Lyme disease is a bacterial infection caused by Borrelia burgdorferi, transmitted to humans through the bite of an infected tick. Ticks thrive in wooded and grassy environments across the United States, including South Carolina. Understanding the risk profile in the state is important, as the likelihood of contracting Lyme disease in the Southeast differs significantly from other regions.
The Status of Lyme Disease in South Carolina
Lyme disease is a reportable condition in South Carolina, and public health data confirms cases within the state. However, compared to high-incidence states in the Northeast and Upper Midwest, South Carolina is considered a low-incidence area for locally acquired infection. The South Carolina Department of Public Health tracks confirmed and probable cases annually.
A challenge in interpreting these numbers is that official data records cases by the patient’s county of residence, not the location of exposure. Many individuals diagnosed in South Carolina acquired the infection while traveling to states where the disease is more common. Therefore, the absolute number of reported cases does not necessarily reflect the rate of local transmission within the state.
Primary Tick Species in South Carolina
South Carolina is home to a diverse population of tick species, three of which are most commonly encountered by humans. The Blacklegged Tick (Ixodes scapularis) is the species responsible for transmitting Lyme disease across the United States. This tick is sometimes called the deer tick and is smaller than other common species, with adults featuring a reddish-brown body and dark legs.
The Lone Star Tick (Amblyomma americanum) is the most frequently collected species in the state, easily identified by the distinct white spot on the back of the adult female. This species is highly aggressive, actively seeking hosts rather than waiting in ambush. The American Dog Tick (Dermacentor variabilis) is another widely distributed species, recognizable by its mottled brown body with white or gray markings.
Understanding the Risk Profile
Lyme disease is less common in South Carolina than in northern states due to biological and environmental factors. Although the Blacklegged Tick, the vector for Borrelia burgdorferi, is present, the rate at which these ticks carry the bacteria is significantly lower than in New England. One study of host-seeking adult Blacklegged Ticks in South Carolina found the infection rate to be around 1.3% for the Lyme disease spirochete.
This low prevalence is partly explained by the different wildlife species acting as reservoir hosts in the South, which may not efficiently maintain the bacteria. Southern Blacklegged Ticks also feed on hosts other than the white-footed mouse, the primary natural reservoir in the Northeast. Furthermore, another Ixodes species, Ixodes affinis, harbors the bacteria at a higher rate in the coastal zone, indicating a localized cycle that rarely involves human infection.
While Lyme disease is less of a concern, other tick-borne illnesses are more prevalent in South Carolina. The aggressive Lone Star Tick is the vector for Ehrlichiosis and Southern Tick-Associated Rash Illness (STARI). The American Dog Tick transmits Rocky Mountain Spotted Fever. These diseases represent a more immediate and common risk from tick bites in the region.
Tick Bite Prevention and Safe Removal
Preventing tick bites begins with taking precautions when spending time in grassy, brushy, or wooded areas. Wearing light-colored clothing makes it easier to spot ticks, and treating clothing and gear with products containing 0.5% permethrin can repel them. Using an insect repellent registered by the Environmental Protection Agency (EPA) on exposed skin is also recommended.
After returning indoors, check clothing, gear, and pets for ticks. Showering within two hours can help wash off unattached ticks. If a tick is found attached, it should be removed quickly to reduce the risk of infection, as transmission often requires the tick to feed for a day or more.
Safe Tick Removal
To safely remove an attached tick:
- Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
- Pull upward with steady, even pressure, avoiding twisting or jerking the tick.
- Thoroughly clean the bite area and hands with rubbing alcohol or soap and water after removal.
- Dispose of the tick by flushing it down the toilet or placing it in a sealed container.
Following removal, monitor the bite area and your health for several weeks for any signs of illness, such as a rash, fever, headache, or joint pain. If symptoms develop, contact a healthcare provider and inform them of the recent tick bite and the location where the exposure likely occurred.