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Jul 01 2022

Lyme disease Q&A

July 1, 2022  /   Family Medicine  /   6-minute read

Forget mosquitoes. In Minnesota, ticks may be the bigger pest. We’re home to thirteen different types of ticks—the most common are the American Dog Tick (AKA the wood tick), the Lone Star Tick, and the Blacklegged Tick (AKA the deer tick). This last one, the deer tick, by far causes the most tick-borne disease, including Lyme disease and at least a half dozen other illnesses. 

In East-central Minnesota, particularly from Mid-May through mid-July, we are considered at high-risk for tick exposure.

Common questions and concerns

To better understand the transmission, symptoms, treatment, and prevention of Lyme disease, we have some answers to some common questions.

Q. What is Lyme disease, and how is it contracted?

A. Lyme disease is the most common tick-borne disease both statewide and nationwide. It is caused by a bacteria called Borrelia burgdorferi and is transmitted to humans and animals through a bite from an infected deer tick. Exposure to deer ticks is most significant in wooded areas. There is no evidence that Lyme disease is transmitted in any other way, such as through person-to-person contact, blood transfusions, or from animals.

Q. What does a deer tick look like?

A. The deer tick is the smallest tick in Minnesota, with adults growing only to about the size of a sesame seed. It is reddish-brown and has a black shield-shaped area on its back. As a deer tick feeds, which can take 3-5 days, its appearance changes dramatically as its body becomes engorged. 

‘Normal’ and engorged deer tick

Q.  What should I do if a tick has bitten me?

A. The very first thing to do once you’ve discovered a tick bite is to remove the tick. While it typically takes 36 to 48 hours for an infected tick to transmit the Lyme disease bacterium, it’s essential to remove the tick promptly. This is best done using fine-tipped tweezers. First, grasp the tick as close to the skin as possible. Pull the tweezers upward with steady, even pressure, avoiding twisting or jerking. If you suspect it is a deer tick and want to have it identified by a provider, take pictures before disposing of it or place it in rubbing alcohol inside a sealed jar or bag. Last, thoroughly clean the tick bite and your hands with rubbing alcohol or soap and water.

When any part of an infected tick remains in the skin, the risk for infection increases, so it’s a good idea to make an appointment with your primary care provider to help remove it.

Q. What is your best advice for any tick bite?

A. There’s no need to let us know about every tick bite. You may experience a change in skin color (redness on light skin or purple or brown on dark skin), swelling, or a sore on the skin – this is normal and not a cause for concern. Following a tick bite, the most important thing is to carefully watch for any symptoms in the days and weeks that follow.

Q. What symptoms indicate that I may have Lyme disease?

A. The first symptoms of Lyme disease typically appear 3-14 days following the bite. However, many won’t see signs for up to a month or longer.

  • The classic Lyme disease symptom of an expanding red rash that appears at the site of the bite in a bull’s-eye pattern – a red center surrounded by a clear ring with a red circle around it
Lyme disease bulls-eye rash
  • Other red rashes may be circular or oval, with or without a clear center
  • An expanding red lesion that may include a crust at the center
  • Flu-like symptoms such as fever, chills, headache, fatigue, muscle and joint aches
  • Swollen lymph nodes

See your healthcare provider if you experience any of these symptoms, even if they subside. 

Q. Can I be diagnosed with Lyme disease even if I don’t remember a tick bite?

A. Yes. Ticks often attach to areas of the body where they won’t easily be found. It’s not uncommon for Lyme disease to be diagnosed without proof of the bite, so when diagnosing, we conduct a careful review of your health history, assess the likelihood of exposure, and perform a physical exam to look for the presence of a rash or other symptoms.

Q. How is Lyme disease treated?

A. In most cases, a 21-day course of antibiotics, such as amoxicillin, cefuroxime, or doxycycline, is prescribed. In more severe cases, or when symptoms of the nervous system are present, intravenous (IV) antibiotics may be used for up to one month.

Q. What happens if Lyme disease goes undetected?

A. Like so many illnesses, early detection is beneficial for effective treatment. Because the early symptoms of Lyme disease can be overlooked or mistaken, it’s not uncommon for it to go untreated. As the disease progresses, so do symptoms. Examples of symptoms that are characteristic of late-stage or chronic Lyme disease are:

  • Severe headaches and neck stiffness
  • Additional rashes on other areas of the body
  • Facial palsy (loss of muscle tone or droop on one or both sides of the face)
  • Arthritis with severe joint pain and swelling, particularly in the knees and other large joints
  • Intermittent pain in tendons, muscles, joints, and bones
  • Heart palpitations or an irregular heartbeat
  • Episodes of dizziness or shortness of breath
  • Inflammation of the brain and spinal cord
  • Nerve pain
  • Shooting pains, numbness, or tingling in the hands or feet

Q. If I get Lyme disease, will I always have Lyme disease? 

A. No. If you are treated with antibiotics in the early stage of the infection, you will likely recover rapidly and completely. Even individuals who are treated with antibiotics in the later stages typically respond well to antibiotics.

Clinical studies continue to investigate the lingering effects of Lyme disease in some patients who experience long-term fatigue, pain, insomnia, and depression. An estimated 1 in 10 people who get Lyme disease have chronic Lyme disease or “post-treatment Lyme disease syndrome” (PTLDS).

Q. What can I do to prevent tick bites?

A. By taking a few precautions, you can prevent tick bites and the trouble they cause.

  • Whenever possible, walk and hike on cleared trails, avoiding the tall grasses, brush, and other foliage where ticks hang out.
  • Minimize skin exposure by wearing long sleeves and pants to cover your arms and legs. To keep ticks from crawling onto your legs, tuck pants into your socks.
  • Wear light-colored clothing to spot ticks easily.
  • Use a bug repellant with at least 20% DEET for any exposed skin. The EPA can help you find the repellent that’s right for you.
  • Spray your clothes with permethrin, or invest in permethrin-treated clothing like InsectShield – both options will repel ticks.
  • When you return home, conduct a thorough tick check. Closely inspect your clothes and body, including underarms, belly button, ears, hair, and any other nooks and crannies where ticks could hide.
  • Did you bring your pet with you? Be sure they get a doggie tick check too.
  • Shower and change into clean clothes after being outside.
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