Lyme Disease

Lyme disease (also called borreliosis) is an infection you can get from the bite of a deer tick. A bacterium called Borrelia burgdorferi causes the infection. Lyme disease is the most common tick-borne infectious disease in the U.S.

Initial symptoms of Lyme disease often include a “bullseye” rash, fever and fatigue. Without treatment, the infection can spread to many parts of your body. It can lead to complications that affect your nervous system, heart and joints. 

Ticks are tiny creatures that can do a lot of damage to your health. That’s why you should be aware of where deer ticks live and do everything you can to prevent bites.

Stages of Lyme disease

Lyme disease can progress through three stages, including:

• Early localized Lyme disease: The early stage occurs one to 28 days following the tick bite.
• Early disseminated Lyme disease: The early disseminated stage develops three to 12 weeks after the initial infection.
• Late Lyme disease: The late stage may occur months after the initial infection.

Early treatment can help prevent the progression to late-stage Lyme disease.

Symptoms of Lyme disease

The symptoms of Lyme disease can vary depending on the stage.

Early symptoms

Symptoms of early Lyme disease include:

• A bullseye rash (erythema migrans)
• Fatigue
• Fever
• Headache
• Muscle and joint aches
• Stiff neck
• Swollen lymph nodes

The bullseye rash starts as a small, red spot at the site of the tick bite. This can happen at any time between one and four weeks after the bite. The spot expands in the coming days or weeks, forming a circular, triangular or oval-shaped rash. The rash may look like a bullseye because it appears as a red ring that surrounds a clear center area. It can range in size from a dime to the width of your body.

Not everyone with Lyme disease develops this rash. It appears in about 7 to 8 out of 10 infected people.

Second-stage symptoms

Symptoms of the second stage of Lyme disease may include:

• Multiple areas of rash
• Paralysis of facial muscles (Bell’s palsy)
• Heart palpitations
• Episodes of dizziness or shortness of breath
• Numbness or tingling (neuropathy)
• Shooting pain (radiculopathy)

Late-stage symptoms

Symptoms of untreated late Lyme disease may include:

• Swollen and painful joints (arthritis) — typically affecting large joints like your knee
• Difficulty concentrating or other mental changes
• Damage to several nerves, like those in your skin, muscles and organs

Lyme disease causes

A bacterium called Borrelia burgdorferi causes Lyme disease. You can get it if an infected deer tick (also called a blacklegged tick) bites you. In general, infected ticks must be attached for more than 24 hours to spread the infection.

Ticks that spread Lyme disease mostly live in wooded areas in the northeastern, mid-Atlantic and north-central United States. Depending on the stage of their life cycle, blacklegged ticks can range in size from that of a poppy seed to a sesame seed. They’re usually black with areas of reddish-brown or white on their backs, depending on whether they’re adults or nymphs

Taking steps to help prevent tick bites can lower your risk of developing Lyme disease.

Complications of this condition

Untreated Lyme disease can lead to complications like:

• Arthritis that comes and goes
• Heart block or an interruption of the electrical system of your heart (Lyme carditis)
• Inflammation of the tissue covering your brain and spinal cord (meningitis)
• The bacteria invading your brain and spinal cord (encephalopathy)

How doctors diagnose Lyme disease

Your healthcare provider considers many factors when assessing you for Lyme disease, like:

• Your symptoms
• Your history of travel or activity in wooded areas
• The likelihood you were exposed to infected ticks
• Blood test results

Many people don’t remember or know that they’ve been bitten by a tick. This is because the tick is tiny, and its bite is usually painless.

Your provider may confirm the diagnosis using a blood test. It checks for antibodies to the bacterium that causes Lyme disease. But it can take several weeks after the initial infection for your body to make enough antibodies for the test to detect.

To be on the safe side, your provider may prescribe treatment without this blood test if:

• You have a bullseye rash and have been in an area known for Lyme disease
• You have a known tick bite from an area known for Lyme disease, but no symptoms

How is it treated?

Antibiotics are the primary treatment for Lyme disease. Common antibiotics include doxycycline, amoxicillin or cefuroxime axetil.

How long you need medicine may vary based on your symptoms or the stage of Lyme disease. For example, you may be on antibiotics for around 10 days for the early stage. If you develop neurological or heart symptoms, you may need to take them for longer. Your healthcare provider will give you specific instructions. Be sure to complete your round of antibiotics.

You may need other treatments to manage symptoms. For example, heart block may require a pacemaker. If arthritis symptoms don’t respond to antibiotics, steroid injections and other therapies may help.

Can my body fight off Lyme disease on its own?

No. You need antibiotics to fight off Lyme disease. Without treatment, the infection can spread in your body and cause complications.

When should I see my healthcare provider?

If you feel sick after spending time in areas where ticks might live, you should see your healthcare provider.

If you have a Lyme disease diagnosis and don’t feel better after taking all your antibiotics, contact your provider. This is especially true if you have symptoms like a stiff neck or mental confusion.

What can I expect if I have this condition?

Early treatment with antibiotics cures most cases of Lyme disease. According to one study, about 80% of people who get early treatment recover completely. Recovery may be slower for some than for others. Keep in contact with your healthcare provider so they can monitor you.

Untreated Lyme disease may lead to serious health issues. But it’s rarely fatal.

Even after treatment, about 5% to 15% of people may experience lingering symptoms, like pain or fatigue. This is known as post-treatment Lyme disease syndrome (PTLDS). The symptoms don’t mean that you still have an infection. It’s more likely that your body didn’t respond properly to treatment.

More antibiotics are unlikely to help PTLDS. Instead, your healthcare provider will suggest other therapies to manage your symptoms.

Can this be prevented?

You can try to prevent Lyme disease by avoiding tick bites and promptly removing ticks. If you remove a tick within 24 hours, you can greatly reduce your chances of getting the infection.

Researchers are working on a vaccine for Lyme disease. It’s currently in clinical trials. If it’s successful, the vaccine may be another way to help prevent the infection.