Southern tick-associated rash illness (STARI) is an

emerging infectious disease An emerging infectious disease (EID) is an infectious disease whose incidence has increased recently (in the past 20 years), and could increase in the near future. The minority that are capable of developing efficient transmission between human ...

related to

Lyme disease Lyme disease, also known as Lyme borreliosis, is a vector-borne disease caused by the ''Borrelia'' bacterium, which is spread by ticks in the genus ''Ixodes''. The most common sign of infection is an expanding red rash, known as erythema migran ...

that occurs in southeastern and south-central United States. It is spread by tick bites and it was hypothesized that the illness was caused by the bacteria ''

Borrelia lonestari Southern tick-associated rash illness (STARI) is an emerging infectious disease related to Lyme disease that occurs in southeastern and south-central United States. It is spread by tick bites and it was hypothesized that the illness was caused by ...

''. However, there is insufficient evidence to declare this Borrelia strain as a causative agent.

Symptoms

Diagnosis is based on a circular "bull's-eye" rash at the site of infection called

erythema chronicum migrans Erythema (from the Greek , meaning red) is redness of the skin or mucous membranes, caused by hyperemia (increased blood flow) in superficial capillaries. It occurs with any skin injury, infection, or inflammation. Examples of erythema not assoc ...

, 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 symptoms ...

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

Causes

This illness 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 ...

carried by the lone star tick ''

Amblyomma americanum ''Amblyomma americanum'', also known as the lone star tick, the northeastern water tick, or the turkey tick, or the "Cricker Tick", is a type of tick indigenous to much of the eastern United States and Mexico, that bites painlessly and commonly ...

''. This tick was first proposed as a possible

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

of disease in 1984, and the illnesses associated with the tick called "Lyme-like disease", but it was not recognized to be distinct from Lyme disease until the late 1990s. 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 make ...

'', which is the causative agent of Lyme disease, in patients from the southern United States. This disease may be caused by the related bacterium ''

'', which is a

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

first isolated in culture in 2004. However, this conclusion is controversial since the spirochete is not detected in all cases of the syndrome, which has led some authors to argue that the illness is not caused by a bacterial pathogen.

Treatment

Infections are treated with antibiotics, particularly

doxycycline Doxycycline is a broad-spectrum tetracycline class antibiotic used in the treatment of infections caused by bacteria and certain parasites. It is used to treat bacterial pneumonia, acne, chlamydia infections, Lyme disease, cholera, typhus, an ...

, 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