Everything You Need to Know About Lyme Disease

Health Line

3 days ago

Key takeaways
Lyme disease progresses through stages, each with distinct symptoms, though individual experiences can vary. Early symptoms may include a bull's-eye rash, fever, and fatigue, while later stages can involve systemic infection affecting the heart, nervous system, and joints.
Diagnosis involves a physical exam and possibly blood tests, but the CDC does not recommend tick testing. Early treatment with oral antibiotics is typically effective, while later stages may require intravenous antibiotics.
Preventing Lyme disease centers on avoiding tick bites by using repellents, wearing protective clothing, and checking for ticks after being outdoors. Although most people recover fully with treatment, some may experience post-Lyme disease syndrome.
Lyme disease was first recognized in the town of Old Lyme, Connecticut, in 1975.
It's an infectious disease caused by the bacterium Borrelia burgdorferi and, in rare cases, Borrelia mayonii.
B. burgdorferiis transmitted to humans by a bite from an infected black-legged tick, also known as a deer tick. These tiny insects become infected after feeding on infected animals, such as deer, birds, or mice.
According to the Centers for Disease Control and Prevention (CDC), infected ticks transmit Lyme disease in the Northeastern, Mid-Atlantic, and North Central United States, as well as on the Pacific Coast of the United States.
Keep reading to learn more about the symptoms and treatments for Lyme disease and how to identify a tick bite.
Stages of Lyme disease
Lyme disease is typically classified into three stages. These help categorize the severity and development of symptoms and the infection.
Signs and symptoms of Lyme disease
Symptoms of Lyme disease vary depending on the stage of infection.
That said, the severity, progression, and presentation of symptoms may vary depending on the individual.
For example, symptoms of stages 1 and 2 may overlap. Or, you may not experience any stage 1 symptoms but experience later symptoms.
Early signs and symptoms of Lyme disease
Symptoms of Lyme disease usually start 3–30 days after the tick bite.
One of the earliest signs of the disease is a bull's-eye rash, also known as an erythema migrans.
Up to 8 out of 10 people experience a bull's eye rash, which occurs at the site of the tick bite. It usually has a central red spot surrounded by a clear spot with an area of redness at the edge.
People with lighter skin may have a rash that's solid red, while people with darker skin may have a rash that resembles a bruise. It may be warm to the touch, but it's not painful and doesn't itch.
chills
fever
enlarged lymph nodes
sore throat
vision changes
fatigue
muscle aches
headaches
Later signs and symptoms of Lyme disease
Early disseminated Lyme disease can appear up to 3 months after the tick bite, while late disseminated Lyme disease may take up to 12 months.
Stages 2 and 3 of Lyme disease are characterized by systemic infection. This means the infection has spread throughout your body, including to other organs.
Symptoms may include:
abnormal heart rhythm, which can be caused by Lyme carditis
neurologic conditions, such as facial palsies and cranial neuropathy
multiple erythema migrans lesions on your body
numbness, tingling, and pain in your hands and feet
severe headaches
neck stiffness
meningitis
arthritis of one or more large joints, typically the knee
encephalopathy, which may cause short-term memory loss, difficulty concentrating, mental fogginess, problems with following conversations, and sleep disturbance
It's important to note that you may experience later symptoms of Lyme disease without experiencing earlier symptoms, such as a bull's eye rash.
Lyme disease symptoms in children
Children generally experience the same Lyme disease symptoms and progression as adults.
That said, a 2019 review suggests that you may also notice some psychological symptoms in your child, such as:
anger or aggression
mood changes
depression
nightmares
If your child seems to be acting differently and can't explain why or what they're feeling, speak with a doctor. These changes could be a sign of many conditions, including Lyme disease.
How is Lyme disease diagnosed?
Lyme disease may be difficult to diagnose because many of the symptoms are similar to those of other conditions.
A healthcare professional will first perform a medical history and physical examination to look for erythema migrans and other symptoms characteristic of Lyme disease.
If you don't have visual symptoms of Lyme disease, they'll recommend a two-step serology. This may include the following two blood tests to help detect antibodies:
enzyme-linked immunosorbent assay (ELISA)
Western blot
It's important to note that blood tests are most reliable only a few weeks after the initial infection. This is when antibodies are present.
Some at-home Lyme disease testing kits are also available. These may be beneficial if you've recently been bitten by a tick or you recently spent time in an area where ticks are common.
However, it's best to see a doctor if you experience any signs or symptoms of Lyme disease.
If you need help finding a primary care doctor, then check out our FindCare tool.
Tick testing for Lyme disease
Some commercial laboratories test ticks for Lyme disease. However, the CDC doesn't recommend tick testing for the following reasons:
Commercial laboratories that offer tick testing aren't required to have the same stringent quality control standards as those for clinical diagnostic laboratories.
If the tick tests positive for a disease-causing organism, it doesn't necessarily mean you have Lyme disease.
A negative result could lead you to the false assumption that you don't have an infection. You could have been bitten by a different tick that transmitted Lyme disease.
If you have Lyme disease, you'll probably start showing the symptoms before you get the tick test results, and you shouldn't wait to start treatment.
