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By Kenya Godette

After wrapping his two-year “Forget Tomorrow World Tour,” pop star Justin Timberlake shared a deeply personal message : he was diagnosed with Lyme disease, a bacterial infection spread by black-legged ticks.

The NSYNC icon, 44, described the disease as “relentlessly debilitating,” citing symptoms like nerve pain, fatigue and sickness. “Sharing all of this with the hope that we can all find a way to be more connected. I’d like to do my part to help others experiencing this disease too,” he wrote.

Timberlake’s call for awareness is well-timed, as health experts caution against the rapid spread of another black-legged tick transmitted illness: babesiosis. A by experts including Old ��ֱ���� University researchers like Holly Gaff, Ph.D. and the Virginia Department of Health reports babesiosis, traditionally found in the Northeast and Midwest, has spread to Mid-Atlantic states like Virginia, West Virginia Maryland and District of Columbia.

Dr. Gaff, professor and chair in the Department of Biological Sciences and director of ODU's Tick Team, spoke with ODU News about the misconceptions, treatment, symptoms and prevention of the tick-borne illness.  

What makes babesiosis a growing concern in Virginia now? 

There have been an increasing number of cases of this rare disease in our region. The emergence of any cases is noteworthy and the word from the Virginia Department of Health is there are even more cases already in 2025. This is a very serious and potentially fatal disease, so it is important that health care providers are aware it is here. 

What is babesiosis and how does it differ from Lyme disease in terms of symptoms, diagnosis and treatment? 

Lyme disease is caused by a bacteria (Borrelia burgdorferi) while babesiosis is caused by a protozoan (Babesia microti). This difference is critical for treatment. Bacteria can be treated with antibiotics, but protozoans need antiparasitic treatments. Babesiosis is more like a tick-borne version of malaria. The symptoms might start with fever, feeling poorly and body aches, but babesiosis does not have the bullseye rash that some Lyme disease sufferers have. Additionally, it is not uncommon for a person to have both Lyme disease and babesiosis at the same time from the same tick. 

Are there any factors driving the increase in tick-borne illnesses in Virginia? 

There are many challenging aspects of understanding tick-borne illness patterns. The biggest driving factor here in Virginia is the southward movement of a more aggressive variant of the black-legged or deer tick (Ixodes scapularis). We have always had the southern variant, but it is less likely to bite humans. With the dramatic increase in the white-tailed deer population in the last 50-100 years, ticks have also increased. The pathogens take a bit longer to follow after these increases, but we are now experiencing that infection curve. 

What common misconceptions do people have about tick exposure and prevention? 

Many people have two misconceptions for risk of tick exposure. First, many folks grew up only worrying about ticks in tall grass or open fields. These areas are likely to have the American dog tick, which remains true, but that tick is now the least likely to make you ill. Second, many folks are convinced that ticks fall from trees and you can wear a hat to prevent tick bites. Ticks live on the ground in the leaf litter and will crawl up you to find a good location to bite. Treating your shoes with permethrin or tucking your pants into your socks is a far more effective method for reducing tick encounters. 

How concerned should Virginians be about tick bites in suburban or even urban areas? 

In our surveillance work, we have found ticks in just about every place we have sampled. There are significantly lower risks in downtown urban areas, but anywhere there are wild animals, there is a risk of tick encounter. We have collected hundreds of thousands of ticks from our field sites since 2009, and all of those are within an hour drive of ODU's campus. The basic rule is that if you see white-tailed deer or raccoons, you are likely to find ticks. 

Has the popularity of outdoor recreation and backyard gardening contributed to increased exposure risks? 

Outdoor recreation and gardening are excellent for human mental and physical health. Humans need time outside with nature, and the risk of tick-borne diseases should not stop that. I encourage people to think about tick risk like you would think about getting dirty when going outside. You are going to encounter ticks. The goal is to be prepared. Dress in long pants, wear repellent and do a complete tick check when you come back inside just like you would wash your hands. 

With a high-profile case like Justin Timberlake’s in the news, do you think public awareness about tick-borne illnesses is shifting? 

The more awareness that we can have for tick-borne illnesses, the better. We need funding for tick surveillance and research as we truly do not understand these complex vectors and their ecology. Ticks live for two to three years, so we need long-term work to explore the impact of changing habitats, weather changes, etc.