Abstract
Lyme disease, caused by the spirochete Borrelia burgdorferi, is traditionally associated with temperate regions of the Northern Hemisphere, where it is transmitted by Ixodes ticks. However, with climate change, globalization, and increased human and animal mobility, there is growing concern about the potential emergence and spread of Lyme disease in tropical regions, including island nations like Fiji. This article explores the feasibility of Lyme disease establishment in Fiji by examining environmental suitability, vector presence, host availability, and socio-economic challenges unique to tropical settings. Through a situational analysis and comprehensive literature review, the study identifies critical gaps in surveillance, diagnostics, and public health infrastructure that could exacerbate the spread of tick-borne diseases in Fiji. The implications for tropical regions are discussed, focusing on the intersection of climate change, ecological shifts, and public health vulnerabilities. Recommendations include enhancing vector monitoring, improving diagnostic capacity, and fostering regional collaboration to mitigate risks. This analysis underscores the urgent need to address emerging infectious diseases in non-traditional areas to protect public health in the face of global environmental changes.
Introduction
Lyme disease, a tick-borne illness caused by Borrelia burgdorferi and related species, is one of the most prevalent vector-borne diseases in temperate regions of North America, Europe, and parts of Asia. The disease manifests with a range of symptoms, from the characteristic erythema migrans rash to severe neurological and cardiac complications if left untreated. Transmission occurs primarily through the bite of infected Ixodes ticks, which thrive in forested, humid environments with abundant mammalian hosts such as deer and rodents (Steere et al., 2016). Historically, Lyme disease has been confined to specific ecological zones in the Northern Hemisphere, but recent evidence suggests a shifting geographical range due to climate change, urbanization, and increased international travel (Ogden et al., 2019).
Fiji, a tropical archipelago in the South Pacific, is not currently recognized as an endemic region for Lyme disease. Its climate, characterized by high temperatures and humidity, differs significantly from the cooler, temperate conditions typically associated with Ixodes ticks. However, the potential for vector-borne diseases to emerge in new regions has been highlighted by the spread of other pathogens like dengue and Zika in tropical areas (Messina et al., 2019). Factors such as climate warming, which may expand the habitable range of ticks, and the introduction of pathogens through migratory birds or human travel, raise questions about the risk of Lyme disease in Fiji. Additionally, Fiji’s ecological diversity, reliance on tourism, and limited public health resources pose unique challenges for monitoring and managing emerging infectious diseases.
This article aims to explore the potential spread of Lyme disease in Fiji, focusing on environmental, biological, and socio-economic factors that could facilitate or hinder its establishment. By analyzing the current situation in Fiji, reviewing global trends in Lyme disease epidemiology, and discussing implications for tropical regions, this study seeks to provide a framework for understanding and addressing this emerging threat. The ultimate goal is to inform policy and research efforts to safeguard public health in Fiji and similar tropical environments.
Situational Analysis
Fiji, comprising over 300 islands, is located in the South Pacific and experiences a tropical maritime climate with average temperatures ranging from 22°C to 31°C and high annual rainfall. The country’s ecosystems include rainforests, mangroves, and coastal regions, which support a diverse range of flora and fauna. While ticks are present in Fiji, species known to transmit Lyme disease, such as Ixodes scapularis and Ixodes pacificus, have not been documented in the region. Instead, ticks like Rhipicephalus sanguineus, commonly associated with dogs, are more prevalent, though their competence as vectors for Borrelia species remains unclear (Walker et al., 2014).
Human activities in Fiji, including agriculture, tourism, and urbanization, create opportunities for vector-host interactions. Tourism, a major economic driver, brings millions of visitors annually from Lyme-endemic regions, potentially introducing pathogens through infected travelers or their pets. Additionally, climate change is altering ecosystems in Fiji, with rising temperatures and changing precipitation patterns potentially creating more favorable conditions for tick survival and reproduction. A study by the U.S. Environmental Protection Agency (2025) highlights how climate change indicators are linked to the increasing incidence of Lyme disease in non-traditional areas, a trend that could extend to tropical regions like Fiji under certain conditions.
