Signs and symptoms of Lyme disease usually appear within 3–30 days of a bite from an infected tick. People in the early stages of illness can experience flu-like symptoms, such as:

• Fever
• Chills
• Headache
• Fatigue
• Muscle and joint aches
• Swollen lymph nodes

Approximately 70–80% of Lyme disease patients will experience a characteristic “bulls-eye” or erythema migrans (EM) skin rash. The EM rash expands gradually over a period of days and may reach a diameter of 12 inches or more. It may feel warm to the touch, but is rarely itchy or painful. EM rashes typically first appear at the site of the tick bite, but may appear on any area of the body.

Erythema migrans rash. Photo: James Gathany, Centers for Disease Control and Prevention.

Later signs of Lyme disease can include arthritis with severe joint pain and swelling, complications affecting the nervous system (e.g., facial palsy), and heart problems (e.g., irregular heartbeat).

Graphic: Centers for Disease Control and Prevention.

Diagnosis of Lyme disease is based upon the patient’s signs and symptoms, a history of possible exposure to ticks, and appropriate laboratory testing. Early recognition of symptoms is important for prompt diagnosis and treatment. If you think that you have Lyme disease, contact your health care provider.

People who have removed an attached tick sometimes wonder if they should have it tested for tick-borne diseases. Although some laboratories offer this testing, IDOH does not recommend it. If the tick tests positive, it does not necessarily mean that you have been infected; if the tick tests negative, it may provide a false sense of security because you may have been unknowingly bitten by a different tick that was infected.

Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Most patients are treated for Lyme disease with a short course of oral antibiotics; however, intravenous treatment may be needed for more severe cases, such as people with complications affecting the heart or nervous system.

Post-Treatment Lyme Disease Syndrome

Some patients may continue to have non-specific symptoms such as fatigue, pain, and joint and muscle aches that persist for months after treatment. This is called post-treatment Lyme disease syndrome, or PTLDS. The cause of PTLDS is unknown.

There is currently no Lyme disease vaccine available for human use. The best way to prevent Lyme disease is to avoid tick bites. Please see our tick prevention page for more information.

For more information about Lyme disease, please visit the CDC Lyme Disease webpage.

For Lyme disease maps and statistics in Indiana, please visit the Indiana Tick-borne Disease Surveillance dashboard.

National statistics for Lyme disease can be found at the CDC Lyme Disease Data and Statistics webpage.