Lyme Disease in Vermont
Lyme disease is a bacterial infection that features a skin rash, swollen joints and flu-like symptoms. You get the disease from the bite of an 
infected tick.
In Vermont, the number of reported Lyme disease cases from exposure to ticks has nearly tripled in the past two years. An increase likely due to a rise in the number of infected ticks, and a heightened awareness about Lyme disease.
Lyme disease can be prevented.
Sometimes it is hard to know if you have Lyme disease because you may not have noticed a tick bite.
Become familiar with the simple precautions you can take to avoid being bitten, and what to do if you find a tick or a bite.
Lyme Disease - The Basics
- What are the symptoms?
- How is Lyme disease spread?
- Who is at risk for Lyme disease?
- What is the treatment for Lyme disease?
- Is Lyme disease preventable?
- What to do if you have a tick bite (See Personal Prevention).
What is Lyme disease?
Lyme disease is an infection caused by bacteria called Borrelia burgdorferi. The infection is transmitted by the bite of infected black-legged ticks (Ixodes scapularis), known as deer ticks.
The disease can cause skin rashes, fatigue, fever, chills, and pain and swelling in the muscles and joints. If left untreated, Lyme disease can lead to heart problems and even neurological (pertaining to the brain) disorders, such as the inability to move certain muscles.
Lyme disease can be successfully treated with antibiotics, especially if treatment is given early.
What are the symptoms of Lyme disease?
There are three stages of Lyme disease: early, early disseminated, and late Lyme disease.
Symptoms - First Stage
The first stage of Lyme disease is called early Lyme disease. Early Lyme disease usually causes one or more of the following symptoms that occur days to weeks after infection:
- fatigue, chills and fever, muscle and joint pain, headache, swollen lymph nodes, Erythema migrans
Erythema migrans is the skin rash associated with Lyme disease. This is an expanding rash which usually appears at or near the site of the tick bite. It may appear anywhere from three days to one month after the infected tick's bite, but it usually appears in about seven to 14 days. The center of the rash may clear as it grows, giving it the appearance of a bull's-eye. The rash may be warm, but it is usually not painful.
The erythema migrans type of skin rash is different from a rash that appears as an allergic reaction a bite. An allergic type of reaction usually appears as redness within a few hours to one day after the bite, does not grow, and disappears within a day or two.
Symptoms - Second Stage
The second stage of Lyme disease is known as early disseminated Lyme disease, which means that the infection is beginning to spread and is affecting certain body functions. This stage occurs weeks to months after the bite of an infected tick. Problems can include:
- Numbness and pain in arms or legs
- Paralysis of facial muscles (usually on one side of the face)
- Meningitis - fever, stiff neck, and severe headaches
- Abnormal heart beat (rare)
Symptoms - Third Stage
The third stage of Lyme disease is called late disseminated Lyme disease. This stage can occur weeks, months, or even years after infection in untreated patients. Patients with late Lyme disease may get:
- Chronic Lyme arthritis - brief bouts of pain and swelling usually occurring in one or more of the large joints, especially the knees
- Nervous system problems, including memory loss and difficulty concentrating
- Chronic pain in muscles and/or unrestful sleep
How is Lyme disease spread?
The spirochetes enter the body when an infected tick attaches to the skin to take a blood meal. In order to transmit Lyme disease, the infected tick must be attached for 24 to 36 hours.
Not all types of ticks carry Lyme disease. In the eastern United States, the black-legged tick is mainly responsible for transmitting the disease. However, not all black-legged ticks carry the spirochete that causes Lyme disease. Most cases of Lyme disease occur in a few highly affected areas.
A history of a known tick bite will help the doctor to know if Lyme disease caused the current symptoms. However, most people with Lyme disease do not remember being bitten by a tick.
Black-legged ticks are tiny and often go unnoticed. They are smaller than dog ticks. In their larval and nymph stages, they are no bigger than the head of a pin. Adult black-legged ticks are larger, about the size of an apple seed.
Photo - from left to right: adult female, adult male, nymph, larvae.
Who is at risk of getting Lyme disease?
Black-legged ticks live in wooded, brushy and grassy places, including lawns and gardens. Individuals at greatest risk are those who spend time out-of-doors in areas that are highly affected by Lyme disease. A person is more likely to get the disease during the spring and summer because a lot of time is spent outside, often with large amounts of skin exposed.
What is the treatment for Lyme disease?
Early treatment of Lyme disease involves antibiotics and almost always results in a full cure. However, the chances of a complete cure decrease if treatment is delayed.
Is Lyme disease preventable?
Taking a few simple precautions can reduce your chance of being bitten.
While outdoors:
- Wear long pants and long-sleeved shirts to minimize skin exposure to ticks.
- Tuck your pants into your socks to form a barrier to tick attachment.
- Wear light-colored clothing to make ticks on your clothing easier to see.
- Check for ticks, looking particularly for what may look like nothing more than a new freckle or speck of dirt.
- Use tick and insect repellents containing DEET or permethrin to help protect against Lyme disease. DEET-containing preparations should be used sparingly, not applied to face or hands, and should not exceed 10% concentrations for children over 3 years of age and 30% for adults. DEET should not be used on infants or children under age 3 without first consulting your health care provider. Follow the label instructions carefully.
For more information about Lyme disease
Please explore this web site for more information, guides, and resources.
You may also call the Vermont Department of Health, Epidemiology Field Unit at 1-800-640-4374 or 863-7240.