Public health infrastructure in Fiji faces significant challenges, including limited resources for disease surveillance, diagnostic capacity, and vector control. While the country has made strides in managing other vector-borne diseases like dengue and lymphatic filariasis (as documented in studies like TropMedHealth, 2020), there is little to no specific monitoring for tick-borne diseases. This gap is compounded by low awareness among healthcare providers and the general population about Lyme disease symptoms and risks, potentially leading to underdiagnosis or misdiagnosis.
Social determinants of health, such as poverty, limited access to healthcare in rural areas, and reliance on subsistence farming, further complicate the situation. In rural Fiji, communities often live in close proximity to wildlife and domestic animals, increasing exposure to potential vectors. Combined with the ecological pressures of deforestation and land use change, these factors create a complex landscape for assessing the risk of Lyme disease emergence. Without baseline data on tick populations, pathogen prevalence, or human cases, Fiji remains vulnerable to undetected spread if conditions become favorable for Lyme disease transmission.
Literature Review
The global epidemiology of Lyme disease provides critical insights into its potential spread to tropical regions like Fiji. Lyme disease is most prevalent in temperate zones, with over 400,000 annual cases reported in the United States alone (CDC, 2025). The disease’s distribution is closely tied to the ecological requirements of Ixodes ticks, which prefer cool, humid environments with dense vegetation and abundant vertebrate hosts (Steere et al., 2016). However, climate change is expanding the geographical range of these ticks, pushing them into higher altitudes and latitudes previously considered unsuitable (Ogden et al., 2019). Studies have also identified Borrelia species in migratory birds, suggesting a mechanism for long-distance dispersal of the pathogen into new regions (Kurtenbach et al., 2006).
In tropical regions, Lyme disease remains rare, but there is growing evidence of related borrelial infections. Research in Africa, for instance, has documented the presence of Lyme group borreliae in ticks and humans, particularly in countries bordering the Mediterranean, where climatic and ecological conditions overlap with temperate zones (Cutler et al., 2024). These findings suggest that tropical environments may not be entirely inhospitable to Lyme disease, especially in areas with cooler microclimates or during seasonal shifts. However, the absence of competent Ixodes vectors in many tropical regions, including Fiji, currently limits the risk of sustained transmission.
Vector competence is a critical factor in Lyme disease epidemiology. Ixodes ticks are highly specialized vectors for Borrelia burgdorferi, with life cycles intricately tied to specific host species. In contrast, tropical ticks like Rhipicephalus and Amblyomma species are adapted to different hosts and pathogens, such as those causing African tick-bite fever (Walker et al., 2014). While these ticks are not currently known to transmit Lyme disease, genetic reassortment or adaptation could theoretically enable new transmission pathways. Moreover, the introduction of Ixodes ticks through global trade or travel poses a latent risk, as seen with other invasive species disrupting local ecosystems (Simberloff, 2013).
Climate change exacerbates these risks by altering vector habitats and host dynamics. Warmer temperatures and increased humidity can accelerate tick life cycles, while changing migration patterns of birds and mammals may introduce pathogens to naive populations (Ogden et al., 2019). For tropical regions like Fiji, the intersection of climate change with other public health challenges—such as high burdens of mosquito-borne diseases—diverts resources and attention from emerging threats like Lyme disease. Recent discussions on climate-driven disease shifts emphasize the need for proactive surveillance in non-endemic areas (Health Journalism, 2025).
Socio-economic factors also play a significant role in the spread and control of Lyme disease. In low- and middle-income countries, limited healthcare infrastructure, inadequate diagnostic tools, and low awareness among medical professionals hinder early detection and treatment (Stanek et al., 2012). In Fiji, where public health efforts are focused on endemic diseases like leptospirosis and dengue, the introduction of a new pathogen like Borrelia burgdorferi could strain existing systems (Transactions of The Royal Society of Tropical Medicine and Hygiene, 2025). Furthermore, cultural practices and economic reliance on tourism may increase human exposure to vectors, as outdoor activities and international travel facilitate contact with potential reservoirs or infected individuals.
Despite these concerns, there is a notable lack of research specific to Lyme disease in Fiji or the broader South Pacific. While studies on other vector-borne diseases provide useful parallels (e.g., TropMedHealth, 2020), the unique characteristics of Lyme disease transmission necessitate targeted investigations into local tick populations, pathogen prevalence, and environmental suitability. This gap in knowledge underscores the importance of the present analysis in identifying potential risks and guiding future research efforts.
