Now that brighter mornings and longer evenings are on the horizon, it’s only natural for us to daydream of the activities we can welcome back into our schedules - including hobbies that allow us to soak up all the great outdoors has to offer.

However, with summer, comes a rise in the number of Lyme disease cases. In fact, according to the Centers for Disease Control and Prevention (CDC), Lyme disease is the most common vector-borne disease in the United States, with estimates suggesting around 476,000 people get Lyme disease each year in the U.S [1]. And for those who enjoy the fresh air during these sunnier months, there is a very real risk of coming into contact with the infamous ‘black-legged tick’ known to reside in grassy, outdoor areas.

Here’s what you need to know about Lyme disease, including the signs and symptoms of Lyme disease, the causes, and how you can get tested.

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What is Lyme disease?

Lyme disease is a bacterial infection caused by bacteria known as Borrelia (B. burgdorferi, B. mayonii, B.garinii, and B. afzelii). It is caused by the bite of a bacteria-carrying black-legged tick, typically referred to as a Deer tick.

Borrelia bacteria are most likely to enter the bloodstream when an infected tick bites a person and begins to feed on their blood. As ticks feed on blood, they simultaneously inject Borrelia bacteria into the bloodstream, leading to infection.

These infamous ticks are more active in the summer months and are usually found in heathland, woodland, parkland, and grassy areas. Generally speaking, the longer a tick has been attached to the skin, the higher the chance of contracting Lyme disease.

Research suggests that ticks need to be attached to the skin and feeding for over 24 hours before there is a real risk of infection. If a tick is removed as soon as it bites, the risk of infection is quite low.

What is typically the first sign of Lyme disease?

The first sign of Lyme disease is usually a small red bump, visible on the skin. This bump will appear where you have been bitten by a tick bite or where a tick has been removed. In most instances, this small red bump will resolve on its own. If the small red bump doesn't disappear and instead begins developing into a rash, it's a primary indicator that you may have Lyme disease.

Erythema migrans is the name commonly given to the rash that develops after the initial bite from a deer tick. This rash is usually in a bulls-eye pattern, however, it is important to note that this rash can take on many different patterns as detailed below.

Between 3-30 days after the initial tick bite, a red rash may begin to expand and spread. A tell-tale sign of Lyme disease occurs when the center of the rash goes from red to clear at the center, often referred to as a "Bulls-eye Rash."

This bull's-eye pattern may expand to twelve inches across the infected area, it is a trademark of the disease, but it's also important to remember that it is not a given for everyone who is diagnosed with Lyme disease.

Some of the other first signs of Lyme disease might include:

  • Fever
  • Fatigue
  • Chills
  • Aches and pains
  • Headaches
  • Stiffness
  • Swollen glands

If the first signs of Lyme disease are severe or you feel unwell, go straight to your doctor for further advice.

What are the common signs and symptoms of Lyme disease?

The signs and symptoms of Lyme disease are largely dependent on what stage of Lyme disease you are at. As previously mentioned, some of the most common early signs and symptoms of Lyme disease include:

  • Rash
  • Fever
  • Chills
  • Fatigue
  • Body aches and pains
  • Headaches
  • Stiffness
  • Swollen glands

Some of the more uncommon symptoms of Lyme disease often present themselves if the Lyme disease has gone untreated over a substantial period of time. Some of these later symptoms of Lyme disease may include:

  • Chronic fatigue
  • Heart problems, such as an irregular heartbeat
  • Hepatitis (liver inflammation or scarring)
  • Eye inflammation or impaired vision

One of the most reliable ways to find out more is through a Lyme Disease Test.

What are the three stages of Lyme disease?

Stage 1: Early, localized Lyme disease (1-4 weeks)

One of the earliest signs is a bulls-eye rash, which is a sign that bacteria are multiplying in the bloodstream. The rash occurs at the site of the tick bite as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isn’t painful and doesn’t itch. This rash will disappear after four weeks.

The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people don’t have this symptom. Some people have a rash that is solid red, while people with dark complexions may have a rash that resembles a bruise.

