Bookmark and Share

Department of Health

Lyme Disease

1. What is the best way to remove a tick?
When you find a tick attached to your skin, there's no need to panic. There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick quite effectively. Firmly grasp the tick as close to the skin's surface as possible. Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

If you are concerned about a tick bite, contact your health care provider. He or she will help you determine the best steps to take after being bitten.

If redness or swelling develops within a few hours after the tick bite, but goes away within a day or 2, it is likely an allergic reaction to the tick and not a rash. Check the site of the bite for a rash and keep close watch on your health for 30 days after the bite. See a doctor if you develop:

  • A fever
  • A rash
  • Flu-like symptoms

Once you have removed the tick from yourself or a family member, you can throw the tick away in your normal garbage. Sometimes it may be helpful to keep the tick so it can be identified by your doctor or another health professional should you develop any symptoms. If you choose to do this, place the tick in a small jar or sealed plastic bag with rubbing alcohol, which will both kill and preserve it.

Avoid folklore remedies such as "painting" the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible--not waiting for it to detach.

2. I just pulled a tick off of myself, what do I do?
If you pulled a tick from your skin, clean the bite area with soap and water. If redness or swelling develops within a few hours after the tick bite, but goes away within a day or two, it is likely an allergic reaction to the tick and not a rash. Check the site of the bite for a rash and keep close watch on your health for 30 days after the bite. See a doctor if you develop:

  • A fever
  • A rash
  • Flu-like symptoms

Once you have removed the tick from yourself or a family member, you can throw the tick away in your normal garbage. Sometimes it may be helpful to keep the tick so it can be identified by your doctor or another health professional should you develop any symptoms. If you choose to do this, place the tick in a small jar or sealed plastic bag with rubbing alcohol, which will both kill and preserve it.

If you are concerned about a tick bite, contact your health care provider. He or she will help you determine the best steps to take after being bitten.

3. How do people get Lyme disease?
The Lyme disease bacterium, is spread through the bite of infected ticks. The bacteria (germs) that cause Lyme disease normally live in mice, squirrels, and other small animals. Lyme disease is transmitted (spread) among these animals, and to humans, through the bites of deer ticks. Deer ticks are also called black-legged ticks.

Most humans are infected through the bites of immature ticks called nymphs. Nymphs are tiny (less than 2 mm) and difficult to see; they feed during the spring and summer months. Adult ticks can also transmit Lyme disease bacteria, but they are much larger and may be more likely to be discovered and removed before they have had time to transmit the bacteria. Adult ticks are most active during the cooler months of the year.

4. What is Lyme disease?
Your doctor can diagnose Lyme disease based on:

  • Symptoms
  • History of possible exposure to infected ticks
  • Lab tests (in some cases)

Your history of possible exposure to infected ticks depends on:

  • Where you live
  • Where you have traveled
  • What your outdoor activities have been

There are other diseases that cause illness similar to Lyme disease. Someone with Lyme disease may not have the characteristic bull's-eye rash or remember being bitten by a tick. Lab testing is NOT recommended for people who don't have symptoms of Lyme disease.

5. What are the signs and symptoms of Lyme disease?
One of the first signs of Lyme disease is usually a circular rash called erythema migrans (er-uh-THEE-muh MY- granz) or EM. An EM appears at the site of a tick bite after 3 to 30 days. This rash slowly expands over a period of several days and can reach up to 12 inches (30 cm) across. The center of the rash may clear as it gets larger, giving it a bull's-eye appearance. The rash may be warm but is not usually painful. A rash that occurs within hours at the site of the tick bite but goes away within a day or 2 is likely an allergic reaction to the tick and not an EM rash.

Other early symptoms of Lyme disease can include:

  • Fatigue (tiredness),
  • Chills
  • Fever
  • Headache
  • Muscle and joint aches, and
  • Swollen lymph nodes

Some people may get these general symptoms in addition to an EM rash, but in others, these general symptoms may be the only evidence of infection.

Some people get a small bump or redness at the site of a tick bite that goes away in 1-2 days, like a mosquito bite. This is not a sign that you have Lyme disease. However, ticks can spread other organisms that may cause a different type of rash. For example, Southern Tick-Associated Rash Illness (STARI) causes a rash with a very similar appearance.