Discussion
The potential spread of Lyme disease to Fiji raises several critical issues, spanning ecological, climatic, and socio-economic dimensions. At the ecological level, Fiji’s tropical environment presents both barriers and opportunities for Lyme disease establishment. High temperatures and humidity may inhibit the survival of Ixodes ticks, which prefer cooler conditions. However, microclimates in elevated, forested areas of Fiji’s larger islands, such as Viti Levu, could theoretically support small populations of introduced ticks. Additionally, the presence of alternative tick species raises the question of whether native vectors could adapt to transmit Borrelia species over time, a phenomenon observed in other regions with non-traditional vectors (Cutler et al., 2024).
Climate change is a pivotal factor in this discussion. Rising global temperatures and shifting weather patterns are expanding the range of many vector-borne diseases, as documented in studies linking climate indicators to Lyme disease incidence (EPA, 2025). In Fiji, changing ecosystems due to deforestation and agricultural expansion further complicate the picture by altering host availability and habitat suitability. Migratory birds, which frequently transit through the Pacific, could serve as reservoirs, introducing Borrelia to local wildlife or ticks. This risk is heightened by Fiji’s position as a hub for international travel, where tourists or returning residents from endemic areas could inadvertently carry infected ticks or pathogens.
From a public health perspective, Fiji’s current infrastructure is ill-prepared to detect or manage Lyme disease. Diagnostic tools for Borrelia infection, such as serologic testing, are not widely available, and clinical expertise in recognizing Lyme disease is limited. Misdiagnosis is a significant concern, as early symptoms like fever and fatigue overlap with more common tropical illnesses such as dengue or leptospirosis. Delayed diagnosis could lead to chronic complications, placing additional burden on an already strained healthcare system. Moreover, vector control programs in Fiji primarily target mosquitoes, with little emphasis on ticks, highlighting a gap in surveillance and prevention strategies.
The implications for tropical regions extend beyond Fiji. Many small island developing states share similar vulnerabilities, including reliance on tourism, limited resources, and high exposure to climate change impacts. The emergence of Lyme disease in such areas could have cascading effects on public health, economic stability, and ecological balance. For instance, a Lyme disease outbreak among tourists could deter visitors, undermining economies heavily dependent on tourism revenue. Additionally, the disease’s impact on rural communities, who often lack access to timely medical care, could exacerbate health disparities.
However, several mitigating factors suggest that the immediate risk of Lyme disease in Fiji remains low. The absence of known Ixodes vectors, coupled with the pathogen’s limited adaptation to tropical climates, provides a natural barrier to transmission. Furthermore, Fiji’s geographic isolation may reduce the likelihood of sustained pathogen introduction compared to continental regions with greater connectivity. Nevertheless, these factors do not eliminate the need for vigilance, as global trends in disease spread underscore the unpredictability of ecological and epidemiological shifts.
Addressing these challenges requires a multifaceted approach that integrates environmental monitoring, public health preparedness, and community engagement. The discussion around Lyme disease in Fiji serves as a case study for broader tropical regions, where emerging infectious diseases are increasingly intertwined with global environmental changes. By preemptively addressing these risks, tropical nations can build resilience against not only Lyme disease but also other vector-borne threats that may arise in the future.
Recommendations
Based on the analysis of Lyme disease risks in Fiji, the following recommendations are proposed to mitigate potential spread and enhance preparedness in tropical regions:
- Establish Vector Surveillance Programs: Implement systematic surveys of tick populations in Fiji to identify species present, their distribution, and potential competence as vectors for Borrelia species. Collaborate with regional entomologists to monitor for the introduction of Ixodes ticks through trade or travel.
- Enhance Diagnostic Capacity: Invest in training healthcare providers to recognize Lyme disease symptoms and ensure access to diagnostic tools, such as enzyme-linked immunosorbent assays (ELISA) and Western blot testing, in major health centers. Develop protocols for differentiating Lyme disease from other endemic illnesses with similar presentations.
- Strengthen Public Health Infrastructure: Allocate resources for disease surveillance and reporting systems specific to tick-borne illnesses. Integrate tick control measures into existing vector management programs, focusing on high-risk areas like forested regions and tourist destinations.
