STARI
Also called: Southern Tick-Associated Rash Illness
Pathogen
Cause not yet identified
Carried by
Lone star tick (Amblyomma americanum)
STARI produces an expanding, bull's-eye-like rash very similar to Lyme's, following a lone star tick bite in the Southeastern and South-Central US where classic Lyme is less common. Its cause remains unidentified — the Lyme community and some researchers argue it may represent an under-characterized Borrelia infection, while public health agencies say the cause is unknown. Either way, people with a Lyme-like rash in the South deserve to be taken seriously.
If you developed a bull's-eye rash in the South and were told 'there's no Lyme here,' your experience is real. Bring photos of the rash to a Lyme-literate clinician.
Symptoms
- Expanding red 'bull's-eye'-like rash at the bite site
- Fatigue, headache, fever, muscle aches
- A picture that closely mimics early Lyme
Testing
There's no specific test for STARI. Because it mimics Lyme, evaluation focuses on history and ruling out other causes.
Geography
Southeastern and South-Central states, wherever the lone star tick is common.
Explore the Where Ticks Live map to see what's carried in your region.
Treatment overview
There's no established treatment, but because it resembles early Lyme, doxycycline is often given and the rash typically resolves.
Frequently asked questions
Is STARI the same as Lyme?
Officially, no — public health agencies say STARI is not caused by the Lyme bacterium and its cause is unknown. Many in the Lyme community believe Southern Lyme-like illness is underdiagnosed. Because the rash and early symptoms mimic Lyme, it's often treated similarly.