Tickborne Disease 

Healthcare Professionals: Common Ticks | Anaplasmosis | Ehrlichiosis | Lyme Disease | Rocky Mountain Spotted Fever | STARI | Tularemia

Lyme Disease

According to the CDC case definition for Lyme disease, Arkansas is considered a low-incidence state meaning there are less than 10 confirmed cases per 100,000 people for the previous three reporting years. Ninety-five percent of Lyme disease cases come from 14 states. They are concentrated heavily in the Northeastern, Mid-Atlantic, and upper Midwestern states. Verified cases reported from other US states are usually associated with travel to states with high rates of infection. Lyme disease is caused by the bacterium Borrelia burgdorferi, and it is transmitted to humans through the bite of infected blacklegged ticks.


Lyme disease testing and interpretation is complicated. CDC currently recommends a two-step process when testing blood for evidence of antibodies against the Lyme disease bacteria. Both steps can be done using the same blood sample. The two steps of Lyme disease testing are designed to be done together. CDC does not recommend skipping the first test and just doing the Western blot. Doing so will increase the frequency of false positive results and may lead to misdiagnosis and improper treatment. Some laboratories offer Lyme disease testing using assays whose accuracy and clinical usefulness have not been adequately established New tests may be developed as alternatives to one or both steps of the two-step process, but before CDC will recommend new tests, their performance must be demonstrated to be equal to or better than the results of the existing procedure, and they must be FDA approved.


Number Cases 2015-2016



Associated with travel



No travel





Northern vs. Southern I.scapularis




Found on humans?



Stromdahl and Hickling 2012

Collected by drag sampling



Diuk-Wasser et al. 2006

Most common host of larvae



Apperson et al. 1993

Questing behavior

On stems

In leaf litter

Arsnoe et al. 2015

For more information, click here to view our Grand Rounds presentation "Does Arkansas Have Lyme Disease?"


· Fever
· Headache
· Fatigue
· A characteristic skin rash called erythema migrans (bulls-eye)

If left untreated, infection can spread to joints, the heart, and the nervous system.
Most cases of Lyme disease can be treated successfully with antibiotics. The ticks that transmit Lyme disease can transmit other tickborne diseases as well.

For Health Care Professionals: Diagnosis, Treatment and Testing

Because Arkansas is categorized as a low-incidence state, healthcare professionals should consider other diagnosis first, like: viral infections, STARI, fibromyalgia, or arthritis.

For Health Care Professionals: Case Definition

The Arkansas Department of Health utilizes the Centers for Disease Control and Prevention (CDC) case definition for Lyme disease for reporting and surveillance purposes. Current case definitions for all tickborne diseases can be found on the CDC website.

In low-incidence states, like Arkansas, a case of Lyme is classified as confirmed with a case of EM rash with laboratory evidence of infection and a known exposure, or any case with at least one late manifestation that has laboratory evidence of infection.

Points for Patients

The Arkansas Department of Health is not responsible for diagnosing and testing for Lyme disease. ADH is mainly responsible for reporting laboratory and health care professional confirmed cases for surveillance purposes. It is important to recognize cases of Lyme when they occur, so ADH examines every Lyme disease related lab result that is reported.

It is possible to get Lyme in the state of Arkansas, but it is not common because of the apparent process of transmission in the state. 

The blacklegged tick can be found in parts of Arkansas. To avoid all tickborne illnesses, you can take these measures to prevent tick bites.