Stage 2: Early disseminated infection (1-4 months)

Early disseminated Lyme disease occurs several weeks after the tick bite. During this stage, bacteria are beginning to spread throughout the body. It’s characterized by flu-like symptoms, such as:

  • Chills
  • Fever
  • Enlarged lymph nodes
  • Sore throat
  • Vision changes
  • Fatigue
  • Muscle aches
  • Headaches

During early disseminated Lyme disease you’ll have a general feeling of being unwell. A rash may appear in areas other than the tick bite, and neurological signs such as numbness, tingling, and Bell’s palsy can also occur. This stage of Lyme disease can be complicated by meningitis and cardiac conduction disturbances. The symptoms of stages 1 and 2 can overlap.

Stage 3: Late persistent Lyme disease

Late disseminated Lyme disease occurs when the infection hasn’t been treated in stages 1 and 2. Stage 3 can occur weeks, months, or years after the tick bite. This stage is characterized by:

  • Severe headaches
  • Arthritis of one or more large joints
  • Disturbances in heart rhythm
  • Brain disorders (encephalopathy) involving memory, mood, and sleep
  • Short-term memory loss
  • Difficulty concentrating
  • Mental fogginess
  • Problems following conversations
  • Numbness in the arms, legs, hands, or feet

How can you get Lyme disease?

It’s important to remember that only a minor number of deer ticks can actually lead to Lyme disease. This is because if the bite is noticed right away, the risk of infection tends to be very low.

In saying that, if you are bitten by an infected deer tick, and it goes unnoticed for a long period of time, it’s possible for Borrelia bacteria to enter your skin, make their way into the bloodstream, ultimately causing Lyme disease. This is unlikely though, according to Mayo Clinic, if the tick has been attached for less than 36-48 hours [2].

The majority of those who get Lyme disease are infected through the bites of immature ticks called nymphs. Nymphs are almost invisible to the naked eye which makes detecting them less likely - this is why the majority of people who are infected with Lyme disease are infected through younger ticks.

While adult ticks can also transmit Lyme disease bacteria, they are much larger and are more likely to be discovered and removed before they have had time to transmit the bacteria into the bloodstream.

Some factors that can increase your risk of getting Lyme disease include:

  • Spending a significant amount of time in woodlands or grassy areas
  • Not using appropriate repellants based on where you are spending a lot of time outside
  • Having uncovered skin
  • Not removing ticks promptly or properly

How do you detect Lyme disease?

You can detect Lyme disease through blood testing. If you think you have Lyme disease, it’s important to get tested immediately. If your physician believes that you have Lyme disease, you will more than likely be put on a course of antibiotics.

There are two common blood tests that are used to test for Lyme disease, these blood tests include:

  1. Enzyme Immunoassay (EIA) → A Blood Test Which Measures Antibodies In The Blood

EIA tests are laboratory tests that are commonly used to detect viruses. An "ELISA" test which stands for "Enzyme Linked Immunosorbent Assay" pretty much carries out the same purpose as an EIA. Both tests are used to detect the antibodies present in your bloodstream.

The benefits of EIA and ELISA tests lies in the fact that they are simple, inexpensive and accurate.

  1. Western Blot → Blood Test Measuring Specific Proteins (Antibodies)

Western Blot tests are commonly used to confirm a positive ELISA. A Western blot test is generally used to confirm a positive HIV diagnosis. The test requires a small sample of blood and is used to detect viral antibodies, not the HIV virus itself.

The Western blot test separates the blood proteins and detects the specific proteins that may indicate an infection. The Western blot is used to confirm a positive ELISA, and the combined tests are 99.9% accurate.

You should get tested for Lyme disease if you have been bitten by a tick. You should especially take a Lyme disease test if the tick went undetected for over 24 hours, as there is a greater likelihood of contracting Lyme disease in these instances. If you notice Erythema migrans, ensure that you seek out testing immediately. Always bear the early symptoms in mind following significant periods spent in grassy or woodland areas.

If your symptoms are severe, go straight to your doctor.

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  1. Centers for Disease Control and Prevention. Lyme Disease. Online:
  2. Mayo Clinic. Lyme Disease. Online: