Bacteria, Epidemiology, Infectious Diseases, Microbiology, tick-borne diseases

Tick-Borne Troubles: Exploring Lyme Disease, History, Symptoms, Diagnosis and More

Author Chandana Balasubramanian , 07-Nov-2023

When we’re running through the woods or hiking up a new trail, we often feel invigorated by the fresh air, exercise, and the opportunity to clear our minds. However, it’s important to be aware that ticks thrive in these environments and can transmit various tick-borne diseases, with Lyme disease being the most widely recognized.


Lyme disease is spread through the bite of deer ticks (Ixodes scapularis ticks)and is caused by the bacterium Borrelia burgdorferi. If Lyme disease is left untreated, it can be dangerous and affect various organs, including the skin, joints, heart, and even the nervous system.


Making things worse, Lyme disease can be hard to diagnose, and there is no vaccine to help prevent the infection. So, it is even more important to stay aware. Also, with cases on the rise, there is a more intense urgency for researchers and the medical community to help find an effective way to prevent Lyme disease.


In this article, we will explore the history, epidemiology, transmission, biology, symptoms, diagnosis, treatment, and prevention of Lyme disease. Let’s get started.



The story of Lyme disease is quite interesting, and new discoveries keep challenging what scientists and doctors thought they knew.

Discovery and identification of Lyme disease

In the mid-1970s, a group of children in Lyme, Connecticut, started having strange symptoms similar to juvenile rheumatoid arthritis. This caught the interest of Dr. Allen Steere, a rheumatologist at Yale University, who started a study to investigate the cause of these symptoms.

Dr. Steere and his team conducted extensive research on the affected children and noticed a common thread – many of them had been bitten by ticks. This led them to suspect that the symptoms might be related to tick bites. In 1977, Dr. Steere published a seminal paper describing the clinical features of what he called ‘Lyme arthritis.’ The condition is now known as Lyme disease.

Around the same time, two other researchers, Dr. Willy Burgdorfer and his team, were studying a mysterious disease affecting cattle in the town of Lyme. They discovered a peculiar bacteria in the midgut of ticks collected from the area. This bacteria was later named Borrelia burgdorferi, after Dr. Burgdorfer, and was identified as the cause of Lyme disease.

Dr. Burgdorfer’s discovery was groundbreaking because it provided a clear link between tick bites and Lyme disease.

Overall, the discovery and identification of Lyme disease involved the collaborative efforts of researchers like Dr. Allen Steere, who recognized the clinical manifestations of the disease, and Dr. Willy Burgdorfer, who identified the bacteria responsible for the disease.

Their contributions have been instrumental in advancing our understanding of Lyme disease and developing effective diagnostic and treatment strategies.

Recent discoveries

In recent years, scientists found that Lyme disease has been around for thousands of years and even discovered in a 5,300-year-old mummy. In 2017, a team of researchers at Yale University found that Borrelia burgdorferi has been circulating in the United States for over 60,000 years, predating human life on the continent!



United States and Canada

Lyme disease is found in all 50 states in the United States and is the most common vector-borne illness in the country. However, it is more prevalent in the upper Midwest, the northeastern and mid-Atlantic states, and parts of Canada. Infection rates are high among children aged 5-15.

The US CDC (Centers for Disease Control and Prevention) estimates that 476,000 people get diagnosed and treated for Lyme disease each year (They note that some people may have been treated as a preventive measure and may not have had Lyme disease). 

In Canada, Lyme disease can be contracted from two types of ticks: the black-legged tick (also known as the deer tick, Ixodes scapularis) in the southeastern and south-central regions and the black-legged tick (Ixodes pacificus) in British Columbia.

Canada surveillance reports slightly over 2000 cases reported a year.


Lyme disease is the most common tick-borne illness in Europe. According to ECDC (European Centers for Disease Prevention and Control), the number of Lyme disease cases is on the rise in Europe, with over 360,000 cases reported in the past two decades.

The distribution of Lyme disease is closely tied to the presence of deer ticks and their preferred hosts, such as white-footed mice and deer. The risk of infection varies within regions and even between counties, depending on the population density of infected ticks.

The highest incidence rates are in Belarus, Belgium, Croatia, Norway, Russia, and Serbia.


Lyme disease is not commonly found in the UK. However, cases do exist. For example, there were about 850 laboratory-confirmed cases of Lyme disease in the UK in 2022. 


How is it spread?

