Lyme Disease – Know the Symptoms

Lyme disease is transmitted to humans through the bite of infected blacklegged ticks. Early signs and symptoms that show up usually 3 - 30 days after a tick bite are fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes. Erythema migraines (EM) rash occurs in approximately 70 - 80 percent of infected persons. This rash begins at the site of the tick bite after a delay of 3 - 30 days, with the average being about 7 days. It expands gradually over a period of days reaching up to 12 inches or more. The rash may feel warm to the touch but is rarely itchy or painful. Sometimes it clears as it enlarges, resulting in a target or "bulls-eye" appearance. To see examples of rashes, visit the Centers for Disease Control and Prevention website.

Bit by a Tick? Get Tested!

The CDC currently recommends a two-step process when testing blood for evidence of antibodies against the Lyme disease bacterial. Both steps can be done using the same blood sample.

The first step uses a testing procedure called "EIA" (enzyme immunoassay) or rarely, an "IFA" (indirect immunofluorescence assay). If this first step is negative, no further testing of the specimen is recommended. If the first step is positive or indeterminate (sometimes called "equivocal"), the second step should be performed. The second step uses a test called an immunoblot test, commonly, a "Western Blot" test. Results are considered positive only if the EIA/IFA and the immunoblot are both positive. The two steps of Lyme disease testing are designed to be done together. CDC does not recommend skipping the first test and just doing the Western Blot. Doing so will increase the frequency of false positive results and may lead to misdiagnosis and improper treatment.

If left untreated, infection can spread to joints, the heart, and the nervous system. For some FAQ's on Lyme disease, visit the Centers for Disease Control and Prevention website.

Tick Identification, Removal and Testing

If you find a tick attached to your skin follow these simple steps:

1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
2. Pull upward with steady even pressure. Don’t twist or jerk the tick: this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
4. Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush the tick with your fingers! If you would like to order a free tick remover kit, visit the Maine Center for Disease Control & Prevention website.

Note: People who have removed a tick often wonder if they should have it tested. Some state or local health departments offer tick identification and testing as a community service or for research purposes (such as evaluating infection rates among ticks in an area). Check with your health department; the phone number is usually found in the government pages of the telephone book or online. In general testing of individual ticks is not useful because:

1. If the test shows that the tick contained disease-causing organisms, that does not necessarily mean that you have been infected.
2. If you have been infected, you will probably develop symptoms before results of the tick test are available. You should not wait for tick testing results before beginning appropriate treatment.
3. Negative results can lead to false assurance. For example, you may have been unknowingly bitten by a different tick that was infected.