Southward Expansion of Ixodes scapularis (Blacklegged) Tick Pathogens - Western North Carolina, November 2024-August...

Southern Appalachia is a region where Lyme disease is emerging but not yet considered endemic. In response to local concerns about increased numbers of tickborne disease cases, researchers collected ticks monthly at 22 residential properties in the town of Biltmore Forest, North Carolina. During November 2024-August 2025, a total of 373 ticks were collected, 287 (76.9%) of which were blacklegged ticks (Ixodes scapularis). Among these, 19 of 48 adult Ix. scapularis (39.6%) tested positive for Borrelia burgdorferi sensu stricto, the bacterium that causes Lyme disease. Borrelia miyamotoi and Anaplasma phagocytophilum were also identified in collected Ix. scapularis ticks, suggesting an expansion of the geographic range of these ticks and pathogens. These findings illustrate the evolving epidemiology of tickborne infection risk and the need for enhanced tick surveillance in southern Appalachia.