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Lyme disease basics

Take steps to prevent infection from Lyme disease if you live in or visit areas that may be home to ticks.

A tick can be so small—the size of a pinhead—that it may appear to be a speck of dirt or a new freckle. But these tiny insects can cause big problems.

Ticks may become infected with Borrelia burgdorferi bacteria. And an infected tick, by burying its minuscule mouth in your skin, spreads Lyme disease.

The tick often attaches in the more hidden areas of the body, such as the groin, armpits and scalp. Generally, the tick must be attached for 36 to 48 hours or more before the infection is spread. Unfortunately, Ixodes scapularis ticks (aka deer ticks or blacklegged ticks)—the type that can carry Lyme disease—are much smaller than common dog or cattle ticks. That means they may be able to attach themselves without you noticing.

Don't get ticked off

Areas of the country where Lyme disease is most prevalent are the Northeast and the Great Lakes states, especially Minnesota and Wisconsin. Animals and humans are exposed to Lyme disease when they brush against the grasses and shrubs that harbor disease-carrying ticks.

Staying safe

If ticks can't bite you, you can't get sick. Prevention starts at home. Follow these tips from the Centers for Disease Control and Prevention (CDC) to help keep ticks away from your property:

  • Remove leaves and clear brush and tall grass around your house and at the edges of your property. If you live in an area that has a deer population, installing fences to keep them out and removing plants that are attractive to them may prevent ticks from getting a free ride onto your property.
  • Avoid places where ticks are likely to live, such as woods or areas with tall grass and lots of shrubs, especially during warmer months, when ticks are most active. If you go camping or hiking in April through September, take extra care to protect yourself from ticks by heeding the advice below from CDC and the American Academy of Family Physicians.

Cover up

When you are in woods or areas with tall grass or shrubs, the following measures will decrease your risk of tick bites:

  • Wear light-colored clothing so ticks on your clothes can be easily spotted and removed before the tick bites you.
  • Wear a hat, long pants and a long-sleeved shirt to keep ticks away from your skin.
  • Tuck pant legs into socks or boots and shirts into pants. Tape the area where socks meet pants so ticks can't crawl in.
  • Walk in the center of trails and avoid brushing against overhanging grass and brush where ticks are likely to lurk.
  • Spray insect repellent containing the chemical DEET on clothes and exposed skin (except the face). Or treat clothing, especially pants, socks and shoes, with the insect repellent permethrin, which kills ticks on contact.

Inspection

When you get indoors, wash and dry your clothing at a high temperature. Inspect your body carefully, especially your scalp, groin and armpits.

If you find a tick, grasp it with tweezers, coming as close to your skin as you can. Slowly pull the tweezers straight back. Be careful to avoid crushing the tick. Either submerse the tick in alcohol, flush it down the toilet or save it in a sealed container. The health department may be able to tell whether it's an Ixodes tick, but they won't be able to tell whether it carries the bacteria that spread Lyme disease.

If you get bitten

The early stage of Lyme disease is usually marked by one or more flu-like symptoms: fatigue, chills, fever, headache, muscle and joint pain, and swollen lymph nodes. The most telling symptom, however, is a red, circular rash that usually appears near the bite area three days to one month after you are bitten. Sometimes many patches of the rash appear. Diagnosis may be difficult because the symptoms are similar to viral infections such as flu or mononucleosis.

In its early stages, Lyme disease is easy to treat, and usually is cured, with antibiotics.

The late stages of Lyme disease may not appear for weeks or months after the infection. Late-stage symptoms generally appear as arthritis of one or more large joints, especially the knees. But it may cause nervous system abnormalities or heart rhythm irregularities. Late-stage Lyme disease is harder to diagnose, as the symptoms may be similar to other diseases such as rheumatoid arthritis or multiple sclerosis.

Most people who are treated in the later phases of Lyme disease respond well to antibiotics, although if the disease has been present for a long time the joints or nervous system may have been permanently damaged. Death from Lyme disease is rare.

If you have any of these symptoms and you've been bitten by a tick, or have been in tick areas, be sure to tell your doctor. Because diagnosis is difficult, it's important to give your doctor as much information as possible.

Reviewed 1/26/2021

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