What is Lyme Disease?
Lyme disease is an infection caused by the bacterium Borrelia burgdorferi, which is transmitted to humans through a tick bite. It can involve any organ but most commonly affects the skin, joints, nervous system and heart.1 Symptoms may develop gradually and, in some people, persist for years. Lyme disease was first described in Lyme, Connecticut, in 1975 and is now the most frequently reported tick-borne illness in both the United States and Europe.2
Lyme disease in Australia
To date, neither Australian ticks nor native animals have been shown to carry the Lyme-causing bacterium.3 However, travellers can acquire the infection overseas and often only recognise symptoms after returning home.
What are the symptoms of Lyme disease?
Symptoms vary widely in type and severity and are generally grouped into three stages, though overlap is common and some individuals may skip early signs and only display later-stage features. The most common manifestations include:6
- A flat, circular “bull’s-eye” rash
- Joint pain and swelling
- Persistent fatigue
- Muscle aches
- Headache and fever
- Swollen lymph nodes
- Difficulty concentrating
- Disrupted sleep
What are the stages of Lyme disease?
Lyme disease progresses through three clinical stages, reflecting how far the bacteria have spread through the body: Stage One (Localized infection) Occurs 3–33 days after the tick bite. You may notice:
- Erythema migrans (a single “bull’s-eye” rash at the bite site)
- A “flu-like” illness: low-grade fever, chills, fatigue and joint aches
- Borreliial lymphocytoma: a red-blue patch, most often on the earlobe, nipple or scrotum (especially in children)
- Stage Two (Early disseminated infection)
Stage Two (Early disseminated infection) Develops days to weeks after infection as the bacteria spread via the bloodstream. Features can include:
- Multiple erythema migrans lesions
- Neurological involvement: Bell’s palsy (facial paralysis), aseptic meningitis (fever, severe headache, neck stiffness), polyradiculitis (pain or numbness in arms/legs)
- Musculoskeletal: arthritis affecting large joints (most often the knee)
- Cardiac: abnormal heart rhythms or carditis
Stage Three (Late disseminated infection) Occurs months to years after the initial bite if untreated. Common late manifestations are:
- Chronic arthritis: severe, persistent joint pain and swelling, typically in one or more large joints
- Acrodermatitis chronica atrophicans (especially in Europe): a violet discolouration and thinning of the skin over affected areas
- Long-term neurological problems: cognitive difficulties, neuropathic pain, encephalomyelitis
Inlate-stage disease (months to years after the tick bite), patients may experience:
- Chronic, severe joint pain and swelling, often in the knee
- Cognitive issues such as confusion, dizziness, short-term memory loss and poor concentration
- Sharp or numb sensations radiating into arms, hands, legs and feet
How is Lyme disