved the first RSV vaccine for adults 60 years and older.
- The vaccine, Arexvy, is manufactured by GSK.
- Clinical trials showed the vaccine was 82.6% effective in preventing RSV-associated lower respiratory tract disease.
- The CDC’s Advisory Committee on Immunization Practices (ACIP) will meet on February 22-23 to discuss recommendations for RSV vaccination.
- RSV
Healio: How and why has the distribution of the lone star tick (Amblyomma americanum) changed, and where are they overlapping now with ticks that cause Lyme disease?
Dattwyler: We don’t know what’s causing the overlapping. They’re overlapping throughout the Mid-Atlantic and into southern New England. The trouble is they’re shifting and could spread in northern parts of New England.
healio: How is the changing epidemiology complicating the diagnosis of Lyme disease and STARI?
Dattwyler: The certainty that the rash (Erythema migrans) is diagnostic of Lyme disease is significantly diminished. So, what we need are better diagnostic tests, which are being developed.
Healio: What are the clinical implications of these changes, and how should clinicians in these areas alter current practices?
Dattwyler: It makes the diagnosis of Lyme disease tougher. I’ve seen thousands of lyme disease cases, and I can’t tell the difference between Erythema migrans and STARI. You can no longer say you definitely have Lyme disease.For the average physician, treat them as if they had Lyme disease. You still follow them up and still do appropriate testing. If I were a PCP and saw the lesion, I would treat it with doxycycline, even though you can no longer definitely say it’s Lyme.It’s safer to treat than not to treat. The risk of missing Lyme is greater than the risk of giving someone doxycycline or amoxicillin who doesn’t need it.
Healio: Do we know to what extent STARI occurs in the Mid-Atlantic states?
Dattwyler: It’s fairly common in the Mid-Atlantic states but we don’t have exact numbers.
Healio: Does STARI resolve on its own without antibiotic treatment? And, if it does, what percentage of cases are resolved without treatment?
dattwyler: Yes, it resolves on its own. We’re not even sure what’s even causing it.People have looked for bacteria and viruses and have not come to a definite conclusion.
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