Southern tick-associated rash illness (STARI) is a

tick-borne disease Tick-borne diseases, which afflict humans and other animals, are caused by infectious agents transmitted by tick bites. They are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and proto ...

resembling a mild form of

Lyme disease Lyme disease, also known as Lyme borreliosis, is a tick-borne disease caused by species of ''Borrelia'' bacteria, Disease vector, transmitted by blood-feeding ticks in the genus ''Ixodes''. It is the most common disease spread by ticks in th ...

, which occurs in southeastern and south-central United States. It is spread by bites from the lone star tick ''

Amblyomma americanum ''Amblyomma americanum'', also known as the lone star tick, northeastern water tick, turkey tick, and cricker tick, is a type of tick indigenous to much of the eastern United States and Mexico that bites painlessly and commonly goes unnoticed, r ...

''. The actual cause is still unknown.

Symptoms

Diagnosis is based on a circular "bull's-eye" rash at the site of infection called erythema chronicum migrans, which is very similar to that seen in Lyme disease. However, the symptoms of STARI are mild, and resemble

influenza Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These sympto ...

, with fatigue, muscle pains, and headache. Fever is sometimes seen, but is not characteristic.

Geography

As of 2018, most cases were from Southeastern Missouri, a few were from South Carolina, North Carolina, Georgia, and one case each in Mississippi and Long Island, New York.

Cause

The illness, first described in 1997, is a

carried by the lone star tick ''

''. The tick had first been proposed as a possible

vector Vector most often refers to: * Euclidean vector, a quantity with a magnitude and a direction * Disease vector, an agent that carries and transmits an infectious pathogen into another living organism Vector may also refer to: Mathematics a ...

of disease in 1984, and the illnesses associated with the tick was called "Lyme-like disease", but it was not recognized to be distinct from Lyme disease until the late 1990s. In 2004, the disease was suggested to be caused by the related bacterium '' Borrelia lonestari'', which is a

spirochete A spirochaete () or spirochete is a member of the phylum Spirochaetota (also called Spirochaetes ), which contains distinctive diderm (double-membrane) Gram-negative bacteria, most of which have long, helically coiled (corkscrew-shaped or ...

first isolated in culture in 2004. However, the conclusion has been controversial since the spirochete has not been detected in many cases of the syndrome, which has led some authors to argue that the illness is not caused by a bacterial pathogen. Several studies have failed to detect ''

Borrelia burgdorferi ''Borrelia burgdorferi'' is a bacterial species of the spirochete class in the genus '' Borrelia'', and is one of the causative agents of Lyme disease in humans. Along with a few similar genospecies, some of which also cause Lyme disease, it m ...

'', which is the causative agent of Lyme disease, in patients from the southern United States. It has been suggested that tick salivary toxins may play a role, as the toxins are similar to spiders, scorpions and homologous to those found in snakes.

Treatment

Infections are treated with antibiotics, particularly

doxycycline Doxycycline is a Broad-spectrum antibiotic, broad-spectrum antibiotic of the Tetracycline antibiotics, tetracycline class used in the treatment of infections caused by bacteria and certain parasites. It is used to treat pneumonia, bacterial p ...

, and the acute symptoms appear to respond to these drugs.

Prognosis

No serious long-term effects are known for this disease, but preliminary evidence suggests, if such symptoms do occur, they are less severe than those associated with Lyme disease.

References

External links

Southern Tick-Associated Rash Illness (STARI) Home Page
Centers for Disease Control
STARI Fact Sheet
Florida Department of Health
Southern Tick-Associated Rash Illness (STARI)
''SCWDS Briefs'', January 2003, Vol.18, No.4 {{Tick-borne diseases Bacterial diseases Tick-borne diseases Lyme disease Spirochaetes