Post by Lyme Challenged on Jun 6, 2017 18:01:43 GMT -5
Southern Tick-Associated Rash Illness (STARI)
Overview
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Adult female Lone Star tick. Photo courtesy of the Centers for Disease Control.
Since the late 1980s, physicians in the south central and southeast United States have observed Lyme disease-like rashes on patients with a recent history of tick bite. However, the tick vector associated with these lesions is Amblyomma americanum, the Lone Star tick, rather than either of Ixodes tick species – I. scapularis or I. pacificus - known to transmit Lyme disease in the United States. In the absence of proof that the causative agent of Lyme disease, Borrelia burgdorferi sensu stricto, is associated with these rashes (and considerable evidence that it is not), this clinical entity has been differentiated from Lyme disease and is called Southern Tick-Associated Rash Illness, or STARI. It is also sometimes referred to as Masters disease, in honor of Edwin Masters, the Missouri family physician who first reported these cases to his state’s Department of Health.
Despite vigorous efforts, the causative agent of STARI has never been cultured and is not currently known. However, some evidence exists that a recently discovered spirochete, Borrelia lonestari, may be responsible: B. lonestari has been detected by polymerase chain reaction (PCR) in Lone Star ticks removed from humans, as well as in Lone Star ticks collected during general epidemiological studies. More convincingly, B. lonestari DNA was detected by PCR in the biopsied skin lesion of a patient with a history of recent Lone Star tick bite, while B. burgdorferi DNA was absent in the same sample. However, other studies have been unable to confirm this finding; in one Missouri investigation, biopsies from the lesions of 31 patients with Lone Star tick bites were negative by both culture and PCR for B. lonestari. Thus, the etiology of STARI remains elusive. It is possible that multiple borrelial species may be responsible.
The known geographic range of the Lone Star tick has expanded over the past two decades and now stretches northward into both New England and the southern Great Lakes area. As a result, there are now regions of the country where both STARI and Lyme disease are endemic, making it difficult sometimes to distinguish between the two diseases on epidemiological grounds alone.
The true incidence of STARI is unknown, as the illness in not nationally reportable.
Read the full story on link below ..
www.columbia-lyme.org/patients/tbd_stari.html