Rising Threat of Lyme Disease in North Carolina

North Carolina is increasingly facing a subtle yet potentially serious threat from ticks, which can sometimes go unnoticed despite their tiny size.

Recent research led by UNC has revealed that the ticks known for spreading Lyme disease are becoming more prevalent in North Carolina. The study found that the rates of infection in western parts of the state are similar to those historically seen in the Northeast, areas often associated with tick-borne diseases.

Dr. Ross Boyce, an infectious diseases specialist at UNC Health, noted, “In places like New York or Pennsylvania, you could find 30% or 40% of the ticks infected. To see similar findings here in western North Carolina is quite striking.”

Boyce has been examining ticks in western North Carolina, particularly as the area has changed significantly over the last ten years.

This latest research focused on Biltmore Forest, a residential area in Buncombe County, just south of Asheville. The investigation began after residents reported incidents of tick-borne illnesses.

The team identified 19 adults from the community who reported having a tick-borne illness, with 17 of them claiming they had Lyme disease.

“The feedback from local residents about their experiences really triggered our research,” Boyce shared.

Between November 2024 and August 2025, researchers conducted a tick survey across 25 homes in Biltmore Forest. They used cloths to collect ticks from vegetation, which were then tested for disease-causing bacteria.

In total, 373 ticks were gathered, with approximately 75% identified as blacklegged ticks, the main species responsible for transmitting Lyme disease.

Among the adult blacklegged ticks tested, a significant 40% were found to carry Borrelia burgdorferi, the bacteria leading to Lyme disease. Additionally, the bacteria was also identified in three out of seven nymphal blacklegged ticks.

“Conducting this research in a residential setting reflects the risk that people face more accurately than if we had examined ticks deep in a national forest,” Boyce remarked. “Understanding that such a risk exists within a community is crucial.”

He added, “For those living near wooded areas, where deer and small wildlife might roam, the lines between nature and neighborhoods are becoming less distinct.”

The results of this study further support the notion that blacklegged ticks—and the diseases they carry—are shifting southward. The researchers suggested that Biltmore Forest might be at the forefront of this southern spread of northern blacklegged tick populations.

Moreover, Lyme disease is not the only health concern linked to these ticks.

The tests also revealed two other types of disease-causing bacteria associated with anaplasmosis and hard tick relapsing fever. While these were detected at lower rates compared to Lyme disease bacteria, Boyce mentioned that CDC data indicates this could be the furthest south these pathogens have been identified.

“As we focus on raising awareness about Lyme disease, it’s important to note that additional tick-borne diseases are also emerging in this region,” Boyce advised.

Given the escalating threat, both outdoor enthusiasts and healthcare professionals should exercise caution, according to Boyce.

“When I attended medical school in Chapel Hill, we were taught that Lyme disease was virtually nonexistent in North Carolina,” he reflected. “Now, we’re trying to sound the alarm about the importance of recognizing and preparing for this threat.”

To minimize the risk of tick bites, especially in the Winston-Salem and Hickory areas, Boyce suggests using repellents containing DEET, performing regular tick checks after being outdoors, and keeping lawns well-trimmed.

“It’s important to note that Lyme disease isn’t transmitted immediately by ticks; it takes some time,” he explained. “This is why regular checks can be effective.”

He noted that most infected ticks usually need about 24 to 36 hours to transmit the bacteria to a human.

“If you find a tick quickly and remove it, you’re likely in the clear. The difficulty, particularly in the spring, is that ticks can be tiny—about the size of a sesame seed—and easily missed,” Boyce said.

Due to the increasing prevalence of disease, ten counties in western North Carolina now recommend administering a single dose of antibiotics within 72 hours if someone finds a tick on themselves. Additionally, veterinarians have been advocating for more pets to receive vaccinations against Lyme disease.