Early Infection

In the first 3-30 days after the bite, if the infection has not spread you may notice:

• Rash
• Muscle and joint aches
• Headache
• Fever
• Fatigue
• Swollen glands

These symptoms do not necessarily mean you have Lyme disease, even if you have spent time outdoors. See your doctor right away if you have these symptoms and think you have been exposed to a tick.

Early Disseminated Infection

An infection that has begun to spread may cause the following symptoms in days to weeks after the bite:

• Multiple lesions
• Persistent headache, stiff neck
• Diffuse numbness, tingling, burning
• Intermittent joint pain and swelling
• Impaired motor coordination
• Irregular heart rhythm
• Muscle pain and swelling
• Facial paralysis— Bell palsy

Late Infection    TOP

Symptoms can develop months or years after the tick bite in untreated infections. These symptoms may occur regularly or intermittently and include:

• Painful inflammation of the joints—arthritis
• Trouble with concentration or memory
• Shooting pains, numbness, and tingling

Less common symptoms of late Lyme disease include:

• Heart abnormalities
• Eye problems such as conjunctivitis
• Chronic skin disorders
• Limb weakness
• Persistent motor coordination problems

Outdoors

If you live or are visiting northeastern, northwestern, mid-Atlantic, or upper north-central regions of the US, and northwestern California:

• Avoid areas that are likely to be infested with deer ticks such as moist, shaded, wooded, or grassy areas
• When going to wooded, grassy areas, especially in spring and summer:
  • Wear light-colored clothing with a tight weave to spot ticks easily.
  • Wear enclosed shoes.
  • Wear a long sleeve shirt. Tuck it into your pants.
  • Tuck pants into socks or boot tops.
  • Wear a hat.
• Stay on cleared, well-traveled paths and walk in the center of trails to avoid overgrown grass and brush. Avoid sitting on the ground or stone walls.
• Remove leaf litter, brush, and woodpiles from around the home and the edges of the yard.

Insect repellent can help prevent tick bites. Repellents containing DEET can be applied to clothes and exposed skin. Repellents that have permethrin can be applied to pants, socks, and shoes, but not to skin. Repellents can cause eye irritation and skin reactions. Be sure to read the label for instructions on application, including:

• Do not apply near eyes, nose, or mouth.
• Do not apply to children's hands.
• Wash your skin when you return indoors.

Tick Management

Deer ticks are unlikely to pass the infection unless they are in contact with the skin for at least 24 hours. After spending time outdoors in a high risk area:

• Do a full-body check for ticks at the end of a day spent outdoors. Consider bathing or showering within 2 hours of coming indoors.
• Check your child for ticks. Make sure to check for hidden areas like the hair, around the ears, or behind the knees.
• Check pets and gear for ticks.
• Put clothes worn outdoors in the dryer for 20 minutes. This will kill any unseen ticks.

If you do find a tick, remove it by doing the following:

• Use a pair of tweezers to grasp the tick by the head, as close to the skin as possible.
• Pull directly outward. Use gentle but firm force. Do not twist the tick out. Try not to crush the tick's body or handle it with bare fingers. This can spread the infection.
• Wipe the site with an antiseptic to prevent infection.

There are some steps that do not help. They may cause more problems.

• Do not put a hot match to the tick.
• Do not cover the tick with petroleum jelly, nail polish, or any other substances.

If you have been bitten by a deer tick, especially if you live in an area where Lyme disease is common, you should watch for a rash to appear. A rash can occur in about 70-80% of infected persons and generally begins at the tick bite site. The rash may appear within 3-30 days, usually before the onset of fever. The rash is usually the first sign of infection, is usually circular, and is called erythema migrans (EM). Some may develop additional EM lesions on other parts of the body.

Medication    TOP

If you have a tick bite and live in a high-risk area, your doctor may recommend a dose of antibiotic. This may reduce the risk of contracting Lyme disease if taken within 72 hours after a tick bite. However, this antibiotic can have serious side effects in children younger than 8 years old. This prevention step is only used in people older than 8 years of age.

The risk of getting Lyme disease after a single tick bite is low. Many experts do not recommend preventive antibiotic treatment.