Nearly 40 percent of adult blacklegged ticks collected from residential yards in a small town outside Asheville tested positive for the bacterium that causes Lyme disease, a rate comparable to parts of the Northeast, mid-Atlantic, and upper Midwest where the illness is long established. The finding was published this week in the CDC’s Morbidity and Mortality Weekly Report.
The number carries a second, harder implication for families in western North Carolina. Many clinicians practicing in the region were trained when Lyme disease was considered a northern problem. That training gap is how symptoms get attributed to something else for years.
The study was conducted by researchers from the University of South Carolina, the University of North Carolina at Chapel Hill, and North Carolina State University, working with a residents’ task force in the town of Biltmore Forest.
Inside the Yards of a 1,600 Acre Town
Between November 2024 and August 2025, the team collected 373 ticks from 25 residential properties, dragging cloth across yards each month at 22 of them and accepting specimens that residents collected themselves. Of those ticks, 287, or about 77 percent, were blacklegged ticks, the primary vector of Lyme disease in the eastern United States.
Testing at CDC’s vector-borne disease laboratory in Fort Collins found 19 of 48 adult blacklegged ticks, 39.6 percent, positive for Borrelia burgdorferi, along with three of seven nymphs. Investigators also detected Borrelia miyamotoi in two adults and two larval pools, and the human active strain of Anaplasma phagocytophilum in four adults. Both can cause serious illness. The MMWR report notes these may represent the farthest south those two pathogens have been identified in blacklegged tick populations.
Earlier surveys of public lands in surrounding Buncombe County found infection rates of 13 to 17 percent in nymphs and 25 percent in adults. Because these ticks came from residential yards rather than trails, the authors write that the higher figure suggests greater potential for human disease than previous work indicated.
The Diagnostic Gap the Study Was Built Around
The research grew out of a resident’s long search for an answer. Angela Newnam, now a co-author, spent years pursuing a diagnosis after a bite she got doing yard work in 2015 was initially attributed to a spider. She eventually tested positive for Lyme-related antibodies and worked with town leaders to organize local tick surveillance, which led to the town task force and, in turn, to the research partnership.
“If you find a doctor practicing in western North Carolina who was trained in the mid-90s or earlier, they would’ve been taught that there was no Lyme disease in North Carolina, and a lot of people still have that mentality,” Michael Reiskind, an NC State entomologist and study co-author, told Asheville Watchdog.
Dr. Ross Boyce of the UNC School of Medicine, a co-senior author, framed the stakes in terms of timing. “Lyme disease can be a life-changing diagnosis, especially if not diagnosed and treated early,” he said in a university statement. “The pace at which we’ve gone from zero-to-sixty, essentially within a 10-year period, means that we are behind.”
Reading the Evidence Honestly
This is tick surveillance, not a human incidence study, and the authors list five limitations plainly. The community survey drew a 12.5 percent response rate, which raises the risk of selection bias. Most of the 19 reported human tickborne illnesses were self-reported, and only four people provided medical records. The collection began shortly after Hurricane Helene, and no comparable pre-storm data exist. Monthly collection over one to three days at a time, across a small dragging area, limits conclusions about tick density and seasonality.
None of that undercuts the pathogen finding, which came from laboratory testing of individual ticks rather than from recollection. What it means is that the report establishes elevated exposure risk in a specific place, not a countywide case count. Several authors also disclosed relevant support, including funding from the state health department for tick surveillance, consulting income from a company that makes repellent-treated clothing, and membership on a diagnostic scientific board.
State guidance already reflects the shift. North Carolina public health officials recommend post-exposure preventive treatment with a single dose of doxycycline under specific conditions for people living in or traveling to ten counties: Buncombe, Madison, Yancey, Mitchell, Avery, Watauga, Ashe, Alleghany, Surry, and Stokes. Those counties were selected because they had a high incidence of human Lyme disease or sit between two high-incidence counties, according to state guidance for clinicians. Buncombe, where Biltmore Forest sits, is the southernmost.
Symptoms That Justify Naming Ticks Out Loud
The practical takeaway is a conversational one. Clinicians order Lyme testing when they are prompted to consider it, so patients in the region benefit from mentioning outdoor exposure directly rather than waiting to be asked.
An expanding rash at a bite site, particularly one that clears in the center, is the classic sign, though it does not always appear. Fever, chills, headache, fatigue, muscle and joint aches after outdoor time are worth reporting. Later stage signs include facial drooping, migrating joint swelling, heart rhythm irregularities, and neurological symptoms such as numbness, neck stiffness, or vision changes. Fever with severe fatigue and no rash can point toward anaplasmosis or a Borrelia miyamotoi infection, which requires different consideration than Lyme alone.
Prevention has not changed and remains effective. CDC guidance calls for EPA-registered repellent, permethrin-treated clothing, long pants tucked into tall socks, a full body check after time outdoors, and showering soon after coming inside. Yard measures that discourage deer and rodents reduce the local tick burden. MedicalDaily previously published a full-body tick check guide for peak season.
The research team is working with the town on a response plan that includes reducing tick populations and improving access to appropriate care, and is expanding surveillance into more rural counties around Asheville. The authors also recommend a public health alert for primary care, urgent care, and infectious disease clinicians in the region, which would be the next concrete step to watch for.
Key Questions Answered
What did the study find? About 40 percent of adult blacklegged ticks collected from residential yards in Biltmore Forest carried the bacterium that causes Lyme disease, a rate similar to regions where the disease is endemic.
Does this mean Lyme cases are rising in Asheville? The report measures pathogen prevalence in ticks, not confirmed human cases. It establishes an elevated exposure risk rather than a case count.
Which other pathogens were detected? Borrelia miyamotoi and the human active strain of Anaplasma phagocytophilum, both capable of causing serious illness and possibly detected here farther south than previously documented.
Why do local diagnoses get missed? Many clinicians in the region were trained when Lyme was considered absent from North Carolina, and testing is generally ordered only when a provider considers the possibility.
What symptoms should prompt a conversation about ticks? An expanding rash, or fever, chills, headache, fatigue, and body aches after outdoor exposure. Facial drooping, joint swelling, numbness, or vision changes warrant prompt evaluation.
How can households reduce risk? EPA-registered repellent, permethrin-treated clothing, tucked pants, a full body check after time outdoors, showering soon after, and yard changes that discourage deer and rodents.
Is Lyme disease treatable? Yes. Early Lyme disease responds well to antibiotics. Delayed diagnosis is associated with more complicated illness, which is why early recognition matters.