Symptoms of Lyme disease and Tick-Borne Illnesses

See a full list of symptoms.

Common symptoms of Lyme - Not everyone infected with the bacteria gets ill. If a person does become ill, the first symptoms resemble the flu and include fever, headache, chills, muscle pain, and lethargy. Headache, stiff neck, backache, weakness, fasciculations, profound fatigue, migratory symptoms like diarrheoa, chest pain, shortness of breath, myalgias, hand or foot pain, stiffness in the morning or if sitting too long, connective tissue weakness, anxiety disorder, mood disorders, sleep disorders and more.

If left untreated or treated insufficiently symptoms may creep into one's life over weeks, months or even years. They wax and wane and may even go into remission only to come out at a later date; even years later.

With symptoms present, a negative lab result means very little as they are very unreliable. The diagnosis, with today's limitations in the lab, must be clinical. You can assist your doctor in making the right diagnosis by detailing and documenting your symptoms, as they may be very subtle and come and go during the day.

Now that you understand some of the issues associated with being diagnosed in the South, the next step is to keep detailed records of your symptoms and be ready to give your doctor as much information that you can, pertinent to your illness. The more information, such as symptoms, family history, possible causes, etc., the better your doctor is able to make an educated diagnosis. There are many symptoms of Lyme disease but the following list is one of the best we've seen. Copy the list and mark which ones apply to you. Bring this list with you during your doctor's visit. The following information is extracted from

The classic rash may only occur or have been seen in as few as 40%-50% of the cases (many rashes in body hair and indiscreet areas go undetected). Treatment in this early stage is critical.

If left untreated or treated insufficiently, symptoms may creep into one's life over weeks, months or even years. They wax and wane and may even go into remission only to come out at a later date...even years later.

With symptoms present, a negative lab result means very little as they are very unreliable. The diagnosis, with today's limitations in the lab, must be clinical.

Many Lyme patients were firstly diagnosed with other illnesses such as Juvenile Arthritis, Rheumatoid Arthritis, Reactive Arthritis, Infectious Arthritis, Osteoarthritis, Fibromyalgia, Raynaud's Syndrome, Chronic Fatigue Syndrome, Interstitial Cystis, Gastroesophageal Reflux Disease, Fifth Disease, Multiple Sclerosis, scleroderma, lupus, early ALS, early Alzheimers Disease, crohn's disease, ménières syndrome, reynaud's syndrome, sjogren's syndrome, irritable bowel syndrome, colitis, prostatitis, psychiatric disorders (bipolar, depression, etc.), encephalitis, sleep disorders, thyroid disease and various other illnesses.

The one common thread with Lyme Disease is the number of systems affected (brain, central nervous system, autonomic nervous system, cardiovascular, digestive, respiratory, muscular-skeletal, etc.) and sometimes the hourly/daily/weekly/monthly changing of symptoms.

Print and take this list with you to your doctor's visit. Identify as many symptoms that apply to you (make sure they are actually related to your illness as many symptoms can be caused by normal aging or non-Lyme related illnesses). Be prepared to explain each one to your doctor so he/she knows to what extent you are affected. Keep a journal, daily if possible, of your symptoms and record all pertinent information. The more detailed information you can give your doctor the better.

Timing of Blood Tests for Lyme Disease - some patients are told by their physician to come back a month later for a test. It is imperative that clinicians understand that the presence of a homogenous or "bull's eye" rash caused by a tick-bite is indicative of infection, and treatment should be started immediately. Do not look at this as simply an allergic reaction to the bite. Error on the side of caution. Most blood tests do not work until 4-6 weeks after infection has occurred, and any delay in treatment may cause complications at a later date.

The incubation period from infection to onset of erythema migrans is typically 7 to 14 days but may be as short as 3 days and as long as years.

Some infected individuals have dormant illness (asymptomatic infection has been determined by serological testing) later manifesting from trauma or immuno-suppression, or manifest only non-specific symptoms such as fever, malaise, tingling/numbness sensations, meningitis, encephalitis, headache, fatigue, or myalgia.

Lyme disease spirochetes disseminate from the site of the tick bite by cutaneous, lymphatic and blood borne routes. The signs of early 'disseminated' infection can occur within days to weeks. Symptoms may also slowly reveal themselves over a long period of time with patients showing up at their doctors with vague, varied symptoms and no knowledge of a tick bite nor rash.

In addition to possible multiple (secondary) erythema migrans lesions, early disseminated infection may be manifest as disease of the nervous system in varying degrees (ie. muscle twitches, tics, numbness/tingling, lower back/neck pain), the musculoskeletal system, or the heart. Early neurologic manifestations include aseptic meningitis (infection in the cerebrospinal fluid also called lymphocytic meningitis), cranial neuropathy (changes in nerve sensation of the skull, face/jaw region, especially facial full/partial nerve palsy), and radiculoneuritis (nerve root involvment). Musculoskeletal manifestations may include migratory joint and muscle pains with or without objective signs of joint swelling.

Cardiac manifestations may include rapid/fluctuating heart rate (tachycardia), slowing of the heart rate below 60 bpm (bradycardia), myocarditis (inflammation of the muscular walls of the heart) and transient atrioventricular blocks [the inappropriate delay (or complete inability) of an electrical impulse, generated in the atria, to reach the ventricles (via the atrioventricular node)].

