Lyme Disease

Lyme disease is caused by the bacteria Borrelia burgdorferi, named after the scientist who discovered it in 1982 – Willy Burgdorfer. It is spread by the bite of an Ixodes scapularis tick, also known as a blacklegged tick or deer tick.

 

What are the Symptoms of Lyme Disease?

Lyme disease can cause a variety of symptoms, depending on the stage of infection.

Early Signs and Symptoms (3 to 30 Days After Tick Bite) 

• Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes.
• Erythema migrans (EM) rash:
  • Does NOT occur in all infected persons. It is estimated that 70 to 80 percent of infected persons will develop the EM rash.
  • Can appear on any part of the body and is NOT usually itchy or painful.
  • The appearance can vary WIDELY. Click this link to view Lyme disease rashes and look-alikes.

The appearance of the EM rash does not always appear as a “classic” bullseye rash. Photo credit: CDC.

Later Signs and Symptoms (Days to Months After Tick Bite) 

 

• Severe headaches and neck stiffness
• Additional EM rashes
• Droop on one side or both sides of the face (facial palsy)
• Arthritis with severe joint pain and swelling, usually on the knees and large joints.
• Heart palpitations or an irregular heartbeat
• Dizziness or shortness of breath
• Nerve pain
• Shooting pains, numbness, or tingling in the hands or feet 

How Does Lyme Disease Spread? 

The Lyme disease bacterium is spread through the bite of an Ixodes scapularis tick (also known as a blacklegged tick or deer tick). Blacklegged ticks are found in every county of Delaware. Learn more about tick species of Delaware here. 

Approximate sizes of Ixodes scapularis ticks. Photo credit: CDC.

Since the blacklegged tick is the only species of tick that can spread Lyme disease in Delaware, it is important to save the tick or take a picture of it for identification. Knowing what species of tick has attached to you, a family member, or a pet will help determine whether you may be at risk for a tick-borne disease.

 

Found a tick and want to know what species bit you? Report the tick bite to DNREC’s Tick Program by clicking the tick image below: 

 

Do you need advice on how to properly remove ticks? Use the CDC’s Tick Bite Assessment below for help. 

There is no evidence that Lyme disease is transmitted from person-to-person. For example, a person cannot get infected from touching, kissing, or having sex with a person who has Lyme disease. Pregnant persons should seek treatment as soon as possible since Borrelia burgdorferi can infect the placenta.

It is important to note that a person can get Lyme disease more than once if they are bitten by another infected tick. 

Diagnosis

Most Lyme disease tests detect antibodies made by the body in response to infection. The CDC currently recommends a two-step process for Lyme disease antibody testing. If the first test (usually an ELISA test) is negative, no further testing is recommended. If the first test is positive or equivocal, the second test (usually a Western Blot) should be performed. The overall result is positive only when the first test is positive (or equivocal) and the second test is positive (or for some tests equivocal). Antibodies can take several weeks to develop, so patients may test negative if infected only recently. It is important to note that antibodies can persist in the blood for months or even years after the infection is gone, so these tests cannot be used to determine cure.

 

New modified two-tier tests (MTTTs) were approved by the FDA in 2019. The MTTTs are more sensitive than the standard two-tier tests during the early stages on Lyme disease infection