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STARI
Sept 4, 2008 10:43:50 GMT -8
Post by LymeEnigma on Sept 4, 2008 10:43:50 GMT -8
South Med J. 2008 Jun 14. [Epub ahead of print] Southern Tick-Associated Rash Illness: Erythema Migrans Is Not Always Lyme Disease. Blanton L, Keith B, Brzezinski W. From the Medical University of South Carolina, Charleston, SC. Southern tick-associated rash illness (STARI) is a rash occurring after a tick bite. It is a form of erythema migrans, an annular rash with central clearing that is almost identical with the erythema migrans seen in Lyme disease. The etiologic agent is not known but may be a Borrelia species. The tick vector is different in the two diseases. Serious systemic complications are not currently recognized with STARI but treatment with doxycycline is prudent. Differentiating STARI from Lyme disease is discussed. PMID: 18580719 [PubMed - as supplied by publisher] www.ncbi.nlm.nih.gov/pubmed/18580719?ordinalpos=28&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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STARI
Sept 5, 2008 16:36:45 GMT -8
Post by LymeEnigma on Sept 5, 2008 16:36:45 GMT -8
Infect Dis Clin North Am. 2008 Jun;22(2):361-76, viii. STARI, or Masters disease: Lone Star tick-vectored Lyme-like illness. Masters EJ, Grigery CN, Masters RW. Ferguson Medical Group, Sikeston, MO 63801, USA. emast7456@aol.com Lyme-like illness (also known as southern tick-associated rash illness [STARI] or Masters disease) is vectored by the Lone Star tick (Amblyomma americanum). Lyme-like illness lesions, which are similar to the erythema migrans rash of Lyme disease, tend to have lymphocytic dermal infiltrates. With the exception of Borrelia lonestari, the possible causative agent or agents of Lyme-like illness have not been cultured. More research is needed to fully understand this newly recognized zoonosis. Clinicians are encouraged to increase their knowledge and awareness of this Lyme disease mimic. PMID: 18452807 [PubMed - indexed for MEDLINE] www.ncbi.nlm.nih.gov/pubmed/18452807?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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STARI
Sept 5, 2008 16:37:56 GMT -8
Post by LymeEnigma on Sept 5, 2008 16:37:56 GMT -8
Curr Top Microbiol Immunol. 2007;315:289-324. Ecological havoc, the rise of white-tailed deer, and the emergence of Amblyomma americanum-associated zoonoses in the United States. Paddock CD, Yabsley MJ. Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. cdp9@cdc.gov Two infectious diseases, and one presumably infectious disease, each vectored by or associated with the bite of the lone star tick (Amblyomma americanum), were identified and characterized by clinicians and scientists in the United States during the 1980s and 1990s. These three conditions-human monocytic (or monocytotropic) ehrlichiosis (HME), Ehrlichia ewingii ehrlichiosis, and southern tick-associated rash illness (STARI)-undoubtedly existed in the United States prior to this time. However, the near-simultaneous recognition of these diseases is remarkable and suggests the involvement of a unifying process that thrust multiple pathogens into the sphere of human recognition. Previous works by other investigators have emphasized the pivotal role of white-tailed deer (Odocoileus virginianus) in the emergence of Lyme disease, human babesiosis, and human granulocytic anaplasmosis. Because whitetails serve as a keystone host for all stages of lone star ticks, and an important reservoir host for Ehrlichia chaffeensis, E. ewingii, and Borrelia lonestari, the near-exponential growth of white-tailed deer populations that occurred in the eastern United States during the twentieth century is likely to have dramatically affected the frequency and distribution of A. americanum-associated zoonoses. This chapter describes the natural histories of the pathogens definitively or putatively associated with HME, E. ewingii ehrlichiosis, and STARI; the role of white-tailed deer as hosts to lone star ticks and the agents of these diseases; and the cascade of ecologic disturbances to the landscape of the United States that have occurred during the last 200 years that provided critical leverage in the proliferation of white-tailed deer, and ultimately resulted in the emergence of these diseases in human populations. PMID: 17848069 [PubMed - indexed for MEDLINE] www.ncbi.nlm.nih.gov/pubmed/17848069?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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STARI
Sept 5, 2008 16:39:19 GMT -8
Post by LymeEnigma on Sept 5, 2008 16:39:19 GMT -8
Vector Borne Zoonotic Dis. 2005 Winter;5(4):383-9. Distribution of borreliae among ticks collected from eastern states. Taft SC, Miller MK, Wright SM. Department of Molecular Genetics, Biochemistry, and Microbiology, University of Cincinnati, Cincinnati, Ohio, USA. Lyme disease is the most commonly reported vector-borne disease in the United States and is transmitted by Borrelia burgdorferi-infected Ixodes species. The disease is typically characterized by an erythema migrans (EM) rash at the site of tick feeding. EM rashes have also been associated with feeding by Amblyomma americanum ticks despite evidence suggesting that they are incompetent vectors for Lyme disease. In 1996, a Borrelia organism only recently cultivated in the laboratory was described in A. americanum ticks and designated B. lonestari. This Borrelia is believed to be the etiologic agent of a novel Lyme-like disease, southern tick associated rash illness (STARI). This study examined ticks collected from eight eastern states to evaluate the epidemiology of B. lonestari, B. burgdorferi, and their tick hosts. Three hundred individual or small pool samples were evaluated