The Facts about Lyme Disease

| Posted On Jun 20, 2011 | By:

As the days get longer and warmer and we move into the summer season, we all look forward to spending time in our yards, taking walks or hikes in the woods, and enjoying leisurely rest in our local parks and playgrounds. However, while there are many advantages of living in Massachusetts, we all need to be aware of the potential for our outdoor activities to expose us to Lyme disease.

What is Lyme disease?

Lyme disease is an infection caused by an organism, a spirochete, that is transmitted by the bite of a deer tick. Lyme disease is NOT spread by other commonly seen ticks, such as dog ticks, which do look different: 

Lyme disease can cause a flu-like illness, with fevers, chills, muscle and joint aches, and fatigue. Often a rash develops at the site of the tick bite. This rash may develop into a characteristic “bulls-eye” target lesion, although in many cases this characteristic rash may NOT appear. Frequently, there may be no rash at all, and you may simply feel like you are suffering from a viral or flu infection.

What are other symptoms of Lyme disease?

In addition to some non-specific flu-like symptoms, Lyme disease can affect the joints, the heart, and the neurologic system. Infection in these other organ systems can lead to joint swelling and joint inflammation, heart rhythm disturbances, a facial palsy (called “Bell’s Palsy”), and potentially other neurologic symptoms.

How do you prevent it?

The best way to prevent infection Lyme disease is to avoid being bitten by the ticks that transmit the infection. Deer ticks are the species of ticks that carry the organism causing Lyme disease. Some ways to prevent tick bites include wearing protective clothing, particularly if you are going to be in wooded or forested areas, as well as checking on a daily basis for any presence of ticks on your body.  Insect repellents that contain DEET can also be used to prevent tick bites.  Although the deer tick that transmits Lyme disease is more likely to be present in wooded or forested areas, it is still possible to be exposed to ticks in more urban areas, as well.

What do I do if I find a tick on me?

If you do find a tick on you, contact your medical care provider as soon as possible. They can provide guidance as to whether you would need to have any further treatment for your tick bite, or whether you can be observed without treatment.

You can try to remove the tick, using the following steps:

1)      Using tweezers or small forceps, try to grab the tick as close to the surface of the skin as possible. You can also use your fingers to remove the tick, using a cloth or paper towel to protect your fingers.

2)      When pulling the tick off, avoiding bending or twisting, and pull straight upwards.

3)      Avoid squeezing, crushing, or puncturing the tick.

4)      Thoroughly clean and disinfect the area where the tick was attached, after tick removal, and wash your hands.

After the tick has been removed, observe the area of the tick bite for up to 1 month afterwards, to see if any rash develops. Ticks typically need to be attached for 2 to 3 days before they can transmit Lyme disease. If you attempt to remove the tick, and it breaks off without complete removal, contact your medical care provider for further guidance. 

What if you think you have Lyme disease?

If you are concerned that you may have been infected with Lyme disease, seek medical attention promptly. You will need to be evaluated, and your medical care provider can determine whether your risk of exposure and your symptoms are due to Lyme disease. You may need to undergo additional testing to confirm the diagnosis of Lyme disease, and you may also need evaluation to check for possible co-infections that occur with Lyme disease.

What is the treatment for Lyme disease?

If you are diagnosed with Lyme disease in the early stages of the infection, you can typically get treated with oral antibiotics for several weeks. Later stages of Lyme disease will require treatment with intravenous antibiotics and may require additional evaluation of your heart, neurologic system, or joints.

Key take-home points:

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About Dr. Elisa Choi

Dr. Elisa Choi is a board-certified Internist and Infectious Disease specialist at Harvard Vanguard’s Kenmore practice, where she sees patients in Internal Medicine and also provides Infectious Disease and HIV consultations for all Harvard Vanguard patients. Dr. Choi has a strong interest in tick-borne infections, and has published articles on this topic. She is on the faculty at Harvard Medical School, where she teaches medical students in the Patient-Doctor 2 course. For the past several years, Dr. Choi has been on the Board of Directors of a non-profit organization, MAP for Health, which focuses its efforts on disease prevention, health care advocacy, and primary care access for the Asian-Pacific Islander and South Asian community. She is the current Chair of the Board of Directors of MAP for Health. Dr. Choi’s other professional and clinical interests include clinical teaching and education, women’s and LGBT health issues, sexually transmitted infections, HIV infection, hepatitis infections, infections in immunocompromised patients, and chronic infection and disease management.


  1. Thanks for this complete and helpful discussion

    Comment by Judith Hill on June 20, 2011 at 8:39 am

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