Ticks and Lyme Disease | Johns Hopkins Medicine

What is Lyme disease?

Lyme disease is an infection caused by the bacterium Borrelia burgdorferi. This spiral bacterium is most often transmitted by a tick bite. The disease is named after Connecticut's Lyme. This is where the disease was first identified in the United States in 1975.

Although Lyme disease is a year-round problem, April through October is considered tick season. Cases of Lyme disease have been reported in nearly every US state and large areas in Europe and Asia, but the most common areas are the Northeast, upper Midwest, and Northwest states.

What causes Lyme disease?

Lyme disease is caused by bacteria that are transmitted to humans from tick bites. The ticks that carry the spirochete are:

• Black-legged deer tick (northeast, mid-Atlantic, and north-central US)

• Western Black-legged Tick (US Pacific Coast)

Ticks prefer to live in wooded areas, grasslands with low growth and backyards. Not all ticks carry the Lyme disease bacteria. Depending on the location, anywhere from less than 1% to more than 50% of ticks are infected with it.

While most tick bites are harmless, several species can cause life-threatening illnesses. Tick-borne diseases include:

Who is at risk for Lyme disease?

Factors that can increase your risk of developing Lyme disease include:

• Working or spending time outdoors in areas where the black-legged tick or western black-legged deer tick is found

• Having pets that can bring ticks into the home

What are the symptoms of Lyme disease?

The list of possible symptoms is long and symptoms can affect any part of the body. The following are the most common symptoms of Lyme disease. But the symptoms are slightly different for each person.

The main symptom is a red rash that:

• It may appear several days after infection or not at all

• It can take up to several weeks

• It can be very small or become very large (up to 12 inches in diameter) and can look like a “bull's eye”

• Can mimic skin problems such as hives, eczema, sunburn, poison ivy and flea bites

• It may itch or feel warm, or it may not be felt at all

• It may disappear and return several weeks later

Several days or weeks after being bitten by an infected tick, you may have flu-like symptoms, such as the following:

Weeks to months after the bite, the following symptoms may appear:

• Neurological symptoms, including inflammation of the nervous system (meningitis) and weakness and paralysis of the facial muscles (Bell's palsy)

• Heart problems, including inflammation of the heart (myopericarditis) and heart rhythm problems

• Eye problems, including inflammation (for example, red eyes)

Months to a few years after a bite, the following symptoms may include:

• Inflammation of the joints (arthritis)

• Neurological symptoms including numbness, tingling and pain in the extremities and difficulties with speech, memory and concentration

Some people may develop post-Lyme disease syndrome (PLDS). A condition also known as chronic Lyme disease includes PLDS, but also other syndromes. Typically, these are characterized by persistent musculoskeletal and peripheral nerve pain, fatigue and memory impairment.

How is Lyme disease diagnosed?

Lyme disease is difficult to diagnose because symptoms are not consistent and can mimic other conditions. The main symptom is a rash, but it may be absent in up to 20% of cases.

A diagnosis of Lyme disease must be made by a health care provider experienced in recognizing Lyme disease. Diagnosis is usually based on symptoms and a history of tick bites. Testing is generally done to confirm the diagnosis and rule out other conditions. This may require blood and other laboratory tests.

Research is ongoing to develop and improve methods for diagnosing Lyme disease.

Symptoms of Lyme disease can look like other medical conditions or problems. Always talk to your healthcare provider about a diagnosis.

How is Lyme disease treated?

Your healthcare provider will find the best treatment for you based on:

• How old are you

• Your general health and past health

• How sick you are

• How well you can handle certain drugs, procedures or treatments

• How long is the condition expected to last?

• Your opinion or preference

Lyme disease in its earliest stages is usually treated with antibiotics for 2 to 3 weeks.

Treatment will also be considered based on these and other factors:

• If you are bitten by a tick that is positive for the bacteria that causes Lyme disease

• If you are bitten by a tick and have any of the symptoms

• If you are bitten by a tick and you are pregnant

• If you are bitten by a tick and you live in a high risk area

What are the complications of Lyme disease?

Lyme disease affects people differently. Relapse and incomplete responses to treatment occur. Relapse and incomplete responses to treatment occur. Complications of untreated early-stage disease include:

Some of these complications result in chronic, debilitating conditions.

Some people may develop post-Lyme disease syndrome (PLDS). A condition also known as chronic Lyme disease includes PLDS, but also other syndromes. Typically, these are characterized by persistent musculoskeletal and peripheral nerve pain, fatigue and memory impairment.

Can Lyme disease be prevented?

People are unable to become immune to Lyme disease. So even if you had Lyme disease, you can get it again. There is no vaccine available to prevent the disease.

The FDA approved a Lyme vaccine called LYMErix in 1998. However, the vaccine was not 100% effective. The FDA still recommended preventing the disease in other ways. In 2002, the company that made LYMErix said it would no longer offer the vaccine.

To help prevent Lyme disease, follow these guidelines.

clothing items

Dress appropriately wearing:

Check for ticks

Often look for ticks in:

• All joints: behind the knees, between the fingers and toes, and in the armpits

• Other areas where ticks are commonly found: belly button, neck, hairline, top of the head and inside and behind the ears

• Pressure point areas, including anywhere clothing presses tightly against the skin

Visually check all other areas of the body and gently run your fingers over the skin.

Insect repellents

Consider using repellents. Remember to use all repellents safely.

• Products that have DEET repel ticks, but they don't kill them. These products are not 100% effective in preventing a tick from feeding on you.

• Products containing permethrin kill ticks. But they should only be sprayed on clothes, not on your skin.

Other measures

These other methods may also help:

What should you do if you find a tick?

• Do not touch the tick with your bare hand.

• Use tweezers to remove the tick. Grasp the tick firmly by its mouth or head as close to your skin as possible.

• Pull up slowly and firmly without twisting until it goes away. Do not squeeze the tick or use petroleum jelly, thinners, knives or a lighted match to kill the tick.

• Save the tick. Place it in a plastic container or bag so it can be checked for disease if needed.

• Wash the bite area thoroughly with soap and water and apply an antiseptic lotion or cream to the area.

• Call your health care provider to learn about aftercare and checking the tick for Lyme disease bacteria.

When should I call my healthcare provider?

If your symptoms worsen or you have new symptoms, tell your healthcare provider.

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