Lyme disease.

Figure 2 - Expanding skin rash

Figure 3 - Rash with Lyme disease may look like a red ring with a clear center

Symptoms

What are some initial warning signs of lyme disease?

You are more likely to spot early signs or symptoms of Lyme disease, rather than see the tick or its bite, because the tick is very small. It's also easy to miss early symptoms of Lyme disease.

Early symptoms

In its early stage, Lyme disease may be a mild illness with symptoms like the flu, or it may appear as an expanding skin rash. The flu-like symptoms can include a stiff neck, chills, fever, swollen lymph nodes, headaches, fatigue, muscle aches, and joint pain. This flu-like illness usually occurs out of flu season, in the spring and summer when ticks bite.

What are symptoms of lyme disease?

The rash of Lyme disease is different from the small red area that often develops just around the bite from a common tick. Many people bitten by an infected tick develop a large, expanding skin rash around the area of the bite (see figure 2). Some people may get more than one rash. The rash may feel hot to the touch and is usually not painful. Rashes vary in size, shape, and color, but often look like a red ring with a clear center (see figure 3). The outer edges expand slowly in size.

It is easy to miss the connection between the rash and a tick bite. The rash develops from three days to as long as a month after a tick bite. Almost one third of people with Lyme disease never get the rash.

Joint pain

Joint or muscle pain may be another early sign of Lyme disease. These aches and pains may be easy to confuse with the pain that comes with other types of arthritis. Unlike many other types of arthritis, this pain seems to move or travel from joint to joint. It lasts only a short time in any one joint.

How do the symptoms of lyme disease change over time?

Later signs of Lyme disease:

• Problems with the nervous system
• Heart problems
• Arthritis, especially in knees

If you notice any of these signs, contact your doctor.

In later stages, Lyme disease may be confused with other medical problems. These problems can develop weeks to years after the first tick bite. For instance, Lyme disease can cause problems with the nervous system that look like other diseases. These include symptoms of stiff neck, severe headache, and fatigue, usually linked to acute viral meningitis. They may include drooping of the muscles on the face called Bell's palsy, or weakness, pain, or numbness elsewhere in the body. Lyme disease can also mimic symptoms of other chronic, disabling diseases of the nervous system. A small percentage of people may develop difficulty in thinking and mood disorders. Treatment is more difficult and less successful in later stages.

Lyme disease may cause other serious problems. It can cause heart problems, such as an irregular or slow heartbeat. Lyme disease can result in intermittent attacks of arthritis in a few large joints. A small percentage of people get a disabling, chronic type of arthritis that most often affects the knees. Researchers think the chronic arthritis of Lyme disease may be linked to how the body's defense or immune system responds to the infection.

It is important to watch for Lyme disease in pets, such as dogs, and farm animals, such as horses and cows. A fever, swollen joints, poor appetite, lameness that comes and goes, or a reluctance to move may be the first clues that infected ticks are in your area. If you notice any of these signs in your pet, see your veterinarian.

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