Ticks do not know borders and are prevalent throughout the country. Indeed, Terminix identified states with the most ticks in 2024 based on the number of tick control services utilized by residents, and Florida ranked #2 nationwide.
Lyme and associated infections have been found throughout the United States, including southern states like Florida. Because the risk and reported incidence of Lyme and other tick-borne diseases in the South is not accurately reported, patients are routinely denied a proper diagnosis and treatment for the cause of what are often an array of symptoms that can impact every system and organ.
The evidence is clear that Lyme disease is undercounted in Florida based on various data sources. The CDC surveillance counts place a heavy emphasis on “high incidence” states—which are primarily confined to the Northeast coast and upper Midwest United States. Doctors and patients are falsely told that there is “no Lyme in Florida” or that it is extremely rare. As a result of this downplaying of the risk of Lyme and other tick-borne infections, people, especially parents, are less likely to take steps to prevent tick bites. Additionally, those infected are less likely to receive an early diagnosis. According to the CDC, “if left untreated, infection can spread to joints, the heart, and the nervous system.”
Due to poor awareness and training, doctors refuse to timely prescribe antibiotics for known tick bites even with symptoms and refuse to test for Lyme because they have been taught there is no Lyme in Florida. There is even less awareness regarding other tick-borne infections that are prevalent in the state, including Babesia, Ehrlichia, Anaplasma, and Bartonella.
- Kerry Clark, PhD has documented Lyme Borrelia in two human biting ticks in Florida (blacklegged ticks and lone star ticks). See: Borrelia species in host-seeking ticks and small mammals in northern Florida. Multiple species of Lyme Borrelia have been detected in human patients in Florida using sensitive molecular methods. Infection with species/strains other than those the traditional tests are designed to detect may contribute to negative test results. See e.g.
- Lyme borreliosis in human patients in Florida and Georgia, USA
- Geographical and genospecies distribution of Borrelia burgdorferi sensu lato DNA detected in humans in the USA
- Isolation of live Borrelia burgdorferi sensu lato spirochaetes from patients with undefined disorders and symptoms not typical for Lyme borreliosis
- A divergent spirochete strain isolated from a resident of the southeastern United States was identified by multilocus sequence typing as Borrelia bissettii.
Lyme and Bartonella infection can persist for years, despite antibiotic treatment (see studies linked above) and following:
New genetic group/species of Bartonella may be responsible for a portion of Lyme-like illness in Florida and other southern states. Standard lab tests for Bartonella will not likely identify these strains.
- The CDC shows a 29.44% increase in reported cases in Florida comparing 2017-2019 data to 2022.
- A 2021 CDC Study analyzing insurance data, revealed that in states the CDC considers to be “low incidence,” only 1 in 50 cases is counted, while in high incidence states 1 in 7 is counted. See also How much does the CDC undercount Lyme cases? It depends on where you live.
- Standard lab tests for Lyme disease were developed to detect a single Borrelia strain present in the Northeast. Such lab tests fail to detect approximately half of actual cases pursuant to numerous peer reviewed studies. See Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States; see also, Project Lyme. For unknown reasons, it appears as though the Florida Department of Health is not counting most CDC-positive Lyme cases. For example, in a July 2018 report (page 7), Quest Diagnostics showed an increase in Florida Lyme cases from 283 in 2015 to 501 in 2017, representing a 77% increase. In contrast, the CDC only reported 166 Florida Lyme cases in 2015 and 210 in 2017. Why are the CDC’s numbers for Florida so much lower than Quest, a single lab? In recent email correspondence, IGeneX has indicated a 48% positivity rate in Florida for 2023, which they consider high. There were 526 CDC-positive cases through IGeneX in 2023. Note that the IGeneX immunoblot has been validated by New York and other states and is covered by Medicare Part B. We do not have data for labs such as Mayo Clinic, Consolidated, ARUP, Medical Diagnostics Laboratory, Stony Brook University Medical Center, Cleveland Clinic, university and other labs which also test for Lyme disease in Florida, but we trust that the Florida Department of Health has this data available. We would appreciate transparency on these numbers.
- Canine maps show a significant increase in incidence of Lyme disease, Ehrlichia, and Anaplasma in the state. Notably, dogs are less likely to travel out of state meaning the infections are more often locally acquired.
- According to the Companion Animal Parasite Council (CAPC), from 2019 – 2023, canine tick-borne infections have increased by 89.53% for Lyme disease; 100.49% for Ehrlichiosis; and 334.23% for Anaplasmosis in Florida.
- In 2022, CAPC reported 4,284 canine cases compared to only 233 human cases reported by the CDC.
- In 2023, CAPC reported 4,888 Lyme disease, 12,601 Ehrlichiosis, and 8,424 Anaplasmosis canine cases.
- According to 2024 data YTD, Florida is considered moderate risk for Lyme and high risk for both Ehrlichia and Anaplasma. Notably, the Lyme incidence changed from 1/200 in 2023 to 1/100 for 2024 YTD.
- The CAPC estimates its data represents “less than 30% of the activity in the geographic regions.” Applying this factor to the 4,284 cases in 2022, CAPC would estimate 14,280 canine cases which is >61x the human reported cases for the same year (4,284/.3 = 14,280).
- MyLymeData statistics for “low incidence” states like Florida likewise show a large disparity between reported and actual cases. See Why Doesn’t the CDC Count Lyme Disease Cases in the South and the West? Everybody Else Does. | LymeDisease.org
