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1. What is Lyme disease?

Lyme disease is a bacterial infection you get from the bite of an infected Deer Tick. Lyme disease may cause symptoms affecting the skin, nervous system, heart and/or joints of an individual. Your doctor can diagnose Lyme disease based on:

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

Your history of possible exposure to infected ticks depends on:

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

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.

2. 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.

3. 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.

4. 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 millimeters) 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.

5. What are the signs and symptoms of Lyme disease?

Discover details regarding signs and symptoms of Lyme Disease on the Signs and Symptoms page.

6. How is Lyme disease diagnosed?

Your doctor can diagnose Lyme disease based on:

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

Your history of possible exposure to infected ticks depends on:

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

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%). 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. For complete details and for a better understanding of possible antibiotics view the Treatment for Lyme Disease page.

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. For details about the future possibilities visit the Possible Future Vaccine for Lyme Disease page.

10. How is Lyme disease transmitted?

Not all ticks carry Lyme Disease, and not all deer ticks are infected with the bacteria that cause Lyme disease. Ticks can become infected if they feed on small animals that are infected. The disease can be spread when an infected tick bites a person and stays attached for a period of time.

(Image) From left to right: The deer tick (Ixodes scapularis) adult female, adult male, nymph, larva on a centimeter scale.

(Image) Adult Female Ticks: Ixodes (Deer Tick) - left and Dermacentor (Dog Tick) - right. Please note, ticks shown approximately three times actual size.

11. When do most people get Lyme disease?

Most cases of Lyme disease occur during the late spring, early summer months when the nymphal stage deer tick is active. This tick is the size of a sesame or poppy seed.

12. Where will I find ticks?

Ticks are everywhere there is grass, especially around your home. They live close to the ground and crawl up on grass or bushes and hang, waiting for a ride to a blood meal. They are usually found at the edges of woods and lawns, on shrubs and bushes, in leaf litter, near stone walls and woodpiles.

13. What can I do to protect myself from getting Lyme disease?

The main thing you can do, to protect yourself, is a daily tick check, especially on children. Ticks need to be attached longer than 24 to 36 hours to pass on the disease, if they are infected. Tick checks should be done frequently while in a tick infested areas and again after leaving. The best time to check is after a bath or shower, feeling the skin for a tiny, scab like bump. A full body check is recommended including, the scalp, around the hairline and ears, neck, chest, armpits, waistband area, groin, behind the knee and between toes. Also check pets thoroughly when they come in from outdoors. Pets may have ticks feeding, which can fall off outdoors and lay eggs. They may also have ticks crawling on their fur which can then attach to our skin. Also, when going outdoors wear protective clothing. Wear shoes and socks; tick live close to the ground. Wear light colors to see ticks if they are crawling. Wear long pants and long sleeved shirts, if it’s not too hot, and tuck pants into socks and shirt into pants. Wear a hat to protect the hair and if you have long hair, tie it up and put it under the hat.

Wear repellents containing deet when outdoors. Follow the directions carefully. Do not spray aerosols indoors. Apply only to exposed skin and wash off when returning indoors. Try not to apply repellents to face and hands. Sweat can cause the repellents to run into eyes, or mouth and hands or fingers can find their way into the mouth. When walking in wooded or grassy areas, stay in the middle of the pathway. Avoid high-risk areas such as the edges of wood and tall grass fields. Moist, shaded areas may also be risk areas.

Keep the area around your property clear. Remove leaf litter and brush as far away from your house as possible. Prune low lying bushes to let in more sunlight, and rake up any leaves in areas where you or children spend time. This should be done every fall because ticks prefer to live during the winter under leaf-litter.

14. I found a tick on me, now what do I do?

The first thing to remember is don’t panic. If you’ve been doing tick checks every day you have a good idea how long the tick has been attached. The tick needs to be removed. Prompt and proper removal will help reduce the risk of infection.

• After removal wash your hands and apply antiseptic to the site.
• The area around the bite site may become immediately red. This is not the bull’s eye rash, this is an allergic reaction to the bite, which is normal, and should go away in a couple of days.
• Do not apply substances such as Vaseline, nail polish remover, repellents, soaps or heat to the tick while it is still attached. These materials might agitate the tick and cause it to regurgitate infective fluid into the site.
• Do not panic if the mouth-part breaks off. The mouth-parts alone cannot transmit Lyme disease because the infective body of the tick is no longer attached. However, to prevent secondary infection, remove the mouth-parts as you would a splinter. Do not squeeze the body of the tick. This may force infection into the site.
• Grasp the tick’s mouth-parts close to the skin and steadily pull upward and outward.
• Use fine pointed tweezers or forceps to be removed.

If you’re not sure what kind of tick you have, the Orange County Department of Health has a free tick identification service available. Also, in cooperation with the New York State Department of Health, ticks brought to the Orange County Health Department will be sent out for identification, which takes a few days. Information in writing, as to what kind of tick it is, approximately how long the tick was attached and if any parts of the tick are missing, will be included in the information sent directly to your home. Neither the Orange County Department of Health nor the New York State Department of Health test ticks for the disease.

After you have all this information, you and your provider determine what action, if any, is needed.

15. When do symptoms appear?

Early symptoms usually appear within three to thirty days after the bite of an infected tick.