May 10, 2023

Lyme Disease

Pennsylvania reports more cases of Lyme disease than anywhere else in the United States ¹. Because of this alarming statistic, familiarizing yourself with the symptoms of Lyme disease can help you avoid serious, and even permanent, health consequences.

Lyme disease is a bacterial infection transmitted via a tick bite. All counties in Pennsylvania are known to have ticks infected with this bacterium, with infection rates as high as 50% in some counties ¹.

Cases of Lyme disease are highest in late spring and early summer, when young ticks no bigger than a poppy seed are more prevalent in the environment. In fact, less than 20% of people with Lyme disease recall ever being bitten by a tick ¹.


Symptoms of Lyme disease

Lyme disease can cause many symptoms, and if untreated, can cause permanent health consequences. It is an inflammatory illness that harms multiple systems and organs in the body, including the central nervous system. Lyme disease happens in stages.

Although it is usually treated in its earliest stages, lack of proper treatment can cause the infection to progress and lead to long-term complications. Therefore, it is important to recognize symptoms early.

Stage One: Localized infection

Symptoms of Lyme disease usually develop within 1-2 weeks of a tick bite ². The earliest stage of Lyme disease can cause mild, flu-like symptoms which includes fever, headache, or muscle pain. Some patients may also develop eye redness and tearing.

About 70-80% of patients will develop an erythema migrans (EM) rash, which generally has a ring-like or bullseye shape ². The rash might feel warm to the touch. Check out pictures of EM rashes here.

Stage Two: Early disseminated Lyme disease

If Lyme disease is not treated, it can progress into the early disseminated stage of the infection. Symptoms include:

  • Multiple EM rashes
  • Fatigue
  • Muscle pain
  • Headache
  • Dizziness
  • Joint pain and stiffness
  • Joint swelling
  • Chest pain
  • Heart palpitations
  • Shortness of breath
  • Eye pain or double vision
  • Eye inflammation

About 20% of patients with early disseminated Lyme disease will develop central nervous system involvement ². This can cause:

Stage Three: Late disseminated Lyme disease

Late disseminated Lyme disease occurs when the bacteria have spread throughout the body. This can occur months or even years after the initial tick bite and cause long-term complications like joint inflammation, brain and nervous system disorders, and sleep disorders ³. In addition to early disseminated symptoms, other symptoms might include:

  • Arthritis
  • Heart rhythm disorders
  • Carditis
  • Abnormal muscle movement
  • Muscle weakness
  • Speech problems
  • Cognitive difficulties
  • Numbness and tingling
  • Nerve disorders
  • Brain disorders
  • Vision problems
  • Skin conditions
  • Other psychiatric and neurological problems

Testing & Treatment for Lyme disease

Lyme disease is treated with antibiotics. The duration of your treatment will depend on the stage of Lyme disease and severity of symptoms. In some cases, your healthcare provider might begin your treatment before the results of your bloodwork come back. For example, an EM rash is diagnostic for Lyme disease on its own. Treatment with antibiotics is effective and an appropriate course of antibiotics will resolve the disease.

It is important to follow all directions given to you by your healthcare provider. Take all antibiotics as prescribed. Individuals being treated for Lyme disease with an antibiotic should not donate blood until they’ve completed their treatment ⁴.


Prevention tips

Because ticks live in grassy or wooded areas, it is not always possible to avoid them. However, you can greatly reduce your risk of a tick bite if you:

  • Treat clothing and gear with products containing 0.5% permethrin
  • Use an EPA approved insect repellant
  • Check clothing, gear, and pets for ticks
  • Shower soon after being outdoors

You should perform regular tick checks with a mirror. The Centers for Disease Control and Prevention (CDC) recommends inspecting ⁵:

  • Under the arms
  • In and around the ears
  • Inside belly button
  • Back of the knees
  • In and around the hair
  • Between the legs
  • Around the waist

Ticks can live in urban areas, too, like in parks or small patches of grass. Performing regular tick checks even after simple activities such as dog walking or gardening can help prevent Lyme disease even if you live in an urban environment.

Proper Tick Removal

Although ticks usually have to be attached for 36-48 hours to transmit Lyme disease, it is important to remove them as soon as possible ⁴. To remove a tick:

  1. Grasp the tick close to the skin with tweezers
  2. Pull upwards with even pressure
  3. Wash the area with warm, soapy water
  4. Dispose of the tick by flushing it in the toilet, putting it in alcohol or a sealed container, or wrapping it tightly in tape.

It is important to properly remove ticks. Improper removal can cause mouthparts to break off into the skin or cause the tick's potentially infectious body fluids to escape, which may increase the risk of contracting a tick-borne infection like Lyme disease ⁶.

Avoid covering the tick with petroleum jelly or using a match near the tick, as it may cause the tick to regurgitate its stomach contents into the wound ¹.

For more information

Lyme disease is a common illness in Pennsylvania and it is estimated that cases will continue to increase. If you are bitten by a tick, it is important to monitor yourself for any Lyme disease symptoms.

Be safe when enjoying the outdoors! Do your best to prevent tick bites and remove ticks properly if they are found. For more information about Lyme disease, visit the CDC or PA Department of Health website.

¹ Pennsylvania Department of Health. (2023). Lyme disease Q&A for healthcare providers in Pennsylvania. Commonwealth of Pennsylvania.
² Skar, G. L., & Simonsen, K. A. (2023). Lyme disease. StatPearls. StatPearls Publishing.
³ National Library of Medicine. (2022, March 10). Lyme disease. National Institutes of Health.
⁴ Centers for Disease Control and Prevention. (2023, January 20). Lyme disease- transmission. U.S. Department of Health and Human Services.
⁵ Centers for Disease Control and Prevention. (2019, September 30). Preventing tick bites on people. U.S. Department of Health and Human Services.
⁶ Gammons, M., & Salam, G. (2002). Tick removal. American family physician66(4), 643–645.