Lyme Disease
Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted by the blacklegged tick. It is the most commonly reported vector-borne disease in the United States and it is spreading across the state of Michigan. Typical clinical signs include flu-like symptoms however, if left untreated may spread to joints, the heart, and/or the nervous system. The majority of cases can be treated successfully with antibiotics. Finding and removing ticks promptly can prevent Lyme disease. 
Who is at risk?
National Lyme Disease Map
Anyone living or recreating where Lyme disease ticks may be present could become infected. Lyme disease is endemic (prevalent) in the Northeast, Northwest, and much of the North Central United States, including Wisconsin, Illinois, Indiana, and Pennsylvania.
Michigan Lyme Disease Risk Map
In Michigan’s Upper Peninsula, multiple counties have well-established tick populations, due in part to the close proximity to Wisconsin. In the Lower Peninsula, the first confirmed infected population of blacklegged ticks were detected in 2002 along the west coast. Since that time, the tick and the bacterium have been invading northward along the Lake Michigan coast. However, currently, infected ticks are spreading and being detected across several portions of the Lower Peninsula.
Signs and Symptoms
- What are the signs and symptoms of Lyme disease?
Looking for a bull's-eye rash? Look again - erythema migrans can take many forms.
Diagnosis and Testing
What should I do if I think I might have Lyme disease?
If you believe you may have Lyme disease, consult with a healthcare provider for evaluation and diagnosis. If you have the tick that was attached to you, bring it with you to your appointment as the physician may be able to properly identify it. Alternatively, Michigan Department of Health and Human Services can also identify the tick(s) at no cost (see below).
How is Lyme disease diagnosed?
Lyme disease is diagnosed based on signs and symptoms in addition to a history of possible exposure to infected blacklegged ticks.
A healthcare provider may order laboratory blood tests for those individuals experiencing symptoms of Lyme disease in order to assist in proper diagnosis. Additionally, Michigan Department of Health and Human Services offers testing at no cost to Michigan citizens, when ordered through their healthcare provider (see link below for information).
Laboratory testing available through the Michigan Department of Health and Human ServicesWhat should I do if I have a tick that I want to identify or test?
Knowing what kind of tick bit you may be important in knowing what your risk of disease is. The Michigan Department of Health and Human Services (MDHHS) provides tick identification at no charge to Michigan citizens. There are two ways to have a tick identified, 1) By submitting a photo of your tick, or, 2) by sending the tick to the MDHHS for microscopic identification. If you want to submit a photo of your tick, the MDHHS will make all attempts to identify the tick based on the condition of the tick and the condition of the photos. However, definitive tick identification may only be made by sending the tick for microscopic examination.
Ticks that are submitted from people to the MDHHS for microscopic identification and identified as blacklegged ticks (also known as deer tick) and are alive will be forwarded to the MDHHS Bureau of Laboratories for Lyme disease screening only, at no cost. Ticks that are dead when they are received or are from animals (dog, cat, horse, etc.) will not be tested however, they will be identified to species and life stage.
Click HERE for instructions on how to submit a photo of your tick for identification
Click HERE for instructions on how to ship a tick to the MDHHS for microscopic identification
Lyme disease information for clinicians
For guidelines, a webinar, and resources please see our Lyme information webpage.
Treatment
What is the treatment for Lyme disease?
Patients treated with appropriate antibiotics during the early stages of Lyme disease typically recover rapidly and completely. Common oral antibiotics used for treatment include doxycycline, amoxicillin, or cefuroxime axetil.
In a small percentage of infected individuals, symptoms may last for more than six months. This is commonly referred to as “chronic Lyme disease” or “Post-Treatment Lyme Disease Syndrome” (PTLDS).
Prevention
How can I prevent Lyme disease?
The most effective way to prevent Lyme disease is to prevent tick attachment.
- Avoid direct contact with ticks
- Ticks are typically found in wooded and brushy areas
- Stay in the center of hiking trails
- Repel ticks with DEET or permethrin
- Use repellents containing 20 to 30% DEET (N, N-diethyl-m-toluamide) on exposed skin and clothing
- Treat clothing and gear with products containing 0.5% permethrin
- Find and remove ticks from your body
- Perform frequent tick checks throughout your day
- Conduct a full-body tick check upon return from tick-infested areas
- Wear light-colored clothing to make it easier to see the ticks
- Tuck long pants into high socks
- Wear a long-sleeve shirt
Considerations:
- Blacklegged ticks must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted.
- Ticks may transmit other diseases in addition to Lyme disease.
- Most people are infected with the immature stage of the tick referred to as nymphs. Nymphs are small in size (less than 2 mm) and are typically active during the spring and summer months. The adult stage of the tick can also infect people, however, they are larger than the nymphs and are more likely to be seen. The adult ticks are active in the spring and the fall. View a pocket-sized card for identifying common ticks in Michigan.
- Ticks can attach to any part of the body but are often found in hard-to-see areas such as the groin, armpits, and scalp.
Important Links:
- Avoid direct contact with ticks
- The Tick Management Handbook
An integrated guide for homeowners, pest control operators, and public health officials for the prevention of tick-associated disease (Connecticut Agricultural Experiment Station)
- Tick Bite and Lyme Disease Prevention in Michigan
- Tick Bite Prevention in Michigan's Outdoors
Educational Materials and Guidance Documents
- Centers for Disease Control and Prevention Lyme Disease Printed Materials
- MDHHS Lyme disease information for Clinicians
Guidelines, webinar, and resources for healthcare providers.
- Communicable Disease Division Publication Order Form
The following Lyme disease publications can be ordered free of charge to Michigan local health departments, healthcare providers, social services agencies, and others:
- Ticks and Your Health Booklet
- Be Aware Trail Head Posting
- Tick Bite Prevention in Michigan's Outdoors Poster
- Tick Bite and Lyme Disease Prevention in Michigan Poster
- Michigan Tick ID Card (2"x3.5" business card size)
- Tick Submission Kit
- Poster: Looking for a bull's-eye rash? Look again-erythema migrans can take many forms.
- Frequently Asked Questions
- Lifecycle of Blacklegged Ticks
- Lyme disease: What you need to know
- Michigan Tick ID Card
Pocket-sized card for identifying common ticks in Michigan. Information regarding tick removal and tick-bite prevention.
- Tick Removal
- Michigan Lyme Disease Risk Map
- Healthcare Provider Lyme Disease Toolkit
- Michigan's Five Most Common Ticks
Ticks are significant vectors (carriers) of pathogens that cause human and animal disease. In Michigan, tick-borne diseases are rare, but they do occur and can be serious if not properly diagnosed and treated.
- Tickborne Diseases of the U.S.
- Tickborne Diseases of the U.S. - information from the CDC
- Ticks and Your Health
Brochure describing Lyme disease and other tick-borne diseases in Michigan. Other topics covered include tick-bite prevention, preventing ticks on pets, and landscape techniques to minimize tick risk.
Data, Statistics, and Maps
Michigan Lyme Disease Maps and Statistics:
Map of cases by county
Map of risk by county
Michigan 2014 Lyme Disease Epidemiology Summary
Michigan citizen submitted ticks by countyNational Lyme Disease Maps and Statistics:
Maps 2012-2015
Table of cases per state 2005-2015
Graphs of cases by: year, age/sex, month, symptom