Vector-borne illness | Lyme disease

Lyme disease is caused by Borrelia  species of bacteria, and is typically transmitted to humans through bites from infected ticks.

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Lyme disease is a vector-borne illness spread through the bite of infected ticks. The main types of ticks that are commonly known to transmit Lyme disease include the blacklegged tick (also known as deer tick), which is native to the northeastern, mid-Atlantic and north-central United States, and the western blacklegged tick, which is native to the Pacific coast of the United States. In Northern, Western, and Eastern Europe, the primary ticks responsible for the spread of Lyme disease include the castor bean tick and the taiga tick.


Lyme disease in the United States is caused by Borrelia burgdorferi, a Gram-negative, microaerophilic bacteria of spirochete morphology. B. burgdorferi  does not produce toxins, unlike most disease-causing bacteria, but instead interacts directly with the cells it infects. In 2013, B. mayonii  was also discovered in North America, but is comparatively much less prevalent than B. burgdorferi. In both Europe and Asia, there are two bacteria attributed to Lyme disease, B. afzelii  and B. garinii.

Lyme transmission is most prevalent in the spring and summer months when ticks carrying the disease are most active, as well as when humans are more frequently interacting with the outdoor environments. The ticks that transmit Lyme disease can occasionally also transmit other tickborne diseases. Ticks may attach to the body anywhere, but are often found in the armpit, groin and scalp areas. Lyme disease is usually transmitted only after the tick has been attached for 36 hours or more.

Immature ticks, called nymphs, are responsible for most human cases of Lyme disease. While adult ticks may spread Lyme disease, they are large enough to be spotted and removed before Lyme can be contracted. Nymphs are much smaller (less than 2 mm in length) and surface contact may go unnoticed. 

To prevent Lyme disease, the CDC recommends:

  • Avoiding areas likely to have ticks 

  • Using insect repellent on skin and clothing

  • Showering as soon as possible after potentially being exposed to ticks 

  • Inspecting your body for ticks and removing them promptly

  • Inspecting pets and equipment for ticks and removing them 

  • Heat-treating clothing that may have been exposed to ticks by placing dry clothing in the dryer on high for 10 minutes, or by washing clothing and drying in a dryer until completely dry and warm

Lyme disease is diagnosed based on signs and symptoms, the possibility of exposure to infected ticks, and laboratory testing. Symptoms of Lyme disease vary depending on the length of infection. 

Early-stage Lyme disease (<30 days) is characterized by:

  • Fever
  • Headache
  • Fatigue
  • Swollen lymph nodes
  • Muscle and joint aches
  • Bullseye skin rash called erythema migrans (EM)


Later-stage Lyme disease (>30 days) can be characterized by:


  • Severe headaches and neck stiffness 
  • Joint pain and swelling 
  • Irregular heartbeat or palpitations
  • EM on other areas of the body
  • Episodes of dizziness or shortness of breath
  • Inflammation of the brain and spinal cord
  • Nerve pain
  • Shooting pains, numbness or tingling in the hands or feet
  • Problems with short-term memory
  • Facial palsy


Because symptoms of Lyme disease can be similar to other illnesses, laboratory tests are ordered to help ensure accurate diagnosis and appropriate treatment. The CDC recommends a two-tiered testing method for Lyme disease. Tests that detect IgG and IgM antibodies produced in response to the Lyme bacteria confirm whether a person has been exposed to certain species of Borrelia. An enzyme-linked immunosorbent assay (ELISA) test can detect if antibodies are present in the blood. And a Western Blot, or immunoblot, can detect specific proteins to confirm the ELISA diagnosis.

If detected early, Lyme disease can be successfully treated with a two- to three-week course of antibiotics, such as:


  • Doxycycline 
  • Amoxicillin 
  • Ceftriaxone (when meningitis or neuritis is present)


Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be prescribed for pain management.

Symptoms generally last for two to four weeks after beginning antibiotic treatment, although some symptoms may last longer. Early diagnosis and early treatment help to prevent complications that may develop due to later-stage Lyme infection.