Southern Tick-Associated Rash Illness
Southern tick-associated rash illness (STARI) is clinically
indistinguishable from Lyme disease in its early stages.
In some cases a skin lesion (or rash) that looks like
a Lyme disease erythema migrans (EM) appears at the
site of the tick bite. Treatment with an antibiotic
regimen similar to that used for LD helps resolve STARI.
In some patients, STARI resolves on its own without
antibiotic treatment. It has been suggested that STARI
is caused by the spirochete B. lonestari that
is transmitted by lone star ticks. Serologic testing
for LD antibodies in STARI patients is not helpful because
STARI is not caused by B. burgdorferi (the
causative agent of LD).
The Centers for
Disease Control and Prevention recommends that patients with
an expanding rash and recent history of exposure to the lone star
tick see a physician. Because of its similarity to Lyme disease,
the extent to which STARI occurs in New Jersey has not been determined.
However, studies in New Jersey have shown that the infection prevalence
of B. lonestari in lone star ticks is 4-9%.
Tick-Associated Rash Illness Fact Sheet