Climate change is helping Lyme disease spread to new parts of the United States—places like Wisconsin and Minnesota where it wasn’t common before. It’s also becoming more frequent in areas where it already exists, including right here at home. Nearly 30 percent of all reported Lyme disease cases between 2016 and 2019 occurred in Pennsylvania, followed by New Jersey with 12 percent of all cases, according to the nonprofit USAFacts.

Lyme disease is most commonly transmitted to humans through the bite of an infected deer tick. When the tick bites, it injects a bacteria called Borreliella burgdorferi into the bloodstream. The bacteria can then spread throughout the body, causing Lyme disease.

Signs and Symptoms of Lyme Disease

Some will develop an erythema migrans rash, also called a “bullseye rash” because of its resemblance to an archery target. A bullseye rash is the only sure sign of Lyme disease. Its presence means a doctor can start treatment right away without any testing.

However, about half of Lyme disease patients never get a rash, according to Garth D. Ehrlich, PhD, professor of microbiology and immunology and otolaryngology–head and neck surgery at Drexel University College of Medicine. Or the rash may never be noticed.

For this and other reasons, diagnosing Lyme disease can be tricky.

Other symptoms can include fever, headache, muscle and joint pain, and fatigue, all of which can be caused by other illnesses. Further complicating matters, several days or weeks may pass before these symptoms emerge.

And Lyme disease tests aren’t always reliable. Dr. Ehrlich explains that’s because the tests check for antibodies—proteins your body makes to fight infections—instead of looking for the actual infection. It can also take a few weeks for your body to produce enough antibodies to show up on a test. Plus, Lyme disease and other infections spread by ticks can weaken your immune system, which slows down how quickly those antibodies develop.

Treatment and Prevention

Treating Lyme disease also isn’t straightforward. For one, treatment is typically most effective when it’s started right after infection. But because of the issues described above, many Lyme disease cases aren’t diagnosed until they’ve progressed past the initial stages.
Lyme disease is treated with antibiotics. The duration of treatment depends on the stage of the infection. It may also be paired with a pain reliever or an anti-inflammatory medication to help manage symptoms.

Here, again, the process is imperfect.

“The bacteria that causes Lyme disease is a very slow-growing organism,” Dr. Ehrlich says, “and slow-growing organisms are really difficult to get rid of with antibiotics.”
His lab is studying a new class of antibiotics that targets this kind of bacteria. The early results have been promising, he says, but they haven’t yet studied their antibiotics’ effect on Lyme disease.

For now, prevention is the surest path.

Dr. Ehrlich says that most infected ticks need to be attached for at least 24 hours to transmit Lyme disease. So closely examine every inch of skin—particularly your armpits and groin—after spending time outdoors. Should you find a tick, carefully remove it with a pair of tweezers and monitor the site for signs of infection.

If you think you’ve been bitten by a tick or are experiencing Lyme disease symptoms, reach out to your health care provider. Early diagnosis and treatment are key. Your provider can help determine the best next steps.