B. burgdorferi (Lyme) infection in the untreated or inadequately treated patient may progress to late disseminated disease weeks to years after infection. Manifestations of late disseminated Lyme disease are intermittent swelling and/or pain of one or a few joints (asymetrically), chronic axonal polyneuropathy, or encephalopathy, the latter usually manifested by cognitive disorders, eye disturbances, sleep disturbance, fatigue, memory and personality changes (including depression, bi-polar disorder and psychiatric manifestations). More frequently, Lyme disease morbidity may be severe, chronic, and disabling. An ill-defined post-Lyme disease syndrome is said to occur in some persons following treatment for Lyme disease. But this is clearly an 'active' not 'post' lyme infection and further treatment must continue if resolution is to be gained.

General symptoms of tick-borne illnesses:

Two to 14 days after being bitten by an infected tick, you may develop nausea, headache, loss of appetite and a sore throat, fever, chills, tenderness and soreness in your bones and muscles, restlessness, trouble sleeping (insomnia), abdominal pain and vomiting may occur. You may have a cough and, possibly, delirium, lethargy and stupor.

Symptoms and notes on STARI

Southern Tick Association Rash Infection or STARI is very common in the Carolinas, among tick-related diseases, and may resemble Lyme disease in many of its symptoms. It has been said that many of the reported cases of Lyme disease are actually due to this disease, and this may be true. But the major point to remember is that it is still a tick-related disease, still capable of making the patient very sick and still treated the same way Lyme disease is treated. The tick that carries STARI can also transmit many of the co-infections found in the South.

Master's Disease (aka STARI) was described in the early 1990's by Dr. Ed Masters of Cape Girardeau, MO, when a number of people were bitten by lone star ticks and developed Lyme disease symptoms. Many patients had a classic rash, nearly identical to the one described in people infected with the more known strain of Lyme, however, the standard Lyme disease tests were not able to detect evidence of the infection in humans.

Recently DNA from a strain of spirochete similar to the one that causes Lyme disease was detected in lone star ticks collected from nine different states, according to the US Army Center for Health Promotion and Preventive Medicine in Aberdeen, MD. Borrelia lonestari, or STARI (Southern Tick Associated Rash Illness), the nick name used to describe this strain, was also detected in the blood of white tail deer, in Sika deer skin samples, and in ticks removed from wild raccoons. In 2004, visualization of live lonestari spirochetes were reported for the first time by researchers at the University of Georgia using dark field microscopy.

According to the CDC, a skin biopsy from a rash resembling the one that can appear in Lyme disease patients was tested for the Borrelia lonestari. The patient reportedly had exposure to ticks in Maryland and North Carolina. The biopsy of the Lyme-like rash, along with the tick that was removed from the patient, both showed evidence of the lonestari strain. Standard blood tests for Lyme disease again failed to detect the presence of infection from this strain of Lyme disease.

People who have been told they do not have Lyme disease and/or who were denied treatment based on negative blood tests should be re-evaluated by an experienced physician if they remain ill, have fluctuating symptoms, or develop additional symptoms. Anyone who has been denied treatment because the tick that bit them was not a "deer tick" may want to take a closer look for the source of any ongoing or worsening symptoms they may be experiencing.

Lone Star ticks are able to transmit STARI to humans, as well as a number of other tick-borne diseases, such as Erhlichiosis (various strains), Rocky Mountain Spotted Fever, Tularemia (rabbit fever), and possibly additional, yet to be discovered, bacteria and viruses. Some of these infections can become chronic or fatal if not promptly or properly treated.

Lone star ticks, Amblyomma americanum, have been found in approximately half of the states in the US. They have also been collected from migrating birds returning to Canada from southern locations. The ticks current known range in the US extends from Texas to Oklahoma, eastward towards the Atlantic coast, and northward to Maine. These ticks are extremely aggressive and actively search for blood meals. Residents from areas with high tick populations have reported removing over 100 of these ticks after a single outing.

Adult lone star ticks are larger than deer ticks; however, the nymph stage ticks can be as small as the period at the end of this sentence. A light colored patch, or star, is displayed on the back of adult female ticks, giving the tick their common name.

Ticks infected with STARI have been found just outside major city limits, posing risks to rural residents and city dwellers alike. Cardinals, wrens, sparrows, woodpeckers, brown thrashers, wild turkeys, bobwhite quails, and other birds are known to transport ticks from site to site. Raccoons, opossum, fox, squirrels, rabbits, mice, and deer are also hosts to this species of tick and provide necessary blood meals during their various stages of growth.

People infected with STARI may develop the rash that may also be seen in approximately 50 percent of the patients who have the more well known strain of Lyme disease. Other STARI symptoms can include fatigue, headaches, possible fever, muscle aches, stiff neck, and joint pains. Untreated or under treated STARI has not yet been documented by the CDC to cause the same debilitating effects found in chronic Lyme disease patients with the similar strain, however, research is ongoing and by no means, complete. The International Lyme and Associated Disease Society (ILADS), has noted in the past, "surveillance studies show that these patients [seronegative] may have a similar risk of developing persistent, recurrent, and refractory Lyme disease compared with the seropositive population."

This page was last updated on July 3, 2012