How is Lyme disease treated?
Treatment for Lyme disease will depend on the progression of the infection.
Early stages
Lyme disease is best treated in the early stages. Treatment for early localized disease is a 10- to 14-day course of oral antibiotics to eliminate the infection.
Medications used to treat Lyme disease include:
Later stages
If Lyme disease has progressed beyond stage 1 or affects your circulatory or central nervous systems, a doctor may prescribe intravenous (IV) antibiotics. This will then be followed up with an oral regimen. The complete course of treatment usually takes 14–28 days.
If you experience abnormal heart rhythm or heart block, a doctor may also recommend you stay in the hospital to be monitored until the abnormality resolves.
Lyme disease transmission
Ticks infected with the bacterium B. burgdorferi can attach to any part of your body. They're more commonly found in moist areas of your body that are hard to see, such as the scalp, armpits, and groin area.
The infected tick must be attached to your body for at least 36 hours to transmit the bacterium.
Most Lyme disease infectious are caused by immature ticks, called nymphs. They feed during the spring and summer. Nymphs are more likely to transmit Lyme disease due to their size. They're roughly the size of a poppy seed, which makes them harder to see and remove than adult ticks.
Is Lyme disease contagious?
There's currently no evidence that Lyme disease is contagious between people, according to the CDC. This means it cannot be transmitted through touching, kissing, having sex, or air, food, and water.
Risk factors for Lyme disease
Living in a state with a high prevalence of Lyme disease may increase your risk of being bitten by an infected tick. According to the CDC, as of 2021, the U.S. states with the highest incidence of Lyme disease include:
Connecticut
Delaware
Maine
Maryland
Massachusetts
Minnesota
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont
Virginia
West Virginia
Wisconsin
People who work outdoors are also at an elevated risk of Lyme disease, including those who work in:
construction
landscaping
forestry
farming
park or wildlife management
Most tick bites happen in the summer when ticks are most active and people spend more time outside.
However, it's possible to get Lyme disease from tick bites in early fall, and even in late winter if the weather is unseasonably warm.
Prevention of Lyme disease and ticks
Here are some frequently asked questions about the prevention of Lyme disease and ticks.
Can I prevent Lyme disease?
Yes, you can prevent Lyme disease by protecting yourself from ticks. This is because the infection is transmitted through bites from infected ticks.
How can I prevent tick bites?
Some ways to prevent tick bites may include:
wearing long pants and long-sleeve shirts when outdoors
protecting your clothing with permethrin
using insect repellents, such as DEET products
using natural insect repellants, such as oil of lemon eucalyptus
checking yourself and your pets after being outside in areas with brush, long grass, and wood
How do I spot a tick?
Checking yourself for ticks in the shower or bath is important after you've come in from outside.
Other than that, check your clothes, especially the folds of your clothes, knowing that ticks can be very small and hard to spot. Running your hands through your hair is also a good idea.
What should I do if a tick bites me?
If a tick bites you, it's important to remove it as soon as possible.
According to the CDC, the best way to remove a tick is to:
Use a pair of tweezers to grab the tick.
Steadily pull upward, being careful not to twist the tweezers (this may cause the mouth parts of the tick to break off and stay stuck in the skin).
After removing the tick, clean the bite area with soap and water, or rubbing alcohol.
Don't crush the tick. Dispose of it by putting it in alcohol, flushing it down the toilet, or putting it in a sealed bag and in the trash.
What is the outlook for someone with Lyme disease?
The majority of people who receive a diagnosis of Lyme disease will recover within 2–4 weeks of starting treatment, according to the CDC.
However, approximately 5–10% of people with Lyme disease will experience post-Lyme disease syndrome, also known as chronic Lyme disease.
Symptoms of post-Lyme disease syndrome are similar to those that occur in the earlier stages of the condition, such as:
fatigue
difficulty sleeping
aching joints or muscles
pain or swelling in your large joints, such as your knees, shoulders, or elbows
difficulty concentrating and short-term memory problems
speech problems
Treatment is primarily focused on easing pain and discomfort. Most people recover, but it can take months or years.
Frequently asked questions
Does Lyme disease go away?
In most cases, Lyme disease can go away with early diagnosis and treatment. However, if you start treatment in the later stages, you may experience long-term complications like damage to your joints.
Can you live a normal life with Lyme disease?
Most people can live a normal life after receiving treatment for Lyme disease. However, up to 10% of people experience chronic symptoms of Lyme disease that could affect mobility and cognitive skills.
What happens when Lyme disease goes untreated?
If left untreated, Lyme disease may progress and cause serious neurological and rheumatoid complications. These may include facial palsy, extreme fatigue, meningitis, and arthritis, among others. It's important to get treated as early as possible if you have Lyme disease.
Can you recover from Lyme on your own?
Antibiotics are needed to treat Lyme disease. Left untreated, the infection can progressively get worse and lead to more serious long-term complications.
Takeaway
Lyme disease is an infection caused by a tick bite from an infected tick.
If you find a tick on your body, it's important to properly remove it as soon as possible. Then, monitor the tick bite area. If a bull's eye rash appears, speak with a healthcare professional as soon as you can.