RALEIGH (AP) — For years, doctors have said that people were unlikely to get Lyme disease in North Carolina.

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But that attitude is changing after the tick-borne disease was diagnosed this year in at least four patients who never left their home counties.

The News & Observer of Raleigh reported Thursday that the state epidemiologist, Dr. Megan Davies, is getting word to doctors, who have been reluctant to even test patients for Lyme disease.

“What we’re trying to communicate to physicians is that it’s possible to acquire Lyme in North Carolina, so don’t hold to an old belief,” Davies said, adding that she and others are meeting with infectious disease doctors at the state’s medical schools to spread the word.

State health officials soon will test 19,000 ticks for pathogens.

Lyme bacteria is carried on the black-legged tick, which appeared to feed on reptiles rather than mammals in Southern states. So it was considered unlikely that ticks would transmit the Lyme bacteria to humans in North Carolina.

Some patients report difficulties getting Lyme tests and diagnoses — even after they’ve been bitten by a tick or are suffering from a rash, fever, headache or fatigue. All are symptoms of Lyme disease.

Angela Stott of Asheville said her son, Max, went several weeks this past summer without a diagnosis before he became so sick he could barely walk and had such excruciating headaches his eyes crossed.

More than one doctor told her Lyme disease was not a factor in North Carolina. Even when a Lyme test came back positive, Stott said, doctors still questioned the diagnosis.

“It was nightmarish,” she said.

A key component of the new message is that the bacterial infection is harder to treat the longer it lingers, said Dr. Carl Williams, state public health veterinarian.

“What we’re interested in is primary prevention of acute disease,” Williams said, noting that an early intervention with antibiotics is generally a cure.

Among the evidence that Lyme disease can be caught in North Carolina are reports from military doctors at Camp Lejeune who offered findings that Marines were coming down with Lyme after being stationed at the Onslow County base.

“It’s taken a lot of investigation to uncover these cases,” Davies said of the confirmed Lyme disease incidents. “We are working to try to protect (people) against this illness in North Carolina.”