Untreated Lyme disease may spread to other parts of the body within a few days to weeks. Symptoms may include:

  • Paralysis (puh-RAL-uh-sis) (inability to move the muscles) of the face, usually on one side or the other (Bell's palsy)
  • Severe headaches and neck stiffness due to meningitis (men-in-JAHY-tis) (swelling around the brain)
  • Heart palpitations and dizziness
  • Pain that moves from joint to joint

After several months, about 60 percent of people with untreated infection will begin to have arthritis that comes and goes, with severe joint pain and swelling. A few untreated people may develop chronic neurological (brain and spine) problems months to years after infection. These include:

  • Shooting pains,
  • Numbness or tingling in the hands or feet
  • Problems with concentration and short-term memory

6. How is Lyme disease diagnosed?
Your doctor can diagnose Lyme disease based on:

  • Symptoms
  • History of possible exposure to infected ticks
  • Lab tests (in some cases)

Your history of possible exposure to infected ticks depends on:

  • Where you live
  • Where you have traveled
  • What your outdoor activities have been

There are other diseases that cause illness similar to Lyme disease. Someone with Lyme disease may not have the characteristic bull's-eye rash or remember being bitten by a tick. Lab testing is NOT recommended for people who don't have symptoms of Lyme disease.

7. How good is testing for Lyme disease?
The accuracy of any test for Lyme disease depends upon the stage of disease. Blood testing for Lyme disease has poor sensitivity in the early stages of disease. Poor sensitivity means some people who have the disease will get a negative test result. CDC has long recommended that patients in the early stages of the disease be diagnosed and treated without the delay and expense of lab testing.

During later stages of disease, currently available testing methods have very good sensitivity (97 to 100 percent). If you think you might have Lyme disease, talk to your doctor.

8. How is Lyme disease treated?
Lyme disease is treated with antibiotics (drugs that kill bacteria). If you think you have Lyme disease, talk to your doctor right away. The recommended length of treatment depends on the antibiotic used. The antibiotic chosen for treatment depends on the symptoms and the patient. There is NO scientific evidence that antibiotic treatment for several months or years is necessary. Long-term antibiotic use can do more harm than good. It can even be deadly.

Common antibiotics (drugs that kill bacteria) used to treat Lyme disease include:

  • Amoxicillin (am-ok-suh-SIL-in)
  • Doxycycline (dok-see-SAHY-kleen)
  • Cefuroxime axetil (SI-fyur-ah-zem AXE-tihl)

Some other oral antibiotics are slightly less effective, but can be used for patients who have allergies or adverse reactions to the primary antibiotics. Antibiotics may be given by IV (through a needle in the vein) for patients with severe heart or neurological (brain and nerve) problems from the disease.

Alternative treatments suggested on certain websites claim to have an effect on the Lyme disease bacteria (germs). However, there is NO scientific evidence that suggests these substances or devices work. In addition, they can be costly, dangerous, or even deadly.

If you need to find a doctor, the American Lyme Disease Foundation (ALDF) may be able to help identify one. The inclusion of a doctor on the ALDF list should NOT be seen as an endorsement by CDC.

You could also choose to see a doctor in your area who specializes in infectious diseases; preferably a doctor associated with a university.

If you have concerns about the treatment you are receiving, contact your state medical board.

9. When will a Lyme disease vaccine become available?
CDC shares your concern about Lyme disease and supports the development of a safe, effective, and adequately validated vaccine against this illness.

Results of recent trials appear promising: http://cid.oxfordjournals.org/content/52/suppl_3/s266.abstract

Unfortunately, a vaccine for Lyme disease is NOT currently available, and the number of other tick-borne infections continues to rise. Therefore, it is more important than ever to protect yourself against all tick-borne diseases by taking the following steps:

  • Use repellent that contains 20%–30% DEET.
  • Wear permethrin-treated clothing when exposure to ticks is likely.
  • Check for ticks daily.
  • Shower soon after coming indoors.
  • Call your healthcare provider if you develop a fever or rash.

For more information on Lyme, please visit the CDC website: www.cdc.gov/lyme/

Source: Centers for Disease Control and Prevention. Lyme Disease. (2015, March 4). Retrieved May 7, 2015, from www.cdc.gov/lyme/