You've probably heard of Lyme disease. It's often
associated with heavily wooded or grassy areas where mice and deer
live. Lyme disease is most common in the northeastern United
States and the Pacific Northwest, as well as the northern
midwestern states.
What Is Lyme Disease?
Lyme disease is an infection caused by the bacterium
Borrelia burgdorferi
. This bacterium is usually found in animals like mice and deer. It
can be carried to people from these animals by
Ixodes
ticks (known as black-legged or deer ticks). These ticks pick up
Borrelia burgdorferi
when they bite infected animals and then infect humans by biting
them and passing the bacteria into the person's
bloodstream.
Sound gross? Maybe. But you can be sure that you won't
witness this process: It's very hard to see the ticks
themselves. Immature ticks, or nymphs, are about the size of a
poppy seed. Adult ticks are about the size of a sesame seed.
Because the ticks are hard to find, it helps to be aware of
the symptoms of Lyme disease. It's easy to overlook a tick
bite. Many people who get Lyme disease don't remember being
bitten. The good news is that most tick bites don't result in
Lyme disease.
What Are the Signs and Symptoms and When Do They Appear?
Lyme disease can affect different body systems, such as the
nervous system, joints, skin, and heart. The symptoms of Lyme
disease are often described as happening in three stages. Not
everyone experiences all of these stages, though:
- Usually, the first sign of infection is a circular rash. This
rash appears within 1-2 weeks of infection but may develop up to
30 days after the tick bite. The rash often has a characteristic
"bull's-eye" appearance, with a central red spot
surrounded by clear skin that is ringed by an expanding red rash.
It may also appear as an expanding ring of solid redness. It may
be warm to the touch and is usually not painful or itchy. The
bull's-eye rash may be more difficult to see on people with
darker skin tones, where it may take on a bruise-like appearance.
The rash usually resolves in about a month. Although this rash is
considered typical of Lyme disease, many people never develop
it.
- Along with the rash, a person may experience flu-like
symptoms such as swollen lymph nodes, fatigue, headache, and
muscle aches. Left untreated, symptoms of the initial illness 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 appear within several weeks after the tick bite,
even in someone who has not developed the initial rash. The
person may feel very tired and unwell, or may have more areas of
rash that aren't at the site of the bite.
Lyme disease can affect the heart, leading to an irregular heart
rhythm or chest pain. It can spread to the nervous system,
causing facial paralysis (Bell's palsy) or tingling and
numbness in the arms and legs. It can start to cause headaches
and neck stiffness, which may be a sign of meningitis. Swelling
and pain in the large joints can also occur.
- The last stage of Lyme disease can occur if the early stages
of the disease were not detected or appropriately treated.
Symptoms of late Lyme disease can appear any time from weeks to
years after an infectious tick bite. They may include arthritis,
particularly in the knees, and memory lapses (this last symptom
happens mainly to adults and is rare in kids and
teens).
Having such a wide range of symptoms can make Lyme disease
difficult for doctors to diagnose. Fortunately, there's a blood
test that looks for evidence of the body's reaction to Lyme
disease.
When Should I Call My Doctor?
If you think you may be at risk for Lyme disease or a tick has
bitten you, contact your doctor. Although conditions other than
Lyme disease can cause the symptoms mentioned above, it's
always a good idea to discuss symptoms with your doctor. That way
you can get further evaluation and treatment if necessary, before
the disease progresses too far. This is especially true if you
develop a red-ringed rash, prolonged flu-like symptoms, joint pain
or a swollen joint, or facial paralysis.
Can I Prevent Lyme Disease?
There's no surefire way to avoid getting Lyme disease. But
you can minimize your risk. Be aware of ticks when
you are in high-risk areas. If you work outdoors or spend
time gardening, fishing, hunting, or camping, take precautions:
- Wear enclosed shoes or boots, long-sleeved shirts, and long
pants. Tuck your pant legs into your shoes or boots to prevent
ticks from crawling up your legs.
- Use an insect repellant containing 20% 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 wear a cap for protection.
- Don't sit on the ground outside.
- Check yourself for ticks regularly - both indoors and
outdoors. Wash your clothes and hair after leaving tick-infested
areas.
If you use an insect repellent containing DEET, always follow
the recommendations on the product's 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.
There is no vaccine for Lyme disease currently on the market in
the United States.
How Is Lyme Disease Treated?
Lyme disease is usually treated with a 2- to 4-week course of
antibiotics. Cases of Lyme disease 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 beginning treatment.
Is It Contagious?
Lyme disease is not contagious, so you can't catch it from
another person. But you can get it more than once from ticks that
live on deer, in the woods, or travel on your pets. So continue to
practice caution even if you've already had Lyme disease.
What Can I Do to Feel Better?
You should know how to remove a tick just in case one lands on
you or a friend. First, don't panic. Your risk of developing
Lyme disease after being bitten by a tick is only about 1% to 3%.
On top of that, it takes at least 24 to 48 hours for the tick to
transmit the bacteria that causes Lyme disease. (To be safe,
though, you'll want to remove the tick as soon as possible.)
This is why a daily tick check is a good idea for people who live
in high-risk areas.
If you find a tick:
- Call your doctor. He or she may want you to save the tick
after removal so that the tick can later be identified as the
type that may carry Lyme disease. You can put the tick in a jar
of alcohol to kill it.
- Use tweezers to grasp the tick firmly at its head or mouth,
next to your skin.
- Pull firmly and steadily on the tick until it lets go of the
skin. If part of the tick stays in your skin, don't worry. It
will eventually come out - although you should call your doctor
if you notice any irritation in the area or symptoms of Lyme
disease.
- Swab the bite site with alcohol.
One note of caution: Don't use "folk remedies" like
petroleum jelly or a lit match to kill and remove a tick.
Tick bites don't generally hurt - that's part of the
difficulty in knowing whether someone has Lyme disease because pain
usually helps to call attention to problems. So be on the lookout
for ticks and rashes, and call your doctor if you're at all
concerned.
Reviewed by:
Stephen C. Eppes, MD
Date reviewed: April 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.