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Lyme disease is an infection
that is spread by ticks. You can get Lyme disease if you are bitten by an
infected tick. But most people who have had a tick bite don't get Lyme
disease. It's still important to see your doctor if you have a tick attached to
you that you can't remove.
Lyme disease is common in the United
States. It can also be found in Canada, Europe, and Asia.
Lyme disease is caused
by bacteria. Infected ticks spread the bacteria by biting people or
Two types of ticks carry the Lyme disease bacteria in the
U.S. They are:
as soon as you notice them. Infected
ticks usually don't spread Lyme disease until they have been attached for at
least 36 hours.
One sign of Lyme disease
is a round, red rash that spreads at the site of a tick
bite. This rash can get very large.
Flu-like symptoms are also
common. People in the early stages of Lyme disease may feel very tired and
have headaches, sore muscles and joints, and a fever.
symptoms can start at any time, from 3 days to up to a month after you have been
bitten. Some people don't have any symptoms when they are in the early stages
of Lyme disease. And they may not even remember getting a tick bite.
If Lyme disease goes untreated, you can have more serious symptoms over
time. These include:
Your doctor will
ask you questions about your symptoms. Your doctor will also ask about your activities to try to find out if
you have been around infected ticks. You may have a blood test to see if you
antibodies in your blood that could mean you have the
The main treatment for Lyme
antibiotics. These medicines usually cure Lyme disease
within 3 weeks of starting treatment.
It's important to get
treatment for Lyme disease as soon as you can. If it goes untreated, Lyme disease can lead to problems with
your skin, joints, nervous system, and heart. These can occur weeks, months, or
even years after your tick bite. The problems often get better with
antibiotics, but in rare cases they can last the rest of your life.
The best way to
prevent Lyme disease is to protect yourself from ticks. Cover up as much skin
as you can when you're going to be in wooded or grassy areas. Wear a hat, a
long-sleeved shirt, and long pants with the legs tucked into your socks. And
keep in mind that it's easier to see ticks on light-colored clothes.
Use a bug repellent that has a chemical (such as DEET, IR3535, or Picaridin) to keep away ticks. Check your pets for ticks after they've been outside.
You can't get Lyme disease from your pet. But your pet can bring infected ticks
inside. These ticks can fall off your pet and attach to you.
Learning about Lyme disease:
Lyme disease is caused
by Borrelia burgdorferi bacteria. Infected ticks spread the bacteria by biting people or
Dogs, cats, and horses can become infected with Lyme
disease bacteria, but they can't pass the illness to humans. But infected
ticks may fall off the animals and then bite and infect humans.
The symptoms of Lyme disease depend on the stage of the disease. You may first notice symptoms weeks to months after the tick bite. If the disease isn't treated, it may progress from mild symptoms to serious, long-term disabilities.
If you don't have symptoms during stage 1, your first symptoms may be those found in stage 2 or 3.
Lyme disease is caused
by a bite from a tick that is infected with bacteria. When an infected tick bites you, bacteria travel
to the tick's salivary glands and then into your body through your skin. It
takes about 24 hours for a tick to attach itself to the skin and begin to feed.
The tick generally must be attached to you for about 36 hours in order for it
to transmit the Lyme disease bacteria.
There are three stages of Lyme disease. If the disease isn't treated, it may progress in stages from mild symptoms to serious, long-term disabilities.
The main risk factor for
Lyme disease is exposure to ticks that are infected
with Lyme disease bacteria. In areas where Lyme disease is widespread, such as the northeastern
United States and Canada, several
factors may increase your risk, including:
Remove ticks right away, as soon as you notice them.
Your risk for getting Lyme disease increases the longer a tick is attached to
your body. Ticks generally cannot transmit Lyme disease until they are attached
for at least 36 hours.
Call your doctor if:
The following health professionals can diagnose and
prescribe treatment for Lyme disease or complications of Lyme disease:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
is often hard to diagnose. Your doctor will take a careful medical history and do a physical
examination to help diagnose early Lyme disease. You may be asked if you
have recently visited an area where you may have been exposed to ticks. The
doctor will ask about your symptoms and look for physical signs of Lyme disease. The clearest physical sign is an expanding, circular red
Lyme disease tests are blood tests that help confirm a diagnosis of Lyme
disease. These tests can detect
antibodies to the bacteria that cause Lyme disease, but they may not be needed. The decision about
when to use blood tests for Lyme disease depends on
whether your doctor strongly thinks you have Lyme disease and whether the test
results will change the course of your treatment.
such as a skin
biopsy, may be done to confirm a diagnosis.
If possible, put the tick
that was attached to you in a dry jar or a ziplock bag and take it to the
doctor with you. Sometimes tests can be done on the tick to see if it is a
carrier of Lyme disease.
Lyme disease is
The type of antibiotic your doctor gives you and the number
of days you take it will depend on your symptoms and the stage of the disease. Talk
to your doctor if you have any questions about your antibiotic
Antibiotic treatment for early Lyme disease is effective, and symptoms usually
go away within 3 weeks of treatment.
earlier antibiotic treatment is started after infection, the faster and more
completely you will recover.
Lyme disease isn't diagnosed and treated until later problems arise, it may
take you a long time to get better. Or you may need more treatment.
If the disease gets worse, treatment options include:
People with partial
facial paralysis as a result of Lyme disease may improve on their own without
Even after successful
treatment for Lyme disease, you can get it again. So it is important to
continue to protect yourself against tick bites.
Lyme disease can be prevented by avoiding and removing ticks. You can also get the disease again after successful treatment, so it is important to continue to protect yourself against
Lyme disease isn't
contagious and cannot be spread from person to person. But there are certain precautions
you can take to prevent the spread of the illness.
If you have active Lyme disease, don't donate blood. The
bacteria that cause the illness can be transmitted this way. If you have been treated for Lyme disease, you may be able to donate blood, but
check with the blood bank first.
A pregnant woman may be able to pass Lyme disease to her unborn
child, but proven cases are rare. Lyme disease hasn't been shown to cause
birth defects or fetal death.
Antibiotics are the main treatment for
Lyme disease. The first course of antibiotics almost always cures the
infection. But if symptoms continue, more evaluation may be needed.
The type of antibiotic prescribed, the amount, and whether the medicine is taken
orally, as an injection, or through a vein
(intravenous, or IV) depends on how bad your symptoms
are and how long you've had Lyme disease.
Different antibiotics may be
used to treat children and adults. The decision to take medicines for Lyme disease may be based on one or
more of these factors:
In rare instances, Lyme disease symptoms may not go away
even after antibiotic treatment has cured the infection. There are a number of
possible reasons why symptoms may take longer to improve:
Other Works Consulted
Halperin JJ, et al. (2007). Practice parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 69(1): 91–102.
Tompkins DC, Luft BJ (2009). Lyme disease and other spirochetal zoonoses. In DC Dale et al., eds., ACP Medicine, section 7, chap. 7. Hamilton, ON: BC Decker.
Wormser GP, et al. (2006). The clinical assessment, treatment, and prevention
of Lyme disease, human granulocytic anaplasmosis,
and babesiosis: Clinical practice guidelines by the
Infectious Diseases Society of America. Clinical Infectious Diseases, 43(9): 1089–1134. [Erratum in Clinical Infectious Diseases, 45(7): 941.]
Current as of:
June 4, 2014
E. Gregory Thompson, MD - Internal Medicine
& Christine Hahn, MD - Epidemiology
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