Lyme Disease: Important Facts to Know

What Is Lyme Disease?

Lyme disease is a bacterial infection. You get it when the blacklegged tick, also known as a deer tick, bites you and stays attached for 36 to 48 hours. If you remove the tick within 48 hours, you probably won’t get infected.

When you do get infected, the bacteria travel through your bloodstream and affect various tissues in your body. If you don’t treat Lyme disease early on, it can turn into an inflammatory condition that affects multiple systems, starting with your skin, joints, and nervous system and moving to organs later on.

The chances you might get Lyme disease from a tick bite depend on the kind of tick, where you were when it bit you, and how long the tick was attached to you. You’re most likely to get Lyme disease if you live in the Northeastern United States. The upper Midwest is also a hot spot. But the disease now affects people in all 50 states and the District of Columbia.

What Are the Symptoms of Lyme Disease?

Symptoms can start anywhere from 3 to 30 days after the bite. They may look different depending on the stage of your infection. In some cases, you won’t notice any symptoms until months after the bite.

Early symptoms include:

• Fever
• Chills
• Headache
• Fatigue
• Muscle and joint pain
• Swollen lymph nodes

All of those symptoms are also common in the flu. In most Lyme infections, one of the first symptoms you’ll notice is a rash.

Without treatment, symptoms can get worse. They might include:

• Severe headache or neck stiffness
• Rashes on other areas of your body
• Arthritis with joint pain and swelling, particularly in your knees
• “Drooping” on one or both sides of your face
• An irregular heartbeat
• Inflammation in your brain and spinal cord
• Shooting pains, numbness, or tingling in your hands or feet

What does the rash look like?

Some Lyme rashes look like a bull's-eye with circles around the middle. But most are round, red, and at least 2 inches across.

The rash slowly gets bigger over several days. It can grow to about 12 inches across. It may feel warm to the touch, but it’s usually not itchy or painful. It can show up on any part of your body.

How small are ticks?

Ticks come in three sizes, depending on their life stage. They can be the size of a grain of sand, a poppy seed, or an apple seed.

How Is Lyme Disease Diagnosed?

Your doctor will diagnose you based on your symptoms and whether you’ve been exposed to a tick. They might also run a blood test. In the first few weeks of infection, the test may be negative because antibodies take a few weeks to show up.

Hopefully soon, there will be tests that can diagnose Lyme disease in the first few weeks after you’re exposed. The earlier you get treated, the less likely it’ll get worse.

What Are the Stages of Lyme Infection?

There are three stages:

• Early localized Lyme: Flu-like symptoms like fever, chills, headache, swollen lymph nodes, sore throat, and a rash that looks like a bull's-eye or is round and red and at least 2 inches long
• Early disseminated Lyme: Flu-like symptoms like pain, weakness, or numbness in your arms and legs, changes in your vision, heart palpitations and chest pain, a rash (that may nor may not be a bull’s- eye rash), and a type of facial paralysis known as Bell’s palsy
• Late disseminated Lyme: This can happen weeks, months, or years after the tick bite. Symptoms might include arthritis, severe fatigue and headaches, dizziness, trouble sleeping, and confusion.

About 10% of people treated for Lyme infection don’t shake the disease. They may go on to have three core symptoms: joint or muscle pain, fatigue, and short-term memory loss or confusion. This is called post-treatment Lyme disease syndrome. It can be hard to diagnose because it has the same symptoms as other diseases. Plus, there isn't a blood test to confirm it.

Experts aren’t sure why Lyme symptoms don’t always go away. One theory is that your body keeps fighting the infection even after the bacteria are gone, like an autoimmune disorder.

How Is Lyme Disease Treated?

With early-stage Lyme disease, you’ll take antibiotics for about 10 days to 3 weeks. The most common ones are amoxicillin, cefuroxime, and doxycycline. The antibiotics will almost always cure your infection. If they don’t, you might get other antibiotics either by mouth or as a shot.

If you don’t treat your Lyme infection, you might need oral antibiotics for symptoms like weakened face muscles and irregular heartbeat. You may need antibiotics if you have meningitis, inflammation in your brain and spinal cord, or more severe heart problems.

If your Lyme is late stage, the doctor might give you antibiotics either by mouth or as a shot. If it causes arthritis, you’ll get arthritis treatment.

There’s no therapy for post-treatment Lyme disease syndrome.

Which Areas Are More Likely to Have It?

The tick that causes Lyme disease has been moving from the Northeast and upper Midwest into the Southern and Western U.S., Mexico, and Canada. Cases in California and Florida are on the rise. After a drop between 2017 and 2018, the numbers jumped a little bit in 2019.

But most Lyme cases in 2019 were in 15 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New

Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, and Wisconsin. Washington, DC, is also a hotspot.

