Attachment Sites of Four Tick Species (Acari: Ixodidae) Parasitizing Humans in Georgia and South Carolina

Abstract

From June 1995 through January 1998, 677 tick specimens were submitted by 521 humans from 14 states. Analysis was limited to specimens originating in Georgia and South Carolina, representing 87.3% of total submissions. Attachment sites were specified in 367 specimens (62.3%). The American dog tick, Dermacentor variabilis (Say), a vector of the agent of Rocky Mountain spotted fever, favored the head and neck in 59% of attached specimens. The lone star tick, Amblyomma americanum (L.), a strongly implicated vector of the agent of human monocytic ehrlichiosis, favored the lower extremities, buttocks, and groin in 54% of specimens. The blacklegged tick, Ixodes scapularis Say, the main eastern vector of the Lyme disease spirochete, had widely distributed attachment sites with no apparent site preference. The Gulf Coast tick, A. maculatum Koch, parasitized humans in too few instances for analysis. In the southeastern United States, prevention of tick bites and tickborne illnesses such as Rocky Mountain spotted fever, ehrlichiosis, and Lyme disease may be enhanced by personal practices and public health measures based on knowledge of preferred attachment sites of potentially infectious tick species.

Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States

“…Sites where ticks commonly attach to humans include, but are not limited to, the scalp, abdomen, axillae, and groin, as well as under socks and along the belt line (306). Using a mirror, or having someone assist for hard-to-see areas, might be helpful.…”

Borrelia lonestariDNA in AdultAmblyomma americanumTicks, Alabama

“…Recently, novel DNA sequences, amplified by PCR with primer sets recognizing the flagellin and 16s rRNA genes, have identified a new spirochete in A. americanum and B. lonestari (6). Nearly identical sequences have been amplified from A. americanum collected from Texas and New Jersey (2) and Maryland (1). B. lonestari is the suspected pathogen responsible for the STARI-related erythema migrans associated with bites by A. americanum (1).…”

“…In the southeastern states, where I. scapularis is widespread but is less commonly found infected with B. burgdorferi or attaching to humans (1,2), isolations from humans are uncommon (3). However, a clinical condition similar to Lyme disease, termed southern tick-associated rash illness (STARI), has been described in humans in the southeastern region of the United States associated with the bite of Amblyomma americanum ticks (1,4,5).…”

“…However, a clinical condition similar to Lyme disease, termed southern tick-associated rash illness (STARI), has been described in humans in the southeastern region of the United States associated with the bite of Amblyomma americanum ticks (1,4,5). Moreover, a new spirochete, B. lonestari, was described from A. americanum on the basis of polymerase chain reaction (PCR) amplification of the flagellin and 16s rRNA genes (6,7).…”

Retrospective Case Reports of Two Central North Carolina Residents

“…Due to today's progressive standards for informed consent, such studies may be difficult or impossible to conduct since they would require a cohort of patients agreeing to no treatment over time in the face of existing evidence of Lyme-like symptoms associated with STARI [33]. Most reports support treating these patients as for Lyme disease [41][42][43], though some question whether treatment is needed in spite of the condition's Lyme-like symptoms [44]. A recent study suggests that in the South, some cases of Lyme disease-like illnesses may be attributable to lone star tick-vectored infections with previously undetected B. burgdorferi sensu lato [45], but more research is needed to confirm these findings.…”