Southern tick-associated rash illness

Last updated
Southern tick-associated rash illness
Other namesMasters' disease
Amblyomma americanum tick.jpg
Lone star ticks can be carriers of southern tick-associated rash illness.
Specialty Infectious disease

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

Contents

Symptoms

"Bull's-eye" STARI rash STARI Rash.jpg
"Bull's-eye" STARI rash

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, with fatigue, muscle pains, and headache. [1] Fever is sometimes seen, but is not characteristic.

Causes

This illness is a tick-borne disease carried by the lone star tick Amblyomma americanum . This tick was first proposed as a possible vector of disease in 1984, [2] and the illnesses associated with the tick called "Lyme-like disease", [3] but it was not recognized to be distinct from Lyme disease until the late 1990s. [4] [1]

Several studies have failed to detect Borrelia burgdorferi , which is the causative agent of Lyme disease, in patients from the southern United States. [5] [6] This disease may be caused by the related bacterium Borrelia lonestari , [7] [8] which is a spirochete first isolated in culture in 2004. [9] However, this conclusion is controversial since the spirochete is not detected in all cases of the syndrome, [6] which has led some authors to argue that the illness is not caused by a bacterial pathogen. [10]

Treatment

Infections are treated with antibiotics, particularly doxycycline, and the acute symptoms appear to respond to these drugs. [8] [11]

Prognosis

No serious long-term effects are known for this disease, [11] but preliminary evidence suggests, if such symptoms do occur, they are less severe than those associated with Lyme disease. [7]

See also

Related Research Articles

<span class="mw-page-title-main">Lyme disease</span> Infectious disease caused by Borrelia bacteria, spread by ticks

Lyme disease, also known as Lyme borreliosis, is a vector-borne disease caused by Borrelia bacteria, which are spread by ticks in the genus Ixodes. The most common sign of infection is an expanding red rash, known as erythema migrans (EM), which appears at the site of the tick bite about a week afterwards. The rash is typically neither itchy nor painful. Approximately 70–80% of infected people develop a rash. Early diagnosis can be difficult. Other early symptoms may include fever, headaches and tiredness. If untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pains, severe headaches with neck stiffness or heart palpitations. Months to years later, repeated episodes of joint pain and swelling may occur. Occasionally, shooting pains or tingling in the arms and legs may develop. Despite appropriate treatment, about 10 to 20% of those affected develop joint pains, memory problems, and tiredness for at least six months.

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 protozoa. The economic impact of tick-borne diseases is considered to be substantial in humans, and tick-borne diseases are estimated to affect ~80 % of cattle worldwide. Most of these pathogens require passage through vertebrate hosts as part of their life cycle. Tick-borne infections in humans, farm animals, and companion animals are primarily associated with wildlife animal reservoirs. many tick-borne infections in humans involve a complex cycle between wildlife animal reservoirs and tick vectors. The survival and transmission of these tick-borne viruses are closely linked to their interactions with tick vectors and host cells. These viruses are classified into different families, including Asfarviridae, Reoviridae, Rhabdoviridae, Orthomyxoviridae, Bunyaviridae, and Flaviviridae.

<i>Borrelia burgdorferi</i> Species of bacteria

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 makes up the species complex of Borrelia burgdorferi sensu lato. The complex currently comprises 20 accepted and 3 proposed genospecies. B. burgdorferi sensu stricto exists in North America and Eurasia and until 2016 was the only known cause of Lyme disease in North America. Borrelia species are Gram-negative.

<span class="mw-page-title-main">Erythema migrans</span> A rash in several vector-borne diseases

Erythema migrans or erythema chronicum migrans is an expanding rash often seen in the early stage of Lyme disease, and can also be caused by southern tick-associated rash illness (STARI). It can appear anywhere from one day to one month after a tick bite. This rash does not represent an allergic reaction to the bite, but rather an actual skin infection of one of the Lyme bacteria species from the genus Borrelia. The rash's name comes from Neo-Latin for "migrating redness".

<i>Dermacentor variabilis</i> Species of tick

Dermacentor variabilis, also known as the American dog tick or wood tick, is a species of tick that is known to carry bacteria responsible for several diseases in humans, including Rocky Mountain spotted fever and tularemia. It is one of the best-known hard ticks. Diseases are spread when it sucks blood from the host. It may take several days for the host to experience symptoms.

Relapsing fever is a vector-borne disease caused by infection with certain bacteria in the genus Borrelia, which is transmitted through the bites of lice or soft-bodied ticks.

