Lyme disease is one of the most frequently discussed and frequently misunderstood tick-borne illnesses in the United States. In Florida, the question of whether Lyme disease is truly a significant concern — versus a condition vastly overdiagnosed through inaccurate testing — is one that our specialists at Florida Infectious Disease Care navigate carefully and regularly.
The answer is nuanced. Lyme disease in Florida does exist, but it is less common than in the northeastern United States, and the diagnosis is frequently applied incorrectly to patients who may have other tick-borne or non-infectious conditions. This guide gives you the evidence-based facts you need to understand your real risk and make informed decisions about testing.
What Is Lyme Disease?
Lyme disease is a bacterial infection caused by Borrelia burgdorferi, transmitted to humans through the bite of infected Ixodes ticks — commonly called black-legged ticks or deer ticks. In the United States, Lyme disease is most heavily concentrated in the Northeast, Upper Midwest, and parts of the Pacific Coast, where the Ixodes scapularis tick population is dense and commonly infected with Borrelia.
According to the CDC, approximately 476,000 people are diagnosed with and treated for Lyme disease in the United States each year. However, the geographic distribution is highly uneven — the majority of confirmed cases occur in just 14 states, primarily in the Northeast and Midwest.
Is Lyme Disease Real in Florida?
Yes — but in a more limited way than many patients expect. Florida does have Ixodes ticks, and confirmed cases of Lyme disease do occur in the state. However, the rate of Lyme disease in Florida is significantly lower than in high-endemic states for several interconnected reasons:
Tick Species and Infection Rates
The primary tick in Florida is the Lone Star tick (Amblyomma americanum) and the American dog tick (Dermacentor variabilis). Neither of these tick species transmits Borrelia burgdorferi efficiently. The black-legged tick (Ixodes scapularis) does exist in Florida — particularly in the northern and panhandle regions — but the rate of Borrelia infection in Florida’s Ixodes ticks is considerably lower than in northeastern populations.
Climate and Habitat
Florida’s hot, humid climate and distinct ecosystem differ markedly from the northeastern forests where Lyme disease transmission is most efficient. The white-footed mouse — the primary reservoir for Borrelia in ticks — is less prevalent in Florida than in northeastern states, reducing the cycle of tick infection.
Southern Tick-Associated Rash Illness (STARI)
A condition called Southern Tick-Associated Rash Illness (STARI) is transmitted by Lone Star ticks in Florida and can produce a rash resembling Lyme disease, as well as fatigue and joint pain. STARI is caused by a different organism — Borrelia lonestari — and its full clinical picture is still being studied. Importantly, STARI does not respond to Lyme disease testing in the same way and may account for some diagnoses that are attributed to Lyme disease in Florida.
Symptoms of Lyme Disease to Watch For
Early Lyme disease — if acquired from a genuine Ixodes tick bite with Borrelia infection — typically presents within 3 to 30 days after the bite with:
- A characteristic expanding rash called erythema migrans — a red, circular or oval rash often described as a bull’s-eye pattern, though not all cases show this pattern
- Fever, chills, fatigue, and muscle or joint aches
- Headache and swollen lymph nodes near the bite site
If untreated, later stages of Lyme disease can involve joint inflammation — particularly in the knees — neurological symptoms such as facial palsy, and in rare cases, heart rhythm abnormalities. These later manifestations occur weeks to months after the initial infection.
The Problem of Lyme Disease Overdiagnosis in Florida
One of the most significant challenges in Lyme disease management in Florida — and across the southern United States — is overdiagnosis. A large number of patients present to clinics having received a Lyme disease diagnosis based on symptoms alone, or through commercial lab tests that are not validated by established scientific standards.
Symptoms such as fatigue, joint pain, brain fog, and headaches are extremely common and have many causes — including other tick-borne diseases, autoimmune conditions, thyroid disorders, sleep disorders, and depression. When these symptoms are inappropriately attributed to Lyme disease and treated with prolonged antibiotic courses not supported by evidence, patients may delay finding the actual cause of their illness while being exposed to unnecessary antibiotic risks.
