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Lyme Disease

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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. 

  • 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.  
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    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. 
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  • Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. These include fever, rash, facial paralysis, and arthritis.

    Early Signs and Symptoms (3 to 30 Days After Tick Bite)

    • Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash
    • Erythema migrans (EM) rash:
      • Occurs in approximately 70 to 80 percent of infected persons
      • Begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days)
      • Expands gradually over several days reaching up to 12 inches or more (30 cm) across
      • May feel warm to the touch but is rarely itchy or painful
      • Sometimes clears as it enlarges, resulting in a target or “bull’s-eye” appearance
      • May appear on any area of the body
      • Does not always appear as a “classic” erythema migrans rash

    Later Signs and Symptoms (days to months after tick bite)

    • Severe headaches and neck stiffness
    • Additional EM 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 the knees and other large joints.
    • Intermittent pain in tendons, muscles, joints, and bones
    • Heart palpitations or an irregular heart beat (Lyme carditis)
    • 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

    Signs and symptoms of untreated Lyme disease

    Looking for a bull's-eye rash?

  • 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).

    MDHHS BOL Mosquito-Borne and Tick-Borne Disease Testing


    What should I do if I have a tick that I want to have identified?

    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. 

    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

    MDHHS Bureau of Laboratories - Lab Services Guide


    Lyme disease information for clinicians

    For guidelines, a webinar, and resources please see our Lyme information webpage.


  • Early diagnosis and proper antibiotic treatment of Lyme disease is important and can help prevent late Lyme disease. The following treatment regimens reflect CDC’s interpretation of the most current data for four important manifestations of Lyme disease. These regimens are consistent with guidance published by the by the Infectious Disease Society of America, American Academy of Neurology, and American College of Rheumatology.

    Erythema migrans
    Neurologic Lyme disease
    Lyme carditis
    Lyme arthritis

    Some patients report persistent symptoms of pain, fatigue, or difficulty thinking even after treatment for Lyme disease. The state of the science relating to persistent symptoms associated with Lyme disease is limited, emerging, and unsettled.

    Additional research is needed to better understand how to treat, manage, and support people with persistent symptoms associated with Lyme disease. In light of these research gaps, recommendations for treatment of persistent symptoms in people previously treated for Lyme disease are not provided here.