from tick genera that included Amblyomma, Ixodes, and Dermacentor. DNA was extracted following tick homogenization and the polymerase chain reaction (PCR) was performed using primers derived from the flagellin gene that amplify sequences from both B. burgdorferi and B. lonestari. Species specific digoxigenin labeled probes were designed and used to differentiate between B. burgdorferi and B. lonestari. Borrelia DNA was detected in approximately 10% of the A. americanum and I. scapularis tick samples, but none was present in any of the Dermacentor samples tested. Positive samples were detected in ticks collected from Kentucky, Maryland, Massachusetts, New Jersey, New York, and Virginia. This is the first known report of B. lonestari from Massachusetts and New York and the first detection in I. scapularis. This suggests that B. lonestari and its putative association with STARI may be more widespread than previously thought. PMID: 16417434 [PubMed - indexed for MEDLINE] www.ncbi.nlm.nih.gov/pubmed/16417434?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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STARI
Sept 5, 2008 16:41:15 GMT -8
Post by LymeEnigma on Sept 5, 2008 16:41:15 GMT -8
Serologic Evaluation of Patients from Missouri with Erythema Migrans-Like Skin Lesions with the C6 Lyme Test Mario T. Philipp,1* Edwin Masters,2 Gary P. Wormser,3 Wayne Hogrefe,4 and Dale Martin1 Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana,1 Family Practice of Dr. Edwin Masters, Cape Girardeau, Missouri,2 Division of Infectious Diseases, Department of Medicine of New York Medical College, Valhalla, New York,3 Focus Diagnostics, Inc., Cypress, California4 Received 26 June 2006/ Accepted 27 July 2006 ABSTRACT Southern tick-associated rash illness (STARI), also known as Masters disease, affects people predominantly in the Southeast and South Central United States. These patients exhibit skin lesions that resemble erythema migrans (EM), the characteristic skin lesion in early Lyme disease. The etiology of STARI remains unknown, and no serologic test is available to aid in its diagnosis. The C6 Lyme enzyme-linked immunosorbent assay was used to evaluate coded serum specimens from patients with STARI at two laboratory sites. The specimens tested at one site consisted of acute- and convalescent-phase samples that were obtained from nine STARI patients from Missouri and from one patient with documented Borrelia lonestari infection who acquired this infection in either North Carolina or Maryland. All of these samples were C6 negative. Seventy acute- or convalescent-phase specimens from 63 STARI patients from Missouri were C6 tested at the second site. All but one of these STARI specimens were also negative. In contrast, of nine acute- and nine convalescent-phase serum specimens obtained from culture-confirmed Lyme disease patients with EM from New York state, seven were C6 positive at the acute stage, and eight were positive at convalescence. The C6 test is negative in patients with STARI, providing further evidence that B. burgdorferi is not the etiologic agent of this disease. Full text: cvi.asm.org/cgi/content/full/13/10/1170?view=long&pmid=17028220
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STARI
Sept 5, 2008 16:42:30 GMT -8
Post by LymeEnigma on Sept 5, 2008 16:42:30 GMT -8
First Culture Isolation of Borrelia lonestari, Putative Agent of Southern Tick-Associated Rash Illness Andrea S. Varela,1 M. Page Luttrell,2 Elizabeth W. Howerth,3 Victor A. Moore,1 William R. Davidson,2,4 David E. Stallknecht,1,2 and Susan E. Little1* Department of Medical Microbiology and Parasitology,1 Southeastern Cooperative Wildlife Disease Study,2 Department of Pathology, College of Veterinary Medicine,3 Warnell School of Forest Resources, University of Georgia, Athens, Georgia 306024 Received 25 August 2003/ Returned for modification 5 October 2003/ Accepted 5 November 2003 ABSTRACT Southern tick-associated rash illness (STARI) is a Lyme disease-like infection described in patients in the southeastern and south-central United States, where classic Lyme disease is relatively rare. STARI develops following the bite of a lone star tick (Amblyomma americanum) and is thought to be caused by infection with an "uncultivable" spirochete tentatively named Borrelia lonestari. In this study, wild lone star ticks collected from an area where B. lonestari is endemic were cocultured in an established embryonic tick cell line (ISE6). The cultures were examined by dark-field microscopy for evidence of infection, and spirochete identity and morphology were evaluated by flagellin B and 16S rRNA gene sequence, by reaction to Borrelia-wide and B. burgdorferi-specific monoclonal antibodies, and by electron microscopy. Live spirochetes were first visualized in primary culture of A. americanum ticks by dark-field microscopy 14 days after the cell culture was inoculated. The sequences of the flagellin B and 16S rRNA genes of cultured spirochetes were consistent with previously reported sequences of B. lonestari. The cultured spirochetes reacted with a Borrelia-wide flagellin antibody, but did not react with an OspA antibody specific to B. burgdorferi, by indirect fluorescent antibody testing. Electron microscopy demonstrated organisms that were free and associated with ISE6 cells, with characteristic Borrelia sp. morphology. This study describes the first successful isolation of B. lonestari in culture, providing a much needed source of organisms for the development of diagnostic assays and forming a basis for future studies investigating the role of the organism as a human disease agent. Full article: jcm.asm.org/cgi/content/full/42/3/1163?view=long&pmid=15004069
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