Living in the northeastern, northwestern, mid-Atlantic, or upper north-central regions of the United States and northwestern California
- Peak tick season in the northeast is April through September
- Outdoor activities, such as hiking, camping, and gardening in areas/seasons with deer ticks
- Living near or going to wooded, grassy areas
- Working outdoors such as surveying, landscaping, forestry, gardening, and utility company service work
|Lyme Disease Rash|
|This is an example of a Lyme disease rash shaped like a bull's eye. It may not always be this shape, nor will a rash always appear.|
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- Muscle and joint aches
- Swollen glands
Early Disseminated Infection
- Multiple lesions
- Persistent headache, stiff neck
- Diffuse numbness, tingling, burning
- Intermittent joint pain and swelling
- Impaired motor coordination
- Irregular heart rhythm
- Muscle pain and swelling
- Facial paralysis ( Bells palsy )
- Painful inflammation of the joints ( arthritis )
- Trouble with concentration or memory
- Shooting pains, numbness, and tingling
- Heart abnormalities
- Eye problems, such as conjunctivitis
- Chronic skin disorders
- Limb weakness
- Persistent motor coordination problems
- Doxycycline—cannot be used in women who are pregnant or children under 8 years of age
- Amoxicillin—can be used in women who are pregnant or children under 8 years of age
Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Ibuprofen (Advil, Genpril, Medipren, Motrin, Nuprin, Rufen)
- Naproxen sodium (Aleve, Anaprox, Naprosyn)
- Steroid injection directly into the joint
- Avoid areas that are likely to be infested with deer ticks such as moist, shaded, wooded, or grassy areas
When going to wooded, grassy areas, especially in spring and summer:
- Wear light-colored clothing with a tight weave to spot ticks easily.
- Wear enclosed shoes.
- Wear a long sleeve shirt. Tuck it into your pants.
- Tuck pants into socks or boot tops.
- Wear a hat.
- Stay on cleared, well-traveled paths and walk in the center of trails to avoid overgrown grass and brush. Avoid sitting on the ground or stone walls.
- Remove leaf litter, brush, and woodpiles from around the home and the edges of the yard.
- Do not apply near eyes, nose, or mouth.
- Do not apply to children's hands.
- Wash your skin when you return indoors.
- Do a full-body check for ticks at the end of a day spent outdoors. Consider bathing or showering within 2 hours of coming indoors.
- Check your child for ticks. Make sure to check for hidden areas like the hair, around the ears, or behind the knees.
- Check pets and gear for ticks.
- Put clothes worn outdoors in the dryer for 20 minutes. This will kill any unseen ticks.
- Use a pair of tweezers to grasp the tick by the head, as close to the skin as possible.
- Pull directly outward. Use gentle but firm forces. Do not twist the tick out. Try not to crush the tick's body or handle it with bare fingers. This can spread the infection.
- Wipe the site with an antiseptic to prevent infection.
- Do not put a hot match to the tick.
- Do not cover the tick with petroleum jelly, nail polish, or any other substances.
Centers for Disease Control and Prevention http://www.cdc.gov
Lyme Disease Foundation http://www.lyme.org
Communicable Disease Control http://www.gov.mb.ca
Public Health Agency of Canada http://www.phac-aspc.gc.ca
Diaz JH. The diagnosis, management, and prevention of common ectoparasitic infections. J La State Med Soc. 2006;158:90-98.
Loewen PS, Marra CA, et al. Systematic review of the treatment of early Lyme disease. Drugs. 1999;57:157-173.
Lyme disease. Centers for Disease Control and Prevention (CDC). Available at: http://www.cdc.gov/lyme. Updated July 26, 2012. Accessed September 26, 2012.
Lyme disease. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 29, 2012. Accessed September 26, 2012.
Lyme disease. lymedisease.org. Available at: http://www.lymedisease.org/lyme101/lyme%5Fdisease/lyme%5Fdisease.html. Accessed September 26, 2012.
Lyme disease. National Institute of Allergy and Infectious Diseases website. Available at: http://www.niaid.nih.gov/topics/lymedisease/Pages/lymeDisease.aspx. Updated March 29, 2011. Accessed September 26, 2012.
Lyme disease. American Academy of Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/lyme-disease.html. Updated January 2010. Accessed September 26, 2012.
Nadelman RB, Nowakowski J, et al. Prophylaxis with single dose doxycycline for the prevention of Lyme disease after an Ixodes Scapularis tick bite. N Engl J Med. 2001;345:79-84.
Weiner HR. Lyme disease: questions and discussion. Compr Ther. 2006;32:17-19.
Wormser GP, Dattwyler RJ, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43:1089-1134.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Warshafsky S, Lee DH, Francois LK, Nowakowski J, Nadelman RB, Wormser GP. Efficacy of antibiotic prophylaxis for the prevention of Lyme disease: an updated systematic review and meta-analysis. J Antimicrob Chemother. 2010;65(6):1137-1144.
- Reviewer: David L Horn, MD, FACP
- Review Date: 12/2013 -
- Update Date: 01/13/2014 -