Lyme disease was first described in the United States in the town of Old Lyme, Connecticut in 1975, but has now been reported in most parts of the United States.

Most cases occur in the Northeast, upper Midwest, and along the Pacific coast. Mice and deer are the most commonly infected animals that serve as host to the tick. Most infections occur in the late spring, summer, and early fall.

The disease can sometimes be difficult to diagnose because the symptoms may mimic other diseases. A characteristic red rash usually occurs at the site of the bite. However, the bite may go unnoticed. A few months to years after the bite, joint inflammation, neurological symptoms, and sometimes heart symptoms may occur.

The initial infection is called primary Lyme disease. Secondary Lyme disease and tertiary Lyme disease may develop.

There are more than 16,000 cases of Lyme disease per year in the United States.

Risk factors for Lyme disease include walking in high grasses, other activities that increase tick exposure, and having a pet that may carry ticks home.

• A flat or slightly raised red lesion (erythema migrans) at the site of the tick bite (This lesion can be larger than 1 to 3 inches in diameter, often with a clear area in the center.)
• Fever
• Headache
• Lethargy
• Muscle pains
• Stiff neck
• Joint inflammation in the knees and other large joints

Additional symptoms that may be associated with this disease:

• Itching, overall
• Behavior, unusual or strange

• Physical examination may show a rash
• Physical examination in advanced Lyme disease may show evidence of joint, heart, or brain abnormalities
• Antibodies to Borrelia burgdorferi by immunofluorescence (IFA) or ELISA. ELISA tests are confirmed with a Western blot test.

Antibiotics are prescribed based on disease stages and manifestations. Doxycycline, tetracycline, cefuroxime, ceftriaxone, and penicillin are some of the choices.

Anti-inflammatory medications, such as ibuprofen, are sometimes prescribed to relieve joint stiffness.

Note: Doxycycline is usually not prescribed for children until after all the permanent teeth have erupted. It can permanently discolor teeth that are still forming.

If diagnosed in the early stages, the disease can be cured with antibiotics. If left untreated, complications involving joints, the heart, and the nervous system can occur.

• Secondary Lyme disease
• Tertiary Lyme disease

Call your health care provider if symptoms of Lyme disease develop.

Contact your health care provider if you live in a Lyme disease high-risk area. The following precautions also help lower your risk of becoming infected.

When walking or hiking in tick infested areas, tuck long pants into socks to protect the legs, and wear shoes and long-sleeved shirts. Ticks will show up on white or light colors better than dark colors, making them easier to remove from your clothing.

Check yourself and your pets frequently. If you find ticks, remove them immediately by using tweezers, pulling carefully and steadily. Insect repellent may be helpful.