<i>Borrelia</i> Genus of bacteria

Borrelia is a genus of bacteria of the spirochete phylum. Several species cause Lyme disease, also called Lyme borreliosis, a zoonotic, vector-borne disease transmitted by ticks. Other species of Borrelia cause relapsing fever, and are transmitted by ticks or lice, depending on the species of bacteria. A few Borrelia species as Candidatus Borrelia mahuryensis harbor intermediate genetic features between Lyme disease and relapsing fever Borrelia. The genus is named after French biologist Amédée Borrel (1867–1936), who first documented the distinction between a species of Borrelia, B. anserina, and the other known type of spirochete at the time, Treponema pallidum. This bacterium must be viewed using dark-field microscopy, which make the cells appear white against a dark background. Borrelia species are grown in Barbour-Stoenner-Kelly medium. Of 52 known species of Borrelia, 20 are members of the Lyme disease group, 29 belong to the relapsing fever group, and two are members of a genetically distinct third group typically found in reptiles. A proposal has been made to split the Lyme disease group based on genetic diversity and move them to their own genus, Borelliella, but this change is not widely accepted. This bacterium uses hard and soft ticks and lice as vectors. Testing for the presence of the bacteria in a human includes two-tiered serological testing, including immunoassays and immunoblotting.

<span class="mw-page-title-main">Arvid Afzelius</span> Swedish dermatologist

Arvid Afzelius (1857–1923) was a Swedish dermatologist.

<span class="mw-page-title-main">Lyme disease microbiology</span>

Lyme disease, or borreliosis, is caused by spirochetal bacteria from the genus Borrelia, which has 52 known species. Three main species are the main causative agents of the disease in humans, while a number of others have been implicated as possibly pathogenic. Borrelia species in the species complex known to cause Lyme disease are collectively called Borrelia burgdorferisensu lato (s.l.) not to be confused with the single species in that complex Borrelia burgdorferi sensu stricto which is responsible for nearly all cases of Lyme disease in North America.

Jorge Benach is a medical researcher at the Stony Brook University in New York state. Benach is the chair of the Department of Molecular Genetics and Microbiology. Benach's main area of research is the tick-borne spirochete Borrelia burgdorferi, which is the causative agent of Lyme disease.

Allen Caruthers Steere is an American rheumatologist. He is a professor of rheumatology at Harvard University and previously at Tufts University and Yale University. Steere and his mentor, Stephen Malawista of Yale University, are credited with discovering and naming Lyme disease, and he has published almost 300 scholarly articles on Lyme disease during his more than 40 years of studies of this infection. At a ceremony in Hartford, Connecticut in 1998, Governor John G. Rowland declared September 24 to be "Allen C. Steere Day".

<i>Amblyomma americanum</i> Species of tick

Amblyomma americanum, also known as the lone star tick, the northeastern water tick, or the turkey tick, is a type of tick indigenous to much of the eastern United States and Mexico, that bites painlessly and commonly goes unnoticed, remaining attached to its host for as long as seven days until it is fully engorged with blood. It is a member of the phylum Arthropoda, class Arachnida. The adult lone star tick is sexually dimorphic, named for a silvery-white, star-shaped spot or "lone star" present near the center of the posterior portion of the adult female shield (scutum); adult males conversely have varied white streaks or spots around the margins of their shields.

Neuroborreliosis is a disorder of the central nervous system. A neurological manifestation of Lyme disease, neuroborreliosis is caused by a systemic infection of spirochetes of the genus Borrelia. Symptoms of the disease include erythema migrans and flu-like symptoms.

<span class="mw-page-title-main">Human monocytotropic ehrlichiosis</span> Medical condition

Human monocytotropic ehrlichiosis is a form of ehrlichiosis associated with Ehrlichia chaffeensis. This bacterium is an obligate intracellular pathogen affecting monocytes and macrophages.

The International Lyme and Associated Diseases Society is a non-profit advocacy group which advocates for greater acceptance of the controversial and unrecognized diagnosis "chronic Lyme disease". ILADS was formed by advocates for the recognition of "chronic Lyme disease" including physicians, patients and laboratory personnel, and has published alternative treatment guidelines and diagnostic criteria due to the disagreement with mainstream consensus medical views on Lyme disease.

