Ticks and Lyme Disease
What is Lyme disease?
Lyme disease is an infection caused by the bacteria Borrelia burgdorferi. This spiral
shaped bacterium is most commonly spread by a tick bite. The disease takes its name
from Lyme, CT. This is where the illness was first identified in the U.S. in 1975.
Lyme disease is a year-round problem. But April through October is generally the most
active tick season. Cases of Lyme disease have been reported in nearly all states
in the U.S. and in large areas in Europe and Asia. But the most common areas are the
Northeast, upper Midwest, and northwestern states.
What causes Lyme disease?
Lyme disease is caused by bacteria that is spread to humans by tick bites. The ticks
that carry the bacteria are:
Black-legged deer tick (northeastern, mid-Atlantic, and North-Central U.S.)
Western black-legged tick (Pacific coastal U.S.)
Ticks prefer to live in wooded areas, low-growing grasslands, and yards. Not all ticks
carry the Lyme disease bacteria. Depending on the location, anywhere from less than
1 in 100 to more than half of the ticks are infected with it.
While most tick bites are harmless, several species can cause life-threatening diseases.
Tick-borne diseases include:
Who is at risk for Lyme disease?
Factors that can increase your risk for getting Lyme disease include:
What are the symptoms of Lyme disease?
Many people infected with the Lyme bacteria will never have symptoms. Their bodies
will cure the infection without needing any treatment. If the infection causes symptoms,
the following are the most common ones that people have. They vary based on how long
the person has had the infection.
The primary symptom is a red rash that:
Can appear several days after infection, or not at all
Can last up to several weeks
Can be very small or grow very large (up to 12 inches across), and may resemble a
Can mimic such skin problems as hives, eczema, sunburn, poison ivy, and flea bites
Can itch or feel hot, or may not be felt at all
Can disappear and return several weeks later
Several days or weeks after a bite from an infected tick, you may get the rash again.
When the rash returns, it often affects many parts of the body. You may also have
flu-like symptoms, such as:
Weeks to months after the bite, you may develop:
Nervous system symptoms, including inflammation (meningitis) and weakness and paralysis
of a facial nerve (Bell palsy)
Heart problems, including inflammation of the heart (myopericarditis) and problems
with heart rate
Eye problems, including inflammation (for example, red eye)
Months to a few years after a bite, you may have:
Inflammation of the joints (arthritis)
Nervous system symptoms, such as numbness in the arms or legs, tingling and pain,
and trouble with speech, memory, and concentration
How is Lyme disease diagnosed?
Sometimes diagnosing Lyme disease can be hard. The symptoms may seem like other health
problems. It may also not be known if the person was exposed to ticks.
Diagnosis is usually based on symptoms, particularly the typical rash of Lyme disease,
along with a history of a known or possible tick bite. At the time of the first rash,
testing is still negative and not helpful. For later symptoms, blood testing may be
done to confirm the diagnosis and rule out other conditions.
The symptoms of Lyme disease may look like other health problems. And other problems
can be mistakenly diagnosed as Lyme disease. Always talk with your healthcare provider
for a proper diagnosis.
How is Lyme disease treated?
Treatment will depend on your symptoms, age, and general health. It will also depend
on how severe the condition is.
Lyme disease in the earliest stage is treated with antibiotics for 2 to 3 weeks. Later
stages may require up to 8 weeks of antibiotics, rarely more. Doxycycline is the most
common antibiotic used. In some cases, amoxicillin, cefuroxime, and ceftriaxone may
Treatment will also be considered based on these and other factors:
If you are bitten by a tick and have any of the symptoms
If you are bitten by a tick and are pregnant
If you are bitten by a tick and live in a high-risk area
What kind of tick you are bitten by
If the tick has taken a blood meal (engorged)
How long the tick has likely been on your body
What are possible complications of Lyme disease?
Lyme disease affects people differently. Many people with Lyme disease are diagnosed
early and cured by their first treatment. Relapse and incomplete treatment are unusual.
You are more likely to become reinfected after proper treatment if you are bitten
by another tick.
Even untreated, most people with the disease will never develop complications. These
Joint infection, usually involving a single large joint such as the knee
Nervous system disease, including meningitis and encephalitis
Heart inflammation (myocarditis)
Rarely these complications can result in chronic, debilitating conditions.
Some people may develop post-Lyme disease syndrome (PLDS). It may cause lasting musculoskeletal
and peripheral nerve pain, fatigue, and memory problems. But there is no active infection
in those with PLDS. Taking more rounds of antibiotics doesn't help.
Can Lyme disease be prevented?
People aren't able to become immune to Lyme disease. So even if you've had Lyme disease,
you can get it again. No vaccine is available currently to prevent the disease in
To help prevent Lyme disease, follow these guidelines.
Dress appropriately to prevent and identify tick bites by wearing:
Checking for ticks
Look for ticks often on:
All joints: behind the knees, between fingers and toes, and on underarms
Other areas where ticks are commonly found: belly button, neck, hairline, top of the
head, and in and behind the ears
Areas of pressure points, including anywhere that clothing presses tightly on the
If you find a tick:
Don't touch the tick with your bare hand.
Use a pair of tweezers to remove the tick. Grab the tick firmly by its mouth or head
as close to your skin as possible.
Pull up slowly and steadily without twisting until it lets go. Don't squeeze the tick,
and don't use petroleum jelly, solvents, knives, or a lit match to kill the tick.
Save the tick. Place it in a plastic container or bag so it can be tested for disease,
Wash the bite area well with soap and water and put an antiseptic lotion or cream
on the site.
Call your healthcare provider to find out about follow-up care. If the tick is discovered
within the first 72 hours after the tick bite, a single dose of doxycycline may be
prescribed to help prevent Lyme disease.
Most experts don't recommend that the tick be tested for the Lyme bacteria. If negative,
this testing is not always accurate. If testing is positive for the germ, it doesn't
mean you were infected.
Strongly consider using repellents. Remember to use all repellents safely.
Use a product with DEET to repel ticks.
Products that have permethrin can be sprayed only on clothing, not on your skin.
These other methods may also help:
When should I call my healthcare provider?
If your symptoms get worse or you have new symptoms, let your healthcare provider
Key points about Lyme disease
Lyme disease is an infection caused by a bacteria called Borrelia burgdorferi.
Many people infected with the Lyme bacteria will never have symptoms.
Lyme disease usually starts with a rash that is often described as a "bulls-eye."
Lyme disease is generally easy to diagnose, based on symptoms and a history of a tick
bite or exposure. Blood tests may also be used.
Lyme disease in the earliest stage is usually treated with antibiotics for 2 to 3
weeks. Some people develop complications if the infection is not found early.
People aren't able to become immune to Lyme disease. You can get it again if you get
another tick bite.
Preventing tick bites is the best prevention for Lyme disease. If a tick is found
on your body in the first 72 hours, your healthcare provider may give you a preventive
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that
Know how you can contact your provider if you have questions.