Lyme disease is primarily transmitted through the bite of infected deer ticks, also known as black-legged ticks.

These ticks can become infected with the Borrelia burgdorferi bacterium after feeding on infected hosts, such as mice or deer. Once infected, the ticks can transmit the bacteria to humans during subsequent feedings.

It’s important to understand that not all deer ticks are infected, and the bacteria is usually transmitted when the ticks are attached to the host for at least 36-48 hours. Detecting and removing ticks early can significantly reduce the risk of infection.


Biology of the disease

Borrelia burgdorferi, the bacterium responsible for Lyme disease, is a spirochete (spiral-shaped bacteria) that can burrow into various tissues in the body. After entering the bloodstream through a tick bite, the bacterium can spread to different organs and systems.

In the early localized stage of the disease, an erythema migrans (EM) rash may appear at the site of the tick bite. If left untreated, the infection can progress to the early disseminated stage, where multiple rashes, facial palsy, and flu-like symptoms may occur.

In the late stage of Lyme disease, severe complications such as arthritis, neurological disorders, and cardiac abnormalities can develop.



Lyme disease symptoms can vary depending on the stage of infection.

Stage 1: Early localized stage

In the early localized stage, which occurs within 3 to 30 days after a tick bite, a characteristic rash called erythema migrans (EM) may appear. The Lyme disease rash often starts as a small red bump and gradually expands, resembling a bull’s-eye or target.

However, not all individuals with Lyme disease or tick bite marks develop this rash, and it may be accompanied by signs of Lyme disease such as fever, headache, fatigue, muscle aches, and swollen lymph nodes.

Stage 2: Early disseminated stage

As the infection progresses to the early disseminated stage, additional symptoms may emerge. These can include multiple rashes on different parts of the body, facial palsy (loss of muscle tone or drooping on one or both sides of the face), migratory joint pains, headaches, and neurological symptoms such as tingling or numbness in the extremities.

Stage 3: Late stage

In the late stage of Lyme disease, which can occur months or even years after infection, more severe complications may arise.

These can include persistent arthritis with joint pain and swelling, neurological disorders affecting memory and cognitive function, cardiac abnormalities, and inflammation of the brain and spinal cord.



Diagnosing Lyme disease can be highly challenging because an infected individual may not know if they have been bitten by ticks and may miss showing their tick bite mark to their healthcare provider.

Plus, Lyme disease symptoms often overlap with other conditions like fibromyalgia, chronic fatigue syndrome, and others.

However, healthcare providers use a combination of clinical evaluation, patient history, and laboratory testing to make a diagnosis.

If a patient has the characteristic rash, it is a strong indication of Lyme disease. However, in cases where the rash is absent or other symptoms are present, serological tests like ELISA and Western blot may be used to detect antibodies against the bacteria. It’s important to note that these tests may not be reliable in the early stages of infection and may require follow-up testing.

In cases where Lyme disease affects the nervous system or joints, additional tests such as a spinal tap or joint fluid analysis may be performed to evaluate the presence of the bacterium or its genetic material. These tests, known as polymerase chain reaction (PCR) tests, can help confirm the diagnosis and guide treatment decisions.



The treatment for Lyme disease involves using antibiotics to get rid of the infection. During the early stage of the disease, doctors usually prescribe oral antibiotics like doxycycline, amoxicillin, or cefuroxime axetil for 10 to 21 days. 

In cases where the disease has progressed to the early disseminated or late stage, intravenous antibiotics may be necessary for a more extended treatment duration. The choice of antibiotics and duration of Lyme disease treatment may vary depending on the individual’s age, symptoms, and the presence of complications.

It’s important to know that finding and treating symptoms of Lyme disease early is necessary to stop the infection from getting worse and causing serious problems. If not treated, Lyme disease can lead to long-term health issues and ongoing symptoms.



Preventing Lyme disease involves taking precautions to avoid tick bites and reducing exposure to tick-infested areas during ‘tick season.’ Ticks are most active during warm weather but can be found all year round.

