Lyme disease

Overview

Lyme disease is caused by Borrelia bacteria. Ticks usually need to be attached for 24 hours or more to spread it, so finding and removing ticks quickly helps.

In the U.S. it's most common in the Northeast, mid-Atlantic, and upper Midwest, mostly from spring to fall.

Symptoms

Early symptoms appear 3 to 30 days after a tick bite.

• A tick bite and a red rash that grows, sometimes like a bullseye
• Fever and chills
• Body aches and headache
• Feeling tired

Less common

• Several rashes on the body
• Facial droop on one or both sides (facial palsy)
• Pain and swelling in many joints, especially knees
• Heart palpitations or dizziness
• A tick stuck to the skin

Look up a symptom: Body aches · Fatigue · Fever · Fever with a rash after a tick bite · One whole side of the face is weak, including the forehead, or one eye won't close · Pain in many joints · Rash · Tick bite or bullseye rash · Tick stuck to the skin

When to get medical care

Causes

Lyme disease is caused by Borrelia bacteria spread by infected blacklegged ticks.

Does it spread or run in families?

• It usually doesn't spread from person to person.
• People get it from: tick bites.

Who is more likely to get it

• Spending time in wooded, brushy, or grassy areas
• Living in or visiting the Northeast, mid-Atlantic, or upper Midwest
• Not checking for ticks

Possible complications

• Lyme arthritis: Swollen knees
• Facial palsy
• Heart block: Rare

Diagnosis

Doctors diagnose it from the rash and tick exposure. Blood tests help in later stages.

Questions you may be asked

• Tick bites or time outdoors in wooded or grassy areas
• When the rash or symptoms started

The exam

They'll look at the rash and check joints, heart, and nerves.

Tests

Tests:

• Two-step Lyme blood test: Used when there's no clear rash. Can be negative early on.

Treatment

Antibiotics cure most people, especially when started early.

Self-care

• Take all your antibiotics
• Remove ticks with fine-tipped tweezers, pulling straight up
• Check your body for ticks after being outdoors

Medicines

Common antibiotics:

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Some people have tiredness or aches for months after treatment. More antibiotics don't help these lingering symptoms; work with your care team on a plan.

Prevention

To prevent tick bites:

• Use EPA-registered insect repellent
• Treat clothing with permethrin
• Check your body, kids, and pets for ticks
• Shower soon after being outdoors

Which doctor treats this

• Start with your primary care provider (family doctor or internist).

Children, pregnancy, and older adults

• Children: Doxycycline can be used for short courses in children of all ages.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Most people recover completely with prompt antibiotics.

Getting ready for your visit

Take a photo of the rash.

What to bring

• Rash photos
• When and where you were bitten

Questions to ask

• How long will I take antibiotics?
• What if symptoms don't go away?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Lyme disease