In 2019, Pennsylvania had the most Lyme infections, with 6,763. New York was next, with 2,847 cases.

In the Southern U.S., where it’s hotter, ticks stay under leaves so they don't dry out. This means people don’t get Lyme from Southern ticks very often because they don't usually come out to bite.

Even though people only report about 30,000 cases of Lyme infection in the U.S. each year, there are actually around 476,000 a year. The same tick also can spread other diseases, including babesiosis, anaplasmosis, and Powassan virus. Those diseases are also on the rise in the U.S.

Who’s likeliest to get Lyme disease?

Boys up to age 15 and men between the ages of 40 and 60 are the most likely to get Lyme disease. That’s because they tend to play outside and go camping, hunting, and hiking.

Some people think Lyme infections are less common in older teens and men in their 20s because those groups are likely to be inside and on a computer. And by the same token, they may be more common in older adults because they tend to work in their back yards, which is where most Lyme infections happen.

Why are there more ticks now than there used to be?

There are several reasons why Lyme is spreading. Some of these are:

• New trees being planted, especially in the Northeastern U.S.
• Climate change and very hot or cold temperatures
• People moving away from large cities
• More contact with white-tailed deer (the blacklegged tick's favorite way to travel)

In the last century, we cut down lots of trees and put buildings in their place. That caused a drop in the deer population. But in the past few decades we’ve planted more trees, so both the deer and tick populations have grown.

Ticks live for 2-3 years and don't move very far, so it takes a while to see large changes.

Deer and white-footed mice give Lyme disease to ticks that bite them. And they’re moving closer to humans as their habitats disappear. Dogs also carry ticks into homes and spread them to their humans.

As the climate warms, people are spending more time outside. That raises the odds of being bitten, particularly in areas where Lyme is common.

That doesn't mean you should be afraid of outdoor activities, as long as you do the right things to avoid tick bites.

What's the Best Way to Prevent a Tick Bite?

Ticks can't fly or jump. But they live in shrubs and bushes and can grab onto you when you pass by. To avoid getting bitten:

• Wear pants and socks in areas with lots of trees and when you touch fallen leaves.
• Wear a tick repellent on your skin and clothing that has DEET, lemon oil, or eucalyptus.
• For even more protection, use the chemical permethrin on clothing and camping gear.
• Shower within 2 hours after coming inside. Look for ticks on your skin, and wash ticks out of your hair.
• Put your clothing and any exposed gear into a hot dryer to kill whatever pests might be on them.

How do you know if you've been bitten?

Since ticks are so small, you've got to have pretty good eyes to see them.

If you have a small, red bump on your skin that looks like a mosquito bite, it could be a tick bite. If it goes away in a few days, it’s not a problem. Remember, a tick bite doesn’t necessarily mean you have Lyme disease.

If you notice a rash in the shape of a bull's-eye, you might have a tick bite. Talk to your doctor about treatment.

If you have an allergic reaction to ticks, you'll notice a bite right away.

What Do You Do If There's a Tick Under Your Skin?

Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.

You probably won’t get infected if you remove the tick within 36 to 48 hours.

How do you throw away a tick?

Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.

When Should You See a Doctor If You Think You Have Lyme?

The rash is a pretty good indication that you may have been bitten. Take a photo of the rash and see your doctor. At this stage, treatment with antibiotics will probably work.

If you don't have the rash but have symptoms like fatigue, fever, and headache but no respiratory symptoms like a cough, you may want to talk to your doctor.

Is There a Vaccine for Lyme Disease?

In 2017, a French company called Valneva started testing a Lyme disease vaccine on adults in the U.S. and Europe. The study is in its second phase and should be completed in 2026.

What If a Tick Bites My Dog?

The more ticks in your region, the likelier it is that your furry pal will bring them home.

Your dog is much more likely to be bitten by a tick than you are. And where Lyme disease is common, up to 25% of dogs have had it at some point.

About 10% of dogs with Lyme disease will get sick. 7-21 days after a tick bite, your dog might seem like they’re walking on eggshells. They also might have a fever and enlarged lymph nodes. Plus, they might seem tired. Dogs also get antibiotics for Lyme.

What if my dog brings ticks into my home?

Use a tick control product on your pet to prevent Lyme disease. Also, have your dog vaccinated against Lyme.

Check your dog’s whole body each day for bumps. If you notice a swollen area, see if there’s a tick there. If you find a tick, wear gloves while you use tweezers to separate it from your dog. Then, put it in soapy water or alcohol, or flush it down the toilet.

Use alcohol to clean the spot on your dog where the tick was attached. Keep an eye on that spot, and also on your dog to make sure they’re behaving normally. If you notice any changes, check with your vet.

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