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What Is Lyme Disease?

What is Lyme disease?
Lyme disease is an illness caused by bacteria that are spread to people and animals by tiny infected deer ticks.

Where is Lyme disease found?
In Massachusetts, deer ticks are found everywhere, but especially in coastal areas, the islands and the Connecticut River Valley. In the Boston area, ticks can be found in grassy, brushy or wooded areas, but the risk of contracting Lyme disease in Boston is considered low. The time the disease is most likely to spread is between late May and early autumn, when ticks are most active.

How is Lyme disease spread?
Deer ticks cling to plants near the ground in brushy, wooded, or grassy places. These ticks are quite small and climb onto animals and people who brush against the plants. Very young ticks, called larvae, which are no bigger than the period at the end of a sentence, pick up the bacteria that cause Lyme disease by biting infected animals. Slightly older ticks, called nymphs, which are the size of a poppy seed, are the stage most likely to bite humans. Adult deer ticks can also transmit the disease, but they are not as great a risk as nymphs are because the adults are less likely to bite humans because they are easier to see and remove.

Ticks live for 2 years and can infect animals as well as people. Not all ticks carry Lyme disease, and being bitten by a deer tick does not mean that you will always get the disease. The tick must usually be attached for at least 24 hours to pass on the bacteria, so removing the tick promptly will greatly decrease your chances of being infected.

What are the symptoms of Lyme disease?
Early stage (days to weeks) An early symptom of Lyme disease is usually a rash where the tick was attached. The rash appears between 3 days and a month after the bite. It often starts as a small red area then spreads, clearing up in the center so it looks like a donut. However, the rash may not always appear like this. Flu-like symptoms, such as fever, headache, stiff neck, sore and aching muscles and joints, fatigue and swollen glands are also common in the early stages of Lyme disease.

Although these early symptoms often go away by themselves after a few weeks, the person may still be infected. Without medical treatment, about half of infected people will get the rash again in other places on their bodies, and many will experience more serious problems. Early treatment with antibiotics can clear up the rash within days and is important to prevent more serious problems from occurring later on.

Later stages (months to years):
People with Lyme disease can develop late-stage symptoms even if they never noticed a donut-shaped rash. Up to 60% of people with untreated Lyme disease get arthritis (inflammation of the joints), usually in their knees, elbows and wrists. The arthritis can move from joint to joint and become chronic. About 10 to 20% of people who don’t get treatment develop nervous system problems. The most common problems include meningitis (an inflammation of the lining of the brain and spinal cord); facial weakness (Bell’s palsy); and weakness, pain, or both in the hands, arms, feet and/or legs. These symptoms can last for months, often shifting between mild and severe. The heart also can be affected in Lyme disease, with slowing down of the heartbeat and fainting. This can happen to the heart in early or late stages of the disease.

How is Lyme disease treated?
Prompt treatment of early symptoms with certain antibiotics is an important step to prevent later, more serious problems. Treatment of Lyme disease in its later stages has not been standardized.

Above content provided by the Boston Public Health Commission in partnership with Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.