Lyme Disease 101: Transmission, Symptoms and Treatment

A tick walks along a blade of grass held by an adult hand

Playing in wooded areas is fun during warm summer days. However, ticks are lurking and ready to hop on and dig in. These small bugs like burrowing in the warm areas of your body and carry a bacteria, which could result in Lyme disease. Kelli Miller, ANP, UnityPoint Health, explains Lyme disease transmission, symptoms and treatment.

How is Lyme Disease Transmitted?

Lyme disease is an infection caused by bacteria transmitted from the bite of a blacklegged tick, also known as a deer tick. These ticks are one of three varieties of ticks commonly found in the United States. They are much smaller in size than the other two varieties: the dog tick and lone star tick.

“The tick that causes Lyme disease becomes active in mid-May, peaks in June and becomes less active in late July,” Miller says. “Lyme disease onset occurs mainly during the summer months of June, July and August since the period between the tick bite and onset of the disease is approximately two to three weeks.”

Ticks usually take up to 24 hours from the time of first contact before they start to feed. Miller says the tick must remain firmly attached to the skin for 48 to 72 hours to pass the bacteria that causes Lyme disease.

The most common sites for tick bites include:

  • Head
  • Neck
  • Arms
  • Legs
  • Back
  • Abdomen
  • Underarms
  • Chest
  • Groin

The Centers for Disease Control and Prevent (CDC) keeps track of cases on a Lyme disease map of the U.S.

Is Lyme Disease Contagious?

“There isn’t any evidence to support that Lyme disease is contagious. For example, it can’t be passed by touching, kissing or having sex with another infected person,” Miller says.

If you are pregnant and think you might have Lyme disease, contact your doctor immediately. The CDC says untreated Lyme disease during pregnancy can lead to infection of the placenta. The spread of the disease from mother to fetus is possible but rare. However, with antibiotics, there is no increased risk of adverse birth outcomes.

What Happens if You Go Untreated for Lyme Disease?

Lyme disease symptoms in adults vary widely from person to person but are all caused by the body’s inflammatory response to the bacteria. As it goes untreated, the disease has different stages.

Stage 1: Early Localized Lyme Disease

“During the early stage, Lyme disease can cause nonspecific, virus-like signs and symptoms, including fatigue, fever, headache, muscle pain, joint pain and swollen lymph nodes. These symptoms may or may not present with a rash,” Miller says.

nullMiller adds the rash sometimes associated with Lyme disease is called erythema migrans and usually occurs within seven to 14 days.

Unlike other bug bites, the Lyme disease rash is usually pink to red-colored. The color may cover the entire bite or may have an area in the center that is flesh-colored. In some cases, the rash consists of multiple rings, giving it a bull’s eye appearance,” Miller says.

Stage 2: Early Disseminated Lyme Disease

As the untreated disease advances into a second, more advanced stage, Miller says the bacteria spreads through the bloodstream to other areas of the body, triggering inflammation in different tissues. This stage usually occurs during the first few months.

“Cardiac symptoms can occur due to inflammation of the cardiac tissue and may interfere with the electrical impulses throughout the heart, causing a slower than normal heart rate, lightheadedness and fainting. There could be neurological symptoms caused by inflammation of the tissue covering the brain and spinal cord, also known as meninges, which could cause headache, neck stiffness, numbness and tingling to extremities,” Miller says.

Stage 3: Late Disseminated Lyme Disease

As the untreated disease progresses into late stage, over the course of several months to years, inflammation often targets the joints or nervous system. Miller says victims might notice muscle and joint pain or arthritis. Inflammation of the nervous system could include difficulty with memory, thinking or numbness and tingling to the extremities.

If you notice any of these symptoms or are worried you have Lyme disease, contact your primary care provider or find an urgent care near you.

Lyme Disease Diagnosis & Treatment

Your provider will consider three things when trying to identify a Lyme disease diagnosis:

  • Recent exposure to ticks
  • Presence of symptoms
  • Blood test for Lyme disease

Once a diagnosis is confirmed, Miller says antibiotics are the primary treatment course. She says the most important thing to remember is Lyme disease is curable.

“The treatment for Lyme disease varies depending upon the stage and symptoms. The rate of recovery may also vary based on similar factors. Recovery may take weeks to months after finishing the antibiotic for Lyme disease,” Miller says.

What is Chronic Lyme Disease?

Chronic Lyme disease, more formally known as post-treatment Lyme disease syndrome (PTLDS), occurs when people have symptoms of pain, fatigue or difficulty thinking lasting up to 6 months after finishing antibiotic treatment. 

“Why this happens isn’t known. Some experts think it’s caused by an auto-immune response, others hypothesize it occurs when the infection is still present, but hard to treat and detect,” Miller says.

While there’s no proven treatment, people with PTLDS usually improve over time. However, it can take months to feel completely recovered. If you’ve been treated for Lyme disease but still don’t feel well, talk to you doctor.

How to Check for Ticks – 3-Step Process


  • Step 1. Check your hair with your fingers. Start by holding your fingers together and use both hands to feel over the entire scalp. Try to find small bumps or objects against the scalp.
  • Step 2. Thoroughly comb your hair with a fine-tooth comb.
  • Step 3. Check the rest of your body from top down. Especially focus on warm areas like behind the knees, groin, neck and ears.

When you’re done, remember to check everyone in your family, even the pets.

Tick Prevention

If you’re going into an area with ticks, Miller provides these six suggestions.

  • Dress in a light-colored, long-sleeved shirt
  • Wear long pants and tuck the pant legs into socks
  • Keep clothes snug fitting
  • Cover hair with a hat
  • Put long hair up in a ponytail
  • Use insect repellent according to manufacturer’s guidelines

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