-
Views
-
Cite
Cite
Steven E. Phillips, Joseph J. Burrascano, Nick S. Harris, Richard Horowitz, Lorraine Johnson, Patricia V. Smith, Raphael B. Stricker, Rash Decisions about Southern Tick—Associated Rash Illness and Lyme Disease, Clinical Infectious Diseases, Volume 42, Issue 2, 15 January 2006, Pages 306–307, https://doi.org/10.1086/499111
Close - Share Icon Share
Extract
Sir—Wormser et al. [1] discuss the “distinct clinical presentations” (p. 958) of Lyme disease in New York, compared with those of southern tick—associated rash illness (STARI) in Missouri. Unfortunately, it appears that little progress has been made in understanding the cause of STARI during the past decade [2]. Even worse, the accompanying editorial by Dennis [3] suggests that, in some circles, the understanding of Lyme disease ecology and epidemiology may have regressed during the same time period.
Wormser et al. [1] confirm that STARI is not caused by Borrelia burgdorferi, the agent of Lyme disease in the United States. The identical conclusion was drawn 10 years ago on the basis of microbiological analysis of STARI patients in Missouri [2]. The observation that these patients have a “milder” clinical illness [3, p. 962] when treated promptly with antibiotics may be misleading. Because patients with STARI were more likely to recall a tick bite and had a faster onset of rash, compared with patients with Lyme disease, it follows that patients with STARI were treated more promptly with antibiotics than the comparison group of Lyme disease patients was, and this difference could account for the more benign course of illness in the STARI patient group. The findings of Wormser et al. [1] also suggest that antibiotic therapy is effective against STARI, which supports an infectious etiology for the disease. Identification of the causative agent of this tickborne illness awaits more-assiduous microbiological and genetic analyses.
