Lyme disease signs and symptoms: When should you seek medical care?

By Bianca Barr Tunno, AccuWeather staff writer

It’s tick season in parts of the United States. Though you may not know you were a tick's target right away, these signs and symptoms of Lyme disease can help you determine when to seek medical treatment.

Lyme disease is caused by infected black-legged (or deer) ticks and symptoms of the disease may vary, depending on how long it takes to discover the signs.

Early signs

Rash: The classic targetoid, or bull's-eye, rash is an early, visible symptom of Lyme disease and is seen in 70 to 80 percent of infected people, according to Dr. Bobbi Pritt, director of the Clinical Parasitology Laboratory at the Mayo Clinic in Rochester, Minnesota. This rash, technically called erythema migrans, takes about three days or more to appear at the site of a tick bite and is typically not painful or itchy.

Flu-like symptoms: Fever, chills, headache, fatigue, muscle and joint aches and swollen lymph nodes often coincide with the rash. But don’t just assume you have a cold, allergies or the flu. If you have these symptoms, even without a telltale rash, Pritt recommends to get treated with antibiotics as soon as possible.

“If you have those symptoms in the summertime, it’s a bit unusual,” Pritt said. “We don’t see influenza that often in the summer, so tick-borne diseases should be pretty high on the list for what could cause those symptoms.”

Lyme Disease Bullseye Rash

This is a classic “bullseye” rash, which manifested at the site of a tick bite on a woman's arm. Lyme Disease patients who are diagnosed early, and received proper antibiotic treatment, usually recover rapidly and completely. (CDC/James Gathany)

Later signs

Joint pain: Arthritis of a single joint may occur weeks, months or years after the initial infection. Pritt said usually a big joint like the knee will be affected and the pain is often only on one side of your body.

Nervous system problems: Symptoms include temporary facial paralysis (Bell’s palsy), short-term memory problems and shooting pain and numbness in hands and feet.

Pritt told AccuWeather that treatment of these more serious Lyme disease symptoms is the same – a course of doxycycline – but once the damage is done, it takes a long time to recover completely, even after the organism has been killed.

“Once a person is treated, they are no longer infected – that’s the good news,” Pritt said. “The bad news is that there is no immunity. You could very easily get Lyme disease again if you get bitten by another tick.”

Where are the ticks?

Pritt said studies show that as many as half of people who have Lyme disease don’t remember getting a tick bite, but they remember being in a place where they could get a tick bite. According to the Centers for Disease Control and Prevention (CDC), it’s likely to be in the Northeast or Upper Midwest.

Tens of thousands of cases of Lyme disease are confirmed each year, and CDC statistics reveal at least 95 percent of them occur in the following 14 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin.

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Identifying ticks

The black-legged tick (Ixodes scapularis) and western black-legged tick (Ixodes pacificus) transmit the bacteria that cause Lyme disease and other serious vector-borne diseases. Pritt said they are generally smaller than other ticks and have reddish bodies with dark-colored legs.

Black-legged ticks

These black-legged ticks, Ixodes scapulars, are found on a wide range of hosts including mammals, birds and reptiles. They are known to transmit Lyme disease to humans and animals. (CDC/Michael L. Levin, Ph. D)

American dog ticks (also called wood ticks) tend to be larger than black-legged (or deer) ticks and may have white streaks on its back.

However, according to this CDC chart, nymphal and larval ticks of any species may be too small or too engorged to identify, so be sure to remove any tick as soon as you notice one.

Ticks can always be submitted to a laboratory for identification, so experts suggest bringing the removed tick to a doctor or lab if you are suspicious.

"This is especially important for engorged ticks, since this indicates that they have been attached for an extended period of time," Pritt said. "The longer they are attached, the greater the risk that they can transmit disease-causing organisms."

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