Biltmore Forest study shows Lyme disease spreading in western North Carolina

More than 300 ticks collected from the lawns of Biltmore Forest homes after Hurricane Helene turned a small town on Asheville’s edge into a hard local measure of how far Lyme disease has moved into western North Carolina. Researchers from the University of North Carolina, the University of South Carolina and NC State University gathered the ticks over the 12 months after the storm, then sent Ixodes scapularis specimens to a Centers for Disease Control and Prevention lab in Colorado for Lyme testing.

That work matters in Buncombe County because the old assumption no longer fits. Buncombe County’s communicable disease guidance says Lyme disease now regularly occurs in Northwest North Carolina, and North Carolina health officials say it remains common in the northwestern part of the state. The state’s 2024 tickborne disease annual report said about 75% of reported Lyme cases in 2024 were most likely acquired in North Carolina, not brought in from somewhere else.

The Biltmore Forest findings fit a broader scientific shift. A 2024 peer-reviewed study said Lyme disease, once concentrated in the Northeast and upper Midwest, is expanding into southwestern Virginia and western North Carolina. UNC researchers reported in 2024 that Lyme disease had rapidly emerged in northwestern North Carolina, with some zip codes showing incidence rates similar to historically high-incidence regions in the Northeast. UNC’s Carolina Population Center later said the Biltmore Forest work showed Lyme disease is firmly established in western North Carolina.

The public-health implications reach beyond one town boundary. Buncombe County says post-exposure prophylaxis for Lyme disease is recommended under specific circumstances for people living in or traveling through Buncombe, Madison, Yancey, Mitchell, Avery, Watauga, Ashe, Alleghany, Surry and Stokes counties. The state health department advises residents to use insect repellent, remove ticks promptly and clear tick habitat around the home. The CDC says blacklegged ticks transmit Lyme disease, that cases have expanded geographically since 1995 and that bite risk is greatest in spring, summer and fall.

The risk is showing up in veterinary surveillance too. A 2024 study found a rapid increase in Borrelia burgdorferi antibodies among dogs in northwestern North Carolina from 2017 to 2021, reinforcing that the disease is moving through the same woods, yards and green spaces where people and pets spend time. In Buncombe County, Lyme disease is no longer a distant warning from New England. Biltmore Forest has made it a local reality.