Lyme Disease

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Reviewed by: Stephen C. Eppes, MD and Clifton Castleman, WEMT & lead acarologist at

Adult female Blacklegged Deer Tick

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.

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Listen to the CWS Podcast about Tick Safety & Lyme Disease

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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.

Blacklegged Tick Engorgement

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.

Test a Tick for Lyme Disease


How long does it take to transmit Lyme?

Even if the tick is infected with Borrelia burgdorferi (the bacteria that causes Lyme disease) the overall risk of developing Lyme disease is low. The tick has to have taken a “blood meal” from the human host before it can pass along an infection. This means the tick has to be attached and consistently feeding for between 36 to 48 hours before it can transmit Lyme. A tick that has not yet attached to the skin is easy to remove or is not engorged (i.e. is still flat) when removed, could not have transmitted Lyme disease or any other infection. That’s why it is important to do regular “tick checks” on yourselves and your children so that ticks can be identified and removed quickly. On a side note, we should mention that there have been several cases documented where transmission occurred within 24–36 hours of attachment, however those are extremely rare.

IMPORTANT NOTE: Many individuals —even some “Lyme literate” physicians— still refer to old and outdated research, and are still under the impression that infection can occur in less than 24 hours of attachment. Numerous (and large) studies have since been published and have disproven this old information, repeatedly.


What Are the Signs and Symptoms?

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:


In roughly 80% of all cases, one of the first signs of infection is a circular, bulls-eye rash. This rash appears within 1-2 weeks of infection but may develop up to 30 days after the tick bite.

The “bull’s-eye” appearance has a central red spot surrounded by normal colored 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, and may include arthritis, particularly in the knees, and memory lapses (this last symptom happens mainly to adults and is rare in kids and teens).

Development of Lyme Disease Symptoms

Testing for Lyme Disease

Having such a wide range of symptoms can make Lyme disease difficult for doctors to diagnose. Fortunately, there are blood tests that looks for evidence of the body’s reaction to Lyme disease. There are currently three tests used; two of which are not reliable, however luckily, the third one typically works sort-of well – the Western Blot Test. This test actually tests for the body’s creation of antibodies to the bacteria that causes Lyme disease.

MainButton TickTesting

Note:The body typically only generates these antibodies after several weeks – not the moment that you were bitten by the tick. If you get tested within a week or two of getting bitten by a tick the test will most likely come back negative for Lyme disease. That said, most physicians are now prophylactically prescribing antibiotics (Doxycycline) immediately when you go for your checkup, and not waiting for test results to come back.


How Is Lyme Disease Treated?

There is no vaccine for Lyme disease currently on the market in the United States (for HUMANS). Lyme disease is usually treated with a 2 to 4–week course of antibiotics (Doxycycline) to ward off the current bacterial infection. 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.

Note that once a person has contracted Lyme disease, he or she has Lyme disease for life. Antibiotics help to manage outbreaks which may be anywhere from months, to years, to decades apart.


Is It Contagious?

Tick400Lyme 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.


How 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 repellent 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 (20-30% +), always follow the recommendations on the product’s label and don’t over-apply 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. Otherwise, we strongly recommend the use of permethrin to treat clothing before going out into tick country.



  • Use a Tick-Twister or a pair of needle-nosed splinter forceps 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.

A Note of Caution:
Do NOT use “folk remedies” like petroleum jelly or a lit match to kill and remove a tick. The thought behind petroleum is that it will suffocate the tick. That is somewhat valid, as ticks breathe, much like fish, primarily through gills on their abdomen. That said, they can also breathe through their mouths while attached. Burning a tick is also not advised, as you’ll probably also burn yourself!

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.


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