Here are some preventive measures you can take:

  1. Avoid tick-infested areas: If possible, avoid walking through tall grass, wooded areas, or areas with leaf litter, as these are typical habitats for ticks.
  2. Use insect repellents: Apply insect repellents containing DEET, picaridin, or other EPA-approved ingredients to exposed skin and clothing. Follow the instructions on the product label.
  3. Wear protective clothing: When spending time outdoors in tick-prone areas, wear long sleeves, long pants, socks, and closed-toe shoes. Tuck your pants into your socks to prevent ticks from crawling up your legs.
  4. Perform regular tick checks: After spending time outdoors, thoroughly check your entire body for ticks. Pay close attention to areas such as the scalp, behind the ears, armpits, groin, and between the toes.
  5. Remove ticks promptly: If you find a tick attached to your skin, use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. Slowly and steadily pull upward, without twisting or jerking, to remove the tick. Cleanse the bite area with soap and water or an antiseptic.
  6. Treat clothing and gear: If you frequently spend time in tick-infested areas, consider treating your clothing and gear with products containing permethrin, which can repel and kill ticks.
  7. Keep your yard tick-free: Create a tick-safe zone in your yard by keeping grass mowed, removing leaf litter, and clearing tall brush and shrubs. Consider using tick control products to reduce tick populations in your yard.


By following these preventive measures, you can significantly reduce your risk of contracting Lyme disease and other tick-borne illnesses.

Tick-borne illnesses are on the rise due to climate change, rapid urbanization, and other environmental issues. Tick-borne encephalitis (TBE), for instance, is a threat to public health in Europe and Asia.

Other diseases spread by ticks that are on the rise are babesiosis, ehrlichiosis, Rocky Mountain Spotted Fever (RMSF), and Colorado Tick Fever.


FAQs about Lyme disease

What is Lyme disease?

Lyme disease is a complex illness caused by the bacterium Borrelia burgdorferi and transmitted by ticks. It is the most common vector-borne illness in North America and Europe.

The symptoms of Lyme disease can affect several organs in the body if left unaddressed. Early diagnosis and treatment are crucial for a successful recovery and to avoid long-term complications.

How do you get Lyme disease?

Lyme disease is spread by tick bites, primarily black-legged deer ticks. The ticks are vectors for Borrelia burgdorferi, the bacterium that causes Lyme disease.

Is Lyme disease contagious?

Lyme disease is not contagious and cannot be transmitted from person to person.

Is Lyme disease curable?

According to the US CDC, Lyme disease cases can be cured within 2-4 weeks of antibiotics treatment. However, some individuals experience Chronic Lyme Disease (CLD) symptoms, including fatigue, joint and muscle aches, cognitive issues, and more.

What is chronic Lyme disease?

Chronic Lyme disease (CLD) refers to cases where symptoms persist for an extended period despite treatment. In most cases, Lyme disease responds well to antibiotic treatment. However, some people continue to experience Chronic Lyme Disease symptoms, including fatigue, joint pain, and muscle aches, even after treatment ends. This is known as Post-Treatment Lyme Disease Syndrome (PTLDS). 

What ticks carry Lyme disease?

The ticks that carry Lyme disease are primarily black-legged ticks (Ixodes scapularis) in the eastern United States and western black-legged ticks (Ixodes pacificus) in the western United States.

These ticks become infected with the bacterium Borrelia burgdorferi after feeding on infected animals like mice and deer. When an infected tick bites a human, it can transmit the bacteria, leading to Lyme disease. Preventive measures such as creating a tick-safe zone in your yard, using tick control products, and wearing protective clothing can help reduce the risk of tick bites and Lyme disease transmission.

Is there a Lyme disease vaccine?

There is no vaccine to help prevent Lyme disease. However, clinical trials for new Lyme disease vaccines are underway.

Is it Lyme disease, Lymes disease, or Lime disease?

The official term is Lyme disease, although some people may casually refer to it as Lyme’s disease. The tick-borne infection is also known as Lyme borreliosis.

The disease has nothing to do with limes, and it may just be a typo if you happen to see it written this way.



Lyme disease is a complex illness caused by the bacterium Borrelia burgdorferi and transmitted by ticks. Symptoms of Lyme disease, if left unaddressed, can affect several organs in our bodies. Early diagnosis and treatment are essential for a successful recovery and to avoid long-term complications.

Understanding the epidemiology, transmission, biology, symptoms, diagnosis, treatment, and prevention of Lyme disease can help individuals protect themselves and reduce the impact of this potentially debilitating disease.

If you suspect you may have been exposed to ticks and are experiencing symptoms, seek medical attention promptly for proper care.


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Chandana Balasubramanian

Chandana Balasubramanian is an experienced healthcare executive who writes on the intersection of healthcare and technology. She is the President of Global Insight Advisory Network, and has a Masters degree in Biomedical Engineering from the University of Wisconsin-Madison, USA.

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