- Raise Public Awareness: Launch educational campaigns targeting both residents and visitors about the risks of tick bites, protective measures (e.g., wearing long sleeves, using repellents), and the importance of early medical consultation for suspicious symptoms. Tailor messaging to rural communities with higher exposure risks.
- Promote Research on Local Ecology: Fund studies on the interaction between local wildlife, domestic animals, and ticks to assess the potential for reservoir hosts in Fiji. Investigate the role of migratory birds in pathogen dispersal through the Pacific region.
- Foster Regional Collaboration: Partner with other Pacific Island nations and international health organizations, such as the World Health Organization (WHO), to share data, resources, and best practices for managing emerging vector-borne diseases. Participate in global networks tracking Lyme disease spread.
- Address Climate Change Impacts: Incorporate vector-borne disease risks into national climate adaptation plans, prioritizing ecosystem preservation and sustainable land use practices to minimize habitat changes that favor tick proliferation.
Implementing these recommendations will require coordinated efforts between government agencies, healthcare providers, researchers, and community leaders. While the current risk of Lyme disease in Fiji appears limited, proactive measures are essential to prevent future emergence and ensure rapid response capabilities.
Conclusion
The potential spread of Lyme disease to Fiji represents a complex intersection of ecological, climatic, and public health challenges unique to tropical regions. While the country’s environment and current vector profile suggest a low immediate risk, factors such as climate change, globalization, and socio-economic vulnerabilities highlight the need for preparedness. This article has explored the feasibility of Lyme disease establishment in Fiji through a situational analysis, literature review, and discussion of broader implications for tropical areas. Key findings indicate that gaps in surveillance, diagnostics, and awareness could exacerbate risks if conditions become favorable for transmission.
The recommendations provided offer a roadmap for Fiji and similar regions to strengthen resilience against Lyme disease and other emerging vector-borne threats. By prioritizing vector monitoring, public health capacity, and regional collaboration, tropical nations can mitigate the potential impact of diseases traditionally associated with temperate zones. Ultimately, this analysis underscores the importance of anticipatory action in the face of global environmental changes, ensuring that even low-probability risks are addressed before they manifest into significant public health challenges. Future research should focus on filling knowledge gaps specific to the South Pacific, enabling evidence-based strategies to protect vulnerable populations in an increasingly interconnected world.
References
- Centers for Disease Control and Prevention (CDC). (2025). Lyme Disease Case Maps. Available at: https://www.cdc.gov/lyme/data-research/facts-stats/lyme-disease-case-map.html
- Cutler, S. J., et al. (2024). Review of Lyme Borreliosis in Africa—An Emerging Threat in Africa. PMC. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11591761/
- Kurtenbach, K., et al. (2006). Host association of Borrelia burgdorferi sensu lato – the key role of host complement. Trends in Microbiology, 14(2), 74-79.
- Messina, J. P., et al. (2019). The current and future global distribution and population at risk of dengue. Nature Microbiology, 4(9), 1508-1515.
- Ogden, N. H., et al. (2019). Climate change and the potential for range expansion of Lyme disease. Canada Communicable Disease Report, 45(9), 212-218.
- Simberloff, D. (2013). Invasive Species: What Everyone Needs to Know. Oxford University Press.
- Stanek, G., et al. (2012). Lyme borreliosis: Clinical case definitions for diagnosis and management in Europe. Clinical Microbiology and Infection, 18(1), 69-79.
- Steere, A. C., et al. (2016). Lyme borreliosis. Nature Reviews Disease Primers, 2, 16090.
- TropMedHealth. (2020). Lymphatic filariasis in Fiji: progress towards elimination, 1997–2007. Tropical Medicine and Health. Available at: https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-020-00245-4
- U.S. Environmental Protection Agency (EPA). (2025). Climate Change Indicators: Lyme Disease. Available at: https://www.epa.gov/climate-indicators/climate-change-indicators-lyme-disease
- Walker, A. R., et al. (2014). Ticks of Domestic Animals in Africa: A Guide to Identification of Species. Bioscience Reports.
Note: Some references are cited based on available web information and may require further verification for complete bibliographic details in a formal submission. Additional primary research specific to Fiji and the South Pacific is needed to supplement the cited works.