Our infectious disease specialists approach Lyme disease testing and diagnosis using the two-tier testing protocol recommended by the CDC and the Infectious Diseases Society of America — an enzyme immunoassay (EIA) followed by a confirmatory Western blot — rather than non-standardized commercial testing panels.
Other Tick-Borne Diseases in Southwest Florida
While Lyme disease is less common in Southwest Florida, other tick-borne illnesses are genuinely present and should be considered in patients with tick exposure and compatible symptoms:
- Rocky Mountain Spotted Fever (RMSF) — caused by Rickettsia rickettsii, transmitted by the American dog tick; potentially fatal without prompt doxycycline treatment
- Ehrlichiosis — caused by Ehrlichia species, transmitted by Lone Star ticks; presents with fever, headache, and low white blood cell count
- Anaplasmosis — caused by Anaplasma phagocytophilum; similar presentation to ehrlichiosis
- Tularemia — rare but present in Florida; caused by Francisella tularensis through tick or other arthropod bites
If you have had a tick bite in Southwest Florida and develop fever, rash, or severe headache within two to four weeks, prompt medical evaluation is critical. Rocky Mountain Spotted Fever in particular can be rapidly fatal without treatment.
When Should You Be Tested for Lyme Disease Florida?
Testing for Lyme disease is appropriate when:
- You have the characteristic expanding bull’s-eye rash following a tick bite — particularly after travel to a high-endemic area such as the northeastern United States
- You have had a confirmed Ixodes tick bite and develop fever or flu-like symptoms within 30 days
- You traveled to a Lyme-endemic region and developed compatible symptoms
Testing is generally not recommended — and not reliable — in the absence of epidemiologically plausible exposure, because false-positive results from non-specific immune reactions can lead to unnecessary antibiotic treatment. Our specialists will take a thorough history of your tick exposures, travel history, and symptom timeline before recommending or ordering Lyme disease testing.
Frequently Asked Questions
Q: I found a tick on me in Fort Myers — should I be tested for Lyme disease?
Not immediately. The risk of Lyme disease from a single tick bite in Southwest Florida is low. The tick species common in our region does not efficiently transmit Borrelia. Additionally, even in endemic areas, a tick typically needs to be attached for 36 to 48 hours to transmit the bacteria. Remove the tick promptly with fine-tipped tweezers, clean the area, and monitor for symptoms. Contact our office if you develop a rash, fever, or significant joint pain within the following month.
Q: What is chronic Lyme disease and is it recognized by infectious disease specialists?
Post-treatment Lyme disease syndrome (PTLDS) — the persistence of fatigue, pain, or cognitive symptoms after completing standard Lyme treatment — is a recognized phenomenon. However, the term chronic Lyme disease as used in some non-mainstream medical settings — implying ongoing active infection requiring months or years of antibiotics — is not supported by clinical evidence. Multiple rigorous clinical trials have shown that prolonged antibiotic therapy beyond the standard course provides no benefit and carries real risks. Our specialists are experienced in evaluating these complex presentations and will work with you to identify treatable causes of persistent symptoms.
Q: Can my dog give me Lyme disease?
No — not directly. Dogs can carry infected ticks into your home and yard, increasing your exposure to tick bites. However, dogs themselves do not transmit Lyme disease to humans. If your dog has been diagnosed with Lyme disease, it is a signal that you may be in an environment with infected ticks and should take appropriate precautions.
Q: How can I protect myself from tick-borne diseases in Southwest Florida?
Use EPA-registered insect repellents containing DEET, picaridin, or permethrin on clothing and skin when spending time outdoors in wooded or grassy areas. Wear long sleeves and pants, tuck pants into socks, and perform a thorough tick check after outdoor activities. Shower within two hours of coming indoors. Remove any attached ticks promptly with fine-tipped tweezers, grasping as close to the skin as possible.
Ready to Take the Next Step?
At Florida Infectious Disease Care in Fort Myers, our board-certified specialists deliver compassionate, expert, and completely confidential care for every patient. Whether you have questions or are ready to book your first appointment, we are here for you. Call us at 239-245-8223 or visit us at 14192 Metropolis Ave, Fort Myers, FL 33912.
Schedule your appointment online at floridaidcare.com/make-an-appointment or find us on Google Maps. You deserve expert care — and we are ready when you are.