Borrelia miyamotoi is a bacterium of the spirochete phylum in the genus Borrelia. A zoonotic organism, B. miyamotoi can infect humans through the bite of several species of hard-shell Ixodes ticks, the same kind of ticks that spread B. burgdorferi, the causative bacterium of Lyme disease. Ixodes ticks are also the primary vector in the spread of babesiosis and anaplasmosis.

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Chronic Lyme disease (CLD) is the name used by some people with non-specific symptoms, such as fatigue, muscle pain, and cognitive dysfunction to refer to their condition, even if there is no evidence that they had Lyme disease. Both the label and the belief that these people's symptoms are caused by this particular infection are generally rejected by medical professionals. Chronic Lyme disease is distinct from post-treatment Lyme disease syndrome, a set of lingering symptoms which may persist after successful antibiotic treatment of infection with Lyme-causing Borrelia bacteria, and which may have similar symptoms to CLD.

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<span class="mw-page-title-main">Baggio–Yoshinari syndrome</span> Medical condition

The Baggio–Yoshinari syndrome, formerly known as the Brazilian Lyme-like disease and Brazilian human borreliosis, is a disease transmitted by the Amblyomma cajennense tick, but the organism that causes the infection is still unknown. Clinical features resemble those of Lyme disease (LD).

References

  1. 1 2 Kirkland KB, Klimko TB, Meriwether RA, et al. (1997). "Erythema migrans-like rash illness at a camp in North Carolina: a new tick-borne disease?". Arch. Intern. Med. 157 (22): 2635–41. doi:10.1001/archinte.1997.00440430117014. PMID   9531233.
  2. Schulze TL, Bowen GS, Bosler EM, et al. (May 1984). "Amblyomma americanum: a potential vector of Lyme disease in New Jersey". Science. 224 (4649): 601–3. Bibcode:1984Sci...224..601S. doi:10.1126/science.6710158. PMID   6710158.
  3. Masters EJ, Donnell HD (July 1995). "Lyme and/or Lyme-like disease in Missouri". Missouri Medicine. 92 (7): 346–53. PMID   7651314.
  4. Masters E, Granter S, Duray P, Cordes P (August 1998). "Physician-diagnosed erythema migrans and erythema migrans-like rashes following Lone Star tick bites". Arch Dermatol. 134 (8): 955–60. doi:10.1001/archderm.134.8.955. PMID   9722725. S2CID   25606594.
  5. Philipp MT, Masters E, Wormser GP, Hogrefe W, Martin D (October 2006). "Serologic Evaluation of Patients from Missouri with Erythema Migrans-Like Skin Lesions with the C6 Lyme Test". Clin. Vaccine Immunol. 13 (10): 1170–1. doi:10.1128/CVI.00238-06. PMC   1595329 . PMID   17028220.
  6. 1 2 Wormser GP, Masters E, Liveris D, et al. (February 2005). "Microbiologic Evaluation of Patients from Missouri with Erythema Migrans". Clin. Infect. Dis. 40 (3): 423–8. doi:10.1086/427289. PMC   2773674 . PMID   15668867.
  7. 1 2 Masters EJ, Grigery CN, Masters RW (June 2008). "STARI, or Masters disease: Lone Star tick-vectored Lyme-like illness". Infect. Dis. Clin. North Am. 22 (2): 361–76, viii. doi:10.1016/j.idc.2007.12.010. PMID   18452807.
  8. 1 2 James AM, Liveris D, Wormser GP, Schwartz I, Montecalvo MA, Johnson BJ (June 2001). "Borrelia lonestari infection after a bite by an Amblyomma americanum tick". J. Infect. Dis. 183 (12): 1810–4. doi: 10.1086/320721 . PMID   11372036.
  9. Varela AS, Luttrell MP, Howerth EW, et al. (March 2004). "First Culture Isolation of Borrelia lonestari, Putative Agent of Southern Tick-Associated Rash Illness". J. Clin. Microbiol. 42 (3): 1163–9. doi:10.1128/JCM.42.3.1163-1169.2004. PMC   356874 . PMID   15004069.
  10. Dennis DT. (2006). "Reply to Masters. "Lyme-Like Illness Currently Deserves Lyme-Like Treatment"". Clinical Infectious Diseases. 42 (4): 581–582. doi: 10.1086/500018 . PMID   16421811.
  11. 1 2 Blanton L, Keith B, Brzezinski W (June 2008). "Southern Tick-Associated Rash Illness: Erythema Migrans Is Not Always Lyme Disease". South. Med. J. 101 (7): 759–760. doi:10.1097/SMJ.0b013e31817a8b3f. PMID   18580719.