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Talbot County Department of Health
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Lyme Disease

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What is Lyme Disease?

Lyme disease is a bacterial infection caused by Borrelia burgdorferi (and rarely Borrelia mayonii in the U.S.), transmitted to humans through the bite of infected blacklegged ticks (also known as deer ticks).

Quick Facts

  • Transmission: Through the bite of infected blacklegged ticks.
  • Common Regions: Northeastern, mid-Atlantic, and upper Midwest regions of the United States.
  • Peak Season: Late spring through early fall.

Signs and Symptoms

Early Signs (3–30 days after tick bite):

  • Erythema migrans (EM) rash: Occurs in approximately 70–80% of infected individuals. The rash:
    • Appears at the site of the tick bite.
    • Expands gradually over several days.
    • May resemble a “bull’s-eye” appearance.
    • Is rarely itchy or painful.
    • Fever, chills, headache, fatigue, muscle and joint aches, swollen lymph nodes.

Later Signs (days to months after tick bite):

  • Severe headaches and neck stiffness.
  • Additional EM rashes on other areas of the body.
  • Arthritis with severe joint pain and swelling, particularly in large joints like the knees.
  • Facial palsy (loss of muscle tone or droop on one or both sides of the face).
  • Heart palpitations or irregular heartbeat (Lyme carditis).
  • Episodes of dizziness or shortness of breath.
  • Inflammation of the brain and spinal cord.
  • Nerve pain, shooting pains, numbness, or tingling in the hands or feet.
  • Problems with short-term memory.

Diagnosis

  • Clinical Evaluation: Based on symptoms, physical findings (e.g., EM rash), and the possibility of exposure to infected ticks.
  • Laboratory Testing: Recommended for patients with symptoms of Lyme disease. The CDC advises a two-step serologic testing process using FDA-cleared tests:
    1. Enzyme immunoassay (EIA) or immunofluorescence assay (IFA).
    2. If the first test is positive or equivocal, it is followed by a Western blot test.

Note: Antibody tests may be falsely negative during the first few weeks of infection.

Treatment

  • Early-Stage Lyme Disease: Can be treated with a 10–14-day course of oral antibiotics such as doxycycline, amoxicillin, or cefuroxime axetil, depending on the stage and extent of the disease.
  • Later Stages: May require longer courses or intravenous antibiotics, depending on the severity and specific manifestations.

Most people recover completely with appropriate antibiotic treatment.

Prevention Tips

  • Avoid wooded and brushy areas with high grass and leaf litter.
  • Walk in the center of trails.
  • Use insect repellents containing 20–30% DEET on exposed skin and clothing.
  • Wear long sleeves and pants; tuck pants into socks or boots.
  • Perform thorough tick checks after outdoor activities.
  • Shower soon after being outdoors to wash off unattached ticks.
  • Tumble clothes in a dryer on high heat for 10 minutes to kill ticks.

Tick Removal Guidelines

  1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Avoid twisting or jerking the tick.
  3. After removal, clean the bite area and your hands with rubbing alcohol or soap and water.
  4. Dispose of the tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet.

When to Seek Medical Attention

If you have been in areas where Lyme disease is common and have symptoms, even if you don’t recall a tick bite.

If you develop symptoms of Lyme disease after a tick bite.

If you observe an expanding rash or other possible symptoms.

CDC Resources