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Lyme Disease

About

Lyme disease is a bacterial illness spread by ticks. In the U.S., Lyme disease is caused by two bacteria, Borrelia burgdorferi, and more rarely, Borrelia mayonii. Both are spread through the bite of infected deer ticks (Ixodes scapularis). 

Lyme disease is the most common tickborne disease in Maine. Cases of Lyme disease increase each year in Maine as the deer tick spreads throughout the state. 

Anyone can get Lyme disease, but certain people are at higher risk, including: 

  • People who spend a lot of time outdoors, whether for work, hobbies, or recreation.
  • People over 65 years of age.
  • Children 5 to 14 years of age. 

Symptoms

Untreated Lyme disease can cause a wide range of symptoms, depending on the stage of infection. 

Early Symptoms

Early symptoms of Lyme disease occur 3 to 30 days after a tick bite. They can include: 

  • Fever and chills
  • Headache
  • Fatigue or unusual tiredness
  • Muscle and joint aches
  • Swollen lymph nodes
  • Erythema migrans (EM) rash, also sometimes called a “bullseye rash”

Later Symptoms

Later symptoms of untreated Lyme disease occur days to months after a tick bite. They can include: 

  • Severe headache and neck stiffness
  • EM rashes on multiple areas of the body
  • Facial palsy (loss of muscle tone or droop on one or both sides of the face)
  • Arthritis with severe joint pain and swelling particularly in knees and other large joints
  • Pain in tendons, muscles, joints, and bones
  • Heart palpitations or irregular heartbeat, also called Lyme carditis
  • Episodes of dizziness or shortness of breath
  • Inflammation of the brain (encephalitis) and spinal cord (meningitis)
  • Nerve pain
  • Shooting pains, numbness, or tingling in hands or feet

About Erythema Migrans (EM) Rash

The erythema migrans (EM) rash is one of the most common symptoms of Lyme disease. EM rash: 

  • Slowly expands in size over time and can grow to 12 inches or more in diameter.
  • Can appear anywhere on the body, not just the site of the tick bite.
  • May feel warm to the touch but is rarely itchy or painful.
  • Sometimes has a clear center as it grows. This causes a “bullseye” appearance. Not all EM rashes have this shape. 

A small bump or redness that resembles a mosquito bite may occur at the site of a tick bite. This usually appears immediately after the bite and is not the EM rash. This is a common reaction to tick bites and usually goes away in 1 to 2 days. It is not a sign of Lyme disease. 

Chronic Symptoms and Lyme Disease

Some people with Lyme disease experience prolonged symptoms after antibiotic treatment. This is called Post-Treatment Lyme Disease Syndrome (PTLDS). Symptoms include fatigue, body aches, or difficulty thinking. The cause of these symptoms is currently unknown, but people have reported similar prolonged symptoms following other types of infections, including COVID-19. 

Patients with prolonged symptoms after Lyme disease treatment usually get better without additional antibiotics, but it can take months to feel completely well. Studies show that long-term antibiotic treatment is no better than placebo treatment for curing prolonged symptoms and may cause further health problems. 

If you experience prolonged symptoms after Lyme disease treatment, work with a health care provider to manage and reduce your symptoms. 

Treatment

If untreated, more severe symptoms of Lyme disease can develop. See a health care provider if you become ill after a tick bite or after spending time in areas where ticks commonly live. Be sure to mention any recent tick bite or outdoor activities to your health care provider. 

Lyme disease is treatable with antibiotics. 

Prevention

Prevent Tick Bites

The best way to prevent tickborne disease is to prevent tick bites in the first place. Take these simple steps every day to prevent tick bites: 

  • Wear light-colored, long-sleeved clothing and pants. Tuck your pants into your socks to prevent ticks from climbing under pant legs.
  • Use an EPA-approved bug spray. This includes products that contain DEET, picaridin, IR3535, and oil of lemon eucalyptus.
  • Treat clothing with permethrin. Never use this directly on your skin.
  • Stay in the middle of trails and avoid contact with plants on the side of trails. This is where ticks often hide.
  • Check for ticks every day and especially after you come inside from outdoor work or recreation.
  • Check pets for ticks. Talk to a veterinarian about tick prevention products for companion animals. 

Protect Your Yard from Ticks

You can make your yard a tick-safe zone:

  • Keep the lawn mowed.
  • Rake leaves and get rid of leaf piles.
  • Move wood piles away from the house. Mice like to live here and can bring ticks into the yard with them.
  • Move birdfeeders away from the house, garden, and yard toys. Deer and mice like birdfeeders and can bring ticks into the yard with them.
  • Use crushed stone or woodchips to make a tick-safe barrier around your yard. This should be 3-feet wide to separate the yard from surrounding woods. It can prevent ticks from crawling into the yard.

Data and Publications

Maine Tracking Network

The Maine Tracking Network uses data from case reports and daily emergency department visits to help understand the spread of tickborne diseases in Maine. The dashboard includes real-time data, maps, charts, and graphs for anaplasmosis, babesiosis, and Lyme disease. 

Surveillance Reports

Report to Maine Legislature on Lyme and Other Tickborne Illnesses

In 2008, the 123rd Legislature passed a law that directed Maine CDC to submit an annual report about tickborne diseases to the Legislature. Each year, Maine CDC submits this annual report to the joint standing committees on health and human services matters and health insurance matters. This report includes recommendations for legislation to address public health programs for the prevention and treatment of tickborne illnesses in Maine. It also reviews and evaluates Lyme disease and other tickborne illnesses in Maine. 

Maine Legislation on Lyme Disease and Other Tickborne Illnesses

Lyme Disease Resources

Resources for Health Care Providers

Public Awareness and Education Groups (may not represent the views of Maine CDC or U.S. CDC)