Lyme Disease

Lyme disease is the most commonly reported tickborne disease in Vermont, and in 2017, Vermont had the highest rate of reported confirmed and probable Lyme disease cases in the U.S.

Lyme disease is caused by an infection with the bacterium Borrelia burgdorferi. In the eastern U.S., B. burgdorferi is transmitted to humans by the bite of infected blacklegged ticks, Ixodes scapularis. Over half of the black-legged ticks recently collected in Vermont tested positive for B. burgdorferi.

The best way to prevent Lyme disease is to prevent tick bites. If you find a tick on your body, remove it quickly to reduce the risk of contracting Lyme disease. See a health care provider if you get sick. Lyme disease is treatable. Early diagnosis and treatment are important to avoid health problems related to Lyme disease. 

Symptoms

Early symptoms of Lyme disease typically begin three to 30 days after a tick bite, and can include:

  • Erythema migrans (EM) rash
  • Headache
  • Fever
  • Chills
  • Muscle pain
  • Joint pain
  • Fatigue

EM rash is characteristic of Lyme disease. It may appear at the site of a tick bite and gradually expands. The center of the rash may clear as it enlarges, giving it the appearance of a bull's eye or target. The rash usually appears 7-14 days after a tick bite. The rash may be warm, but it is usually not painful or itchy. See photos of examples of EM rashes CDC's website

Not everyone with Lyme disease will develop a rash. About 30% of confirmed cases of Lyme disease reported to the Vermont Department of Health do not have an EM rash at the time of their diagnosis. Lyme disease that is not diagnosed and treated early may cause additional symptoms as the illness progresses. These symptoms occur days to months after a tick bite and may include:

  • Multiple EM rashes
  • Joint swelling with severe pain (arthritis)
  • Drooping of facial muscles (facial palsy)
  • Pain that comes and goes in muscles, joints, bones and tendons
  • Pain, numbness or tingling in the hands or feet (radiculoneuropathy)
  • Problems with short-term memory
  • Heart palpitations or an irregular heartbeat (carditis)
  • Inflammation of the brain and spinal cord (meningitis/encephalitis)

These symptoms are relatively rare in Lyme disease cases reported to the Vermont Department of Health.

Who is at risk in Vermont?

Anyone who spends time outdoors can be at risk for Lyme disease. The tick that transmits Lyme disease in Vermont, the blacklegged tick, can live in a variety of habitats such as wooded areas or fields with tall grass and brush. People who frequent these settings (hikers, campers, hunters, farmers, gardeners, landscapers, and other outdoor workers) may be at increased risk for Lyme disease.

The property around many homes is also suitable habitat for ticks, particularly yards next to woods, or those with tall grass or leaf litter. That is why it is important to take steps to prevent tick bites.

Vermonters of all ages get sick with Lyme disease, but males get Lyme disease more frequently than females. Boys aged 5-14 years and older men are at highest risk.

When are Vermonters at risk for Lyme disease?

In Vermont, cases of Lyme disease are reported every month of the year. However, the number of reported cases is highest in June, July and August. Since symptoms of Lyme disease appear 3-30 days after a tick bite, most patients acquire Lyme disease by being bitten by an infected blacklegged tick during April through July.

Where in Vermont are people at risk?

While Vermonters in every county can be exposed to the bacteria that causes Lyme disease, the risk varies depending on where you live or visit in the state. The rate of Lyme disease is generally highest in the southern-most counties.

Trends over time

Reports of Lyme disease used to be rare in Vermont. In the early 1990's the Health Department received a dozen or fewer confirmed reports of the illness each year. Since that time, the number of reported cases has increased substantially. It is now common that over 500 cases are reported each year.

Diagnosis

Lyme disease can only be diagnosed by a health care provider. As part of an evaluation for Lyme disease a provider may perform a physical examination and review patient symptoms and exposure history. A blood specimen may also be collected for laboratory testing.

For more information, please visit the CDC's website on Lyme disease diagnosis and testing.

Treatment

Lyme disease can be treated with antibiotics. Most people who receive a timely diagnosis and begin treatment early in the course of their illness fully recover. Find more information on treatment for Lyme disease here.

Some people may experience lingering symptoms even after being appropriately treated, a condition called "Post-treatment Lyme Disease Syndrome." It is not clear why this happens, but it does not appear to be due to an ongoing infection with Borrelia burgdorferi. Find more information from CDC on Post-treatment Lyme Disease Syndrome.

For more information on Lyme disease, visit the CDC Website.

The best way to prevent Lyme disease is to prevent tick bites.