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Lyme Disease

What Is Lyme Disease?

Lyme disease is the leading tick-borne disease in the United States. It's caused by a type of bacteria found in animals like mice and deer. Ixodes ticks (also called black-legged or deer ticks) that feed on these animals can then spread the bacteria to people through tick bites.

Tick bites instruction sheet

Ticks are small and often hard to see. Immature ticks, called nymphs, are about the size of a poppy seed. Adult ticks are about the size of a sesame seed.

It's important to know and watch for signs of Lyme disease because ticks are hard to find and it's easy to miss a tick bite. Many people who get Lyme disease don't remember being bitten. The good news is that most tick bites don't lead to Lyme disease.

What Are the Signs & Symptoms of Lyme Disease?

Lyme disease can affect different body systems, such as the nervous system, joints, skin, and heart.

Symptoms often happen in three stages (but not everyone has all three):

  1. A circular rash at the site of the tick bite often is the first sign of infection, usually within 1–2 weeks. But many people never have one.

    The rash sometimes has a "bull's-eye" appearance, with a central red spot surrounded by clear skin that is ringed by an expanding red rash. It also can look like an expanding ring of solid redness. It's usually flat and painless, but sometimes can be warm to the touch, itchy, scaly, burning or prickling.

    The rash can look and feel very different from one person to the next, and might look like a bruise on people with darker skin. It expands over days to weeks, and eventually disappears. A person also may have flu-like symptoms such as fever, tiredness, headache, and muscle aches.

  2. If not treated, early symptoms may go away on their own. But in some people, the infection can spread to other parts of the body. Symptoms of this stage of Lyme disease usually start within several weeks of the tick bite, even in those who didn't have the initial rash. A person might feel very tired and unwell, or have more areas of rash that aren't at the bite site.

    Lyme disease can affect the heart, leading to an irregular heart rhythm, which can cause dizziness or heart palpitations. It can also spread to the nervous system, causing facial paralysis (Bell's palsy) or meningitis.
  3. The last stage of Lyme disease happens if the early stages were not found or treated. Symptoms can start anytime from weeks to years after the tick bite. In kids, this is almost always in the form of arthritis, with swelling and tenderness, particularly in the knee or other large joints.

    Having such a wide range of symptoms can make Lyme disease hard for doctors to diagnose, although blood tests can look for signs of the body's reaction to Lyme disease.

Ankle with a red circular bullseye rash around a tick bite.

How Is Lyme Disease Treated?

Lyme disease is usually treated with a 2- to 4-week course of antibiotics. Cases that are diagnosed quickly and treated with antibiotics almost always have a good outcome. A person should be feeling back to normal within several weeks after treatment starts.

Is Lyme Disease Contagious?

Lyme disease is not contagious, so it can't spread from person to person. But people can get it more than once.

When Should I Call the Doctor?

If you think your child could be at risk for Lyme disease or has been bitten by a tick, call your doctor. This is especially important if your child has:

  • a red-ringed rash
  • flu-like symptoms
  • joint pain or a swollen joint
  • facial paralysis

Can Lyme Disease Be Prevented?

There's no sure way to avoid getting Lyme disease. No Lyme disease vaccine is currently on the market in the United States.

To minimize your family's risk in the great outdoors:

  • Be aware of ticks in high-risk areas like shady, moist ground cover or areas with tall grass, brush, shrubs, and low tree branches. Lawns and gardens may harbor ticks too, especially at the edges of woods and forests and around old stone walls.
  • Wear closed shoes or boots, long-sleeved shirts, and long pants. Tuck pant legs into shoes or boots to prevent ticks from crawling up legs.
  • Use an insect repellent containing 10% to 30% DEET (N,N-diethyl-meta-toluamide).
  • Wear light-colored clothing to help you see ticks more easily.
  • Keep long hair pulled back or tucked in a cap for protection.
  • Don't sit on the ground outside.
  • Check for ticks regularly — both indoors and outdoors. Wash clothes and hair after leaving tick-infested areas.

If you use an insect repellent containing DEET, always follow the directions on the product label and don't overapply it. Place DEET on shirt collars and sleeves and pant cuffs, and only use it directly on exposed areas of skin. Be sure to wash it off when you go back indoors.

What If I Find a Tick?

You should know how to remove a tick in case one lands on you or your child.

If you find a tick:

  • Use tweezers to grasp the tick firmly at its head or mouth, next to the skin.
  • Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in the skin, don't worry. It will eventually come out. But call your doctor if you notice any irritation in the area or symptoms of Lyme disease.
  • Swab the bite site with alcohol.
  • Put the tick in a sealed container. Call your doctor, who might want to see the tick.

    Note: Don't use "folk remedies" like petroleum jelly or a lit match to kill and remove a tick. These won't get the tick off skin and might just cause it to burrow deeper.

Tick bites usually don't hurt — and that can make it hard to find a bite early. So be on the lookout for ticks and rashes, and if you live in high-risk area, do a daily tick check on yourself and your kids.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date Reviewed: 14-09-2015

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