Andrew J. Spano, Westchester County Executive

Lyme Disease Fact Sheet

What is Lyme disease?

Lyme disease is caused by a bacteria transmitted by infected deer ticks.

Where is it found?

Lyme disease is found along the East Coast, the upper Midwest and the valleys of the West Coast. New York State has one of the highest incidences of Lyme disease in the country. The New York State Department of Health is aware of over 40,000 cases in the state occurring since Lyme disease became reportable in 1986. Westchester County had the sixth highest incidence in New York State in 2000.

How is it spread?

Infected deer ticks spread Lyme disease. These insects live in wooded areas, clinging to plants. Ticks do not jump or fly but stay low to the ground and grab onto animals or people brushing up against them. Ticks can become infected if they feed on small animals that are infected. The bacteria can be transmitted when an infected tick bites a person or domestic animal if the tick remains attached for at least 48 hours.

Deer ticks can be found throughout the spring, summer and fall. They are most active in June and July. People can be exposed when they spend time in tick-infested areas. Lyme disease cannot be caught from other people, animals or insects. It is important to remember that not all deer ticks are infected.

What are the symptoms of Lyme disease?

Early symptoms of Lyme disease usually appear three to 30 days after a tick bite. The most common symptom, occurring in 60 – 80% of the cases, is a rash at the site of the bite. The rash often starts as a small red area, which then spreads and is called a “bulls eye rash.” Flu-like symptoms, such as fever, headache, stiff neck, sore and aching muscles and joints, are also common early symptoms of Lyme disease.

These early symptoms often go away by themselves after a few weeks, but the person will still be infected. Without medical treatment, a rash often appears again in other places on the body. Many will experience more serious problems.

Later symptoms can affect the joints, nervous system and heart. These symptoms can appear weeks or months after a tick bite. Most people with untreated Lyme disease get arthritis in their large joints. Swelling and large joint pain can recur over many years. Other late stage problems include meningitis (an inflammation of the membranes covering the brain and spinal cord), drooping on one side of the face (Bell’s palsy), heart abnormalities and weakness or pain in the hands, arms, feet and legs. These later symptoms may appear in people who did not have early symptoms or did not recognize them.

How is Lyme disease diagnosed?

Lyme disease is fairly easy to diagnose when the classic rash develops. It is harder to diagnose without this rash because other early symptoms resemble other diseases, like the flu.

A blood test can be done to test for antibodies to the Lyme disease bacteria. Antibodies will not appear until about 4 weeks after infection. Therefore, a blood test done too soon after a tick bite will not give reliable information.

People often ask about getting the tick itself tested for Lyme disease. In Westchester County, private laboratories can perform this test. The test is expensive and because many physicians will wait to see if Lyme disease symptoms appear, the findings may be of limited value. Westchester County has a tick identification service to identify deer ticks and indicate approximately how long ticks were attached. This information is important. Even if the deer tick was infected, if it was attached for less than 48 hours, there is a lower chance of the bacteria being passed on to you.

How is Lyme disease treated?

To treat early stage Lyme disease, antibiotics such as amoxicillin or doxycycline are given for 3-4 weeks. Treatment is usually effective and almost always results in a full cure. The cure rate decreases the longer treatment is delayed.

Later stage Lyme disease may require intravenous antibiotic therapy. The disease can be treated effectively but the response to treatment is individual.

Antibiotics for tick bites that are not accompanied by any Lyme disease symptoms are not indicated.

Can Lyme disease be fatal?

Lyme disease is rarely, if ever, fatal.

Can a person be reinfected with Lyme disease?

Yes. Having Lyme disease does not protect against reinfection. Some people have had Lyme disease more than once after being bitten again by an infected deer tick. This stresses the need for continued precaution.

How can you prevent Lyme disease?

● AVOID TICK-INFESTED AREAS (wooded or grassy areas)
especially in May, June and July.

● WEAR LIGHT-COLORED, TIGHTLY-WOVEN CLOTHES to
spot ticks more easily.

● WEAR A LONG-SLEEVED SHIRT, LONG PANTS AND
ENCLOSED SHOES to reduce the skin area exposed to ticks.

● TUCK YOUR PANTS INTO SOCKS AND SHIRT INTO
PANTS.

● USE INSECT REPELLENTS containing DEET according to label
instructions. Click here to read more about insect repellents.

● STAY ON CLEARED, WELL-TRAVELED TRAILS. Avoid
contacting vegetation.

● AVOID SITTING DIRECTLY ON THE GROUND OR ON
STONE WALLS.

● KEEP LONG HAIR tied back, especially when gardening.

● DO FREQUENT CHECKS FOR TICKS after outdoor activities
such as gardening, hiking or picnicking. Inspect the entire body
(parents should check their children) and remove ticks promptly.

● REMEMBER TO CHECK YOUR PETS. Pets can bring ticks
indoors and put your family at risk.

DEPARTMENT OF HEALTH

Joshua Lipsman, M.D., M.P.H., Commissioner