Written on May 22, 2023 by Lori Mulligan, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Lyme disease is a bacterial illness that can cause fever, fatigue, joint pain, and skin rash, as well as more serious joint and nervous system complications. It is the most common vector-borne disease in the United States.
Lyme disease is transmitted through the bite of certain species of infected ticks (referred to commonly as deer ticks) that carry the bacteria that cause Lyme disease (Borrelia burgdorferi and, rarely, Borrelia mayonii).
These ticks live not only on deer but also on rodents, birds, and other host animals. Deer do not harbor the bacteria that cause Lyme disease, but certain other hosts, such as white-footed mice, do, and ticks pick up the bacteria by feeding on these infected hosts.
Understanding Lyme disease prevalence helps you better appreciate the need to recognize symptoms for improved diagnosis, prevention, and treatment.
What is the Lyme disease prevalence in the United States?
There is no way of knowing exactly how many people get Lyme disease. A recently released estimate based on insurance records suggests that each year approximately 476,000 Americans are diagnosed and treated for Lyme disease.
This number is likely an overestimate of actual infections because patients are sometimes treated presumptively in medical practice. Regardless, this number indicates a large burden on the healthcare system and the need for more effective prevention measures.
What are the symptoms of Lyme disease?
Signs and symptoms of early Lyme disease typically include :
- A reddish rash or skin lesion known as erythema migrans (EM). The rash starts as a small red spot at the site of the tick bite anywhere from one to four weeks after the bite. The spot expands over a period of days or weeks, forming a circular, triangular, or oval-shaped rash. The rash may look like a bull’s eye because it appears as a red ring that surrounds a clear center area. The rash can range in size from that of a dime to the entire width of a person’s back. As infection spreads, several EM rashes (lesions) can appear at different sites on your body.
- Stiff neck
- Body and joint aches
- Swollen lymph nodes (swollen glands)
Signs and symptoms of the second stage of Lyme disease (the early disseminated stage) may include:
- Multiple areas of rash
- Paralysis of facial muscles (Bell’s palsy)
- Heart block or an interruption of the electrical system of the heart
- Areas of numbness or abnormal feelings
Signs and symptoms of untreated late Lyme disease, which may happen from months to a year after infection, may include:
- Recurring episodes of swollen joints (arthritis), typically affecting large joints like the knee
- Difficulty concentrating, known as “brain fog.” This is a form of encephalopathy or damage to the brain.
- Damage to nerves all over your body, including your skin, muscles, and organs (polyneuropathy)
How is Lyme disease diagnosed?
If you experience the symptoms above, it is important to see a healthcare provider who can run tests to determine if you’re infected and need treatment.
Lyme disease tests look for signs of infection in a sample of your blood or cerebrospinal fluid (CSF). CSF is a clear liquid that flows in and around your brain and spinal cord. The tests check your samples for antibodies that your immune system makes to fight the bacteria that cause Lyme disease.
How do you prevent Lyme disease?
- Avoid wooded, brushy, and grassy areas, especially during warmer months (April – September), although tick exposure can occur anytime.
- Wear light-colored clothing so that you can see ticks that get on you.
- Treat clothing and gear with products containing 0.5% permethrin.
- Apply insect repellents on uncovered skin, and ensure the products are registered by the Environmental Protection Agency.
- Wear long pants and long-sleeved shirts, and shoes that cover the entire foot.
- Tuck pant legs into socks or shoes, and tuck shirts into pants.
- Wear a hat for extra protection.
- Walk in the center of trails to avoid brush and grass.
- Remove your clothing after being outdoors, and wash and dry them at high temperatures.
- Do a careful body check for ticks after outdoor activities.
There are no licensed vaccines available in the U.S. to aid in preventing Lyme disease in people.
How do you treat Lyme disease?
Antibiotics are used to treat Lyme disease. In most cases, recovery will be quicker and more complete the sooner treatment begins.
The standard treatment for Lyme disease is an antibiotic taken as a pill, such as doxycycline or amoxicillin. The treatment usually lasts 10 to 14 days. Treatment may be longer, depending on your symptoms. It’s important to take all pills as directed, even if you’re feeling better.
Your healthcare provider may prescribe an antibiotic given directly into a vein, also called an intravenous (IV) antibiotic. An IV antibiotic may be used for more serious disease, especially if you have symptoms of :
- Long-lasting arthritis
- Disease affecting the nervous system
- Disease affecting the heart
However, multiple clinical trials funded by NIH and others have shown no benefit to additional IV antibiotic treatment in patients with Lyme disease, although some have challenged the interpretation of those results.
Everlywell can help you check for Lyme disease
Only 70% of people develop the “bull’s-eye” rash commonly associated with Lyme disease after getting bit by an infected tick. So, if you think you’ve been exposed and are suffering from symptoms like fatigue, headaches, or joint pain, this at-home Lyme Disease Testcan help tell you if you have antibodies against three Lyme-causing bacteria.
Why have tick-borne diseases increased?
Who's at risk of Lyme disease?
Where is Lyme disease common?
- Climate Change Indicators: Lyme Disease. Environmental Protection Agency. https://www.epa.gov/climate-indicators/climate-change-indicators-lyme-disease#tab-1. Web update: April 2021. Accessed on May 28, 2023.
- How many people get Lyme disease? Centers for Disease Control. https://www.cdc.gov/lyme/stats/humancases.html#:~:text=Print-,How%20many%20people%20 get%20 Lyme%20disease%3F,and%20treated%20for%20Lyme%20disease. Last Reviewed: January 13, 2021. Accessed on May 28, 2023.
- Lyme Disease. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/11586-lyme-disease#:~:text=A%20healthcare%20provider%20will%20diagnose,its%20bite%20is%20usually%20painless. Accessed on May 28, 2023.
- MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); Lyme Disease. https://medlineplus.gov/lab-tests/lyme-disease-tests/#:~:text=Lyme%20disease%20tests%20look%20for,bacteria%20that%20cause%20Lyme%20disease. Accessed on May 28, 2023.
- Ticks and Lyme Disease: Symptoms, Treatment, and Prevention. Food and Drug Administration. 04/17/2023. https://www.fda.gov/consumers/consumer-updates/ticks-and-lyme-disease-symptoms-treatment-and-prevention. Accessed on May 28, 2023.
- Lyme disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/lyme-disease/diagnosis-treatment/drc-20374655. February 10, 2023. Accessed on May 28, 2023.
- Lyme Disease Antibiotic Treatment Research. National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/lyme-disease-antibiotic-treatment-research. Accessed on May 28, 2023.