Southern Tick-Associated Rash Illness
Southern Tick-Associated Rash Illness (STARI) or Masters disease is a
Lyme-like illness that seems to be transmitted by the Lone star tick (Amblyomma
americanum), which is the most common human-biting tick in Florida. It
was identified in people with a rash and other symptoms similar to those in Lyme
disease that did not have evidence of infection with Borrelia burgdorferi
and had been bitten by a different type of tick. A related bacterium,
Borrelia lonestari has been identified and may be the cause of the illness
but is not confirmed. STARI has been discovered in Florida and research on the occurrence of the
disease is underway. However, it may take some time before all the necessary
information can be collected since much is still unknown about STARI.
 
Amblyomma americanum and its distribution in the United States
Symptoms and Treatment
The most obvious sign of a STARI infection is a rash called erythema migrans (EM),
which has
the shape of a "bull's eye". This symptom is often confused with Lyme
disease, which has a similar or identical rash. The rash can bee seen
about seven days after the tick bite, and expands outward from the site of the
bite. There may be a central area of clear skin. Other signs can include
tiredness, fever, headaches, muscle and joint pain. STARI differs from Lyme
disease in that chronic symptoms, such as arthritis and neurological symptoms
are not likely to occur. According to past and recent studies on STARI,
patients recover quickly from the rash and other symptoms after treatment with
oral antibiotics.
Patient
with STARI;
1) site of tick bite,
2) red, radial, expanding edge of rash,
3) central clearing. Photo courtesy of CDC.
Prevention of Tick-borne Diseases
Resources
Centers for Disease Control and Prevention (CDC) Southern Tick-Associated Rash
Illness.
http://www.cdc.gov/stari/
Little, Susan.
Southern tick-associated rash illness: A newly recognized
tick-borne disease. DVM Newsmagazine: Best Practices 2003.
Purdue University Medical Entomology Department: STARI (Southern Tick-Associated
Rash Illness)
www.entm.perdue.edu/publichealth/diseases/tick/stari.html
Masters E, Grigery C, Masters R. STARI, or Masters Disease: Lone Star
Tick-Vectored Lyme-like Illness. Infect Dis Clin N Am. 2008; 22:361-376.
Tick Bites and Erythema Migrans in Georgia: It Might Not Be Lyme Disease
http://health.state.ga.us/pdfs/epi/gers/ger0801.pdf
CDC Research on STARI
The Centers for Disease Control and Prevention (CDC) is requesting
participation in a study to ascertain if a Borrelia
organism other than B. burgdorferi is causing Lyme-like
disease, Southern Tick-Associated Rash Illness (STARI), in
southern states. Physicians are encouraged to contact the CDC if
a patient develops an expanding rash (5 cm or more in diameter) after a recent
lone star tick bite. Included below are the CDC letters of
explanation to physicians and their patients interested in
participating in this study.
All files in this section are PDFs, open in a new window, and are under 30
KB.
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