UNC-led research reveals Lyme disease-carrying ticks are expanding southward in North Carolina, with 40% of blacklegged ticks in Biltmore Forest infected, prompting public health warnings and community action.
North Carolina is confronting a growing threat from ticks transmitting Lyme disease, with a UNC-led study finding infection rates in western parts of the state comparable to historic hotspots in the Northeast. Researchers in Biltmore Forest, a residential community in Buncombe County, discovered that 40% of adult blacklegged ticks carried the bacteria causing Lyme disease, while 75% of collected ticks were blacklegged. The findings, published in a study led by Dr. Ross Boyce, highlight a southward shift in tick populations and underscore the need for heightened awareness and prevention measures.
Community Alerts Spurred Research on Tick-Borne Threats
The study emerged after residents of Biltmore Forest reported multiple cases of tickborne illness, prompting Dr. Boyce and his team to investigate. Among 19 adults who self-reported tickborne illness, 17 were diagnosed with Lyme disease. That’s really what sort of perked our ears up and started this whole process,
Boyce said, referencing community reports of exposures and sickness. The research, conducted from November 2024 through August 2025, involved dragging cloth across vegetation to collect ticks, with 373 ticks tested for disease-causing bacteria.
Biltmore Forest, a town of nearly 1,500 residents, became a focal point for the study. Jonathan Kanipe, the town manager, noted that public works employees frequently encountered ticks, with one instance involving ticks found on his hands while walking near grass in a parking lot. It freaked me out because I wasn’t even walking in the woods,
Kanipe said. His collaboration with Angela Newnam helped mobilize community efforts, leading to the UNC study. Kanipe and Newnam are listed as citizen co-authors in the research.
Tick-Borne Diseases Extend Beyond Lyme, Raising Health Concerns
The study identified not only Lyme disease but also two additional pathogens in ticks: one linked to anaplasmosis and another to hard tick relapsing fever. While these were detected at lower rates than Borrelia burgdorferi, their presence marks a concerning expansion. As much as we're trying to raise awareness about people around Lyme disease, now we've suddenly got these other two tick-borne diseases that can cause important disease,
Boyce said. The CDC’s Fort Collins lab, which provided testing for the study, noted that these pathogens may now be the farthest south they’ve been detected in ticks.
The research also revealed that 17 Biltmore Forest residents said they’ve been diagnosed with the disease. They also reported cases of babesiosis and one case of ehrlichiosis, though the researchers, from both South and North Carolina, didn’t find ticks carrying the bacteria that cause these diseases. However, the researchers identified Borrelia miyamotoi in two adult ticks and two collections of pooled DNA from larval ticks. This bacterium causes hard tick relapsing fever; the most common symptom is a high temperature, though some patients experience chills or shakes, fatigue, joint pain, headache, and nausea. The findings align with broader trends of ticks expanding into southern regions, driven by warmer winters and shifting wildlife populations.
Public Health Warnings and Prevention Strategies
Boyce emphasized the importance of preventive measures, particularly for residents when traveling in the Winston-Salem or Hickory areas of the state. He recommended using DEET-based repellents, conducting frequent tick checks, and keeping grass mowed short. Lyme disease, unlike some of the other tickborne illness diseases, it does take the tick a while to actually transmit the bacteria to the person,
he explained. That’s where tick checks can make a difference.
The study’s timeline and methodology highlight the risks faced by suburban communities. Unlike forested areas, Biltmore Forest’s residential setting reflects the everyday risk people encounter. We did this in a residential community. That’s actually representative of the risk that people more likely face,
Boyce said. He noted that the blurring of wildlife and residential spaces—due to deer and small animals in backyards—increases exposure. Especially for folks who live with some woods in the backyard, there’s deer, there’s small animals, and not as much of a clean divide between what we say is wildlife and yards,
he added.
Rising Infections Outpace Awareness and Testing
A recent editorial in the Journal of the American Medical Association criticized the reliance on antibody tests that take weeks to yield results, potentially delaying treatment. Current tests are reliable once patients have been infected for several weeks and have long-term symptoms,
the author wrote, advocating for improved diagnostics to enable earlier interventions.
Health officials warn that the migration of ticks has expanded the geographic range of these diseases. Lars Eisen, a research epidemiologist at the CDC’s Division of Vector-Borne Diseases in Fort Collins, Colorado, noted that warmer winters are driving deer, mice, and other rodents—and the ticks that feed on them—into new areas. It’s important people understand the changing risks for Lyme and other tick-borne diseases,
Eisen said. The CDC’s Morbidity and Mortality Weekly Report highlighted that Biltmore Forest represents the leading edge of southward expansion
of blacklegged ticks, with 76.9% of ticks tested in the area carrying Borrelia burgdorferi.
For residents, the implications are clear. Ten western North Carolina counties now recommend a single dose of antibiotics within 72 hours of a tick bite. I did my medical school here in Chapel Hill, and the teaching at that point was there’s not much, if any, Lyme disease in North Carolina,
Boyce said. What we’ve really been trying to do is sort of raise up the red flag and say hey, this is something you really need to pay attention to and be ready for.
