Lyme Disease (Tick-borne borreliosis, Lyme arthritis) Fact Sheet

Last Reviewed: July 2017

What is Lyme disease?

Lyme disease is an infection caused by the bacteria Borrelia burgdorferi and is spread to humans through the bite of infected blacklegged ticks (or deer ticks). Not all deer ticks are infected with the bacteria. Lyme disease can affect people of any age. A vaccine for Lyme disease is not currently available. Lyme disease is the most prevalent tick-borne disease in New York and has been reportable since 1986.

Who gets Lyme disease?

Lyme disease can affect people of any age. People who spend time outdoors in activities such as camping, hiking, golfing, or working or playing in grassy and wooded environments are at increased risk of exposure. The chances of being bitten by a deer tick are greater during times of the year when ticks are most active. Ticks can be active any time the temperature is above 45° F. Young deer ticks, called nymphs, are active from mid-May to mid-August and are about the size of poppy seeds. Adult ticks are most active from March to mid-May and from mid-August to November and are about the size of sesame seeds. Both nymphs and adults can spread Lyme disease. Infected deer ticks can be found throughout New York State.

How is Lyme disease spread?

Not all deer ticks are infected with the bacteria that cause Lyme disease. Ticks can become infected if they feed on animals such as mice and other mammals that are infected. The disease can be spread when an infected tick bites a person and stays attached for a period of time. In general, the tick must be attached for 36 to 48 hours or more. Lyme disease does not spread from one person to another. Transfer of the bacteria from an infected pregnant woman to her fetus is extremely rare.

What are the signs and symptoms of Lyme disease?

Early symptoms usually appear within 3 to 30 days after the bite of an infected tick. In 60-80 percent of cases, a circular bull's eye rash about two inches in diameter, called erythema migrans, appears and expands around or near the site of the tick bite. Sometimes, multiple rash sites appear. One or more of the following symptoms usually mark the early stage of Lyme disease: chills and fever, headache, fatigue, stiff neck, muscle and/or joint pain, and swollen glands. If Lyme disease is unrecognized or untreated in the early stage, more severe symptoms may occur. As the disease progresses, severe fatigue, a stiff aching neck, and tingling or numbness in the arms and legs, or facial paralysis can occur. The most severe symptoms of Lyme disease may not appear until weeks, months or years after the tick bite. These can include severe headaches, painful arthritis, swelling of the joints, and heart and central nervous system problems.

How is Lyme disease diagnosed?

Symptoms and possible tick bite exposure may cause a health care provider to suspect Lyme disease. If suspected, lab tests can be performed to confirm diagnosis.

What is the treatment for Lyme disease?

Patients treated with antibiotics in the early stages of Lyme disease usually recover quickly and completely. Antibiotics commonly used for treatment include doxycycline, amoxicillin, or cefuroxime axetil. Patients with certain neurologic or cardiac forms of illness may require additional treatment. It is important to speak with your health care provider if you think you might have Lyme disease. The best treatment for Lyme disease is prevention and awareness.

Does past infection with Lyme disease make a person immune?

Lyme disease is a bacterial infection. Even if successfully treated, a person may become re-infected if bitten later by another infected tick.

What can be done to prevent Lyme disease?

The best prevention of Lyme disease is through awareness. Generally, ticks cannot jump or fly onto a person. They wait in vegetation and cling to animals and humans when they brush by. When in a potentially tick-infested habitat (wooded and grassy areas) take special care to prevent tick bites, such as wearing light-colored clothing (for easy tick discovery) and tucking pants into socks and shirt into pants. Check after every 2 to 3 hours of outdoor activity for ticks on clothing or skin. Brush off any ticks on clothing or skin before skin attachment occurs. A thorough check of body surfaces for attached ticks should be done at the end of the day. If removal of attached ticks occurs within 36 hours, the risk of tick-borne infection is minimal. For proper tick removal, please watch the video at Tick removal. A vaccine for Lyme disease is not currently available.

Insect repellents can be effective at reducing bites from ticks that can spread disease. If you decide to use a repellent, use only what and how much you need for your situation. More information on repellents can be found at Environmental Protection Agency - insect-repellents.

In addition:

• Be sure to follow label directions.
• Try to reduce the use of repellents by dressing in long sleeves and pants tucked into socks or boots.
• Children should only handle repellents with adult supervision. Adults should apply repellents to their own hands first and then gently spread on the child's exposed skin. Avoid applying directly to children's hands. After returning indoors, wash your child's treated skin and clothing with soap and water or give the child a bath.
• Do not apply near eyes, nose or mouth and use sparingly around ears.
• After returning indoors, wash treated skin with soap and water.

Domestic animals can carry ticks into areas where you live so it is important to check pets for ticks before they enter the home.

How should a tick be removed?

Grasp the mouthparts with tweezers as close as possible to the attachment (skin) site. Be careful not to squeeze, crush or puncture the body of the tick, which may contain infectious fluids. Pull firmly and steadily upward to remove the tick. After removing the tick, thoroughly disinfect the bite site and wash hands. The NYSDOH has created a video on proper tick removal (Proper Tick removal) and a printable card with steps on how to remove ticks (How to Remove a Tick Card). See or call a doctor if there are concerns about incomplete tick removal. Do not attempt to remove ticks by using petroleum jelly, lit cigarettes or other home remedies because these may actually increase the chance of contracting a tick-borne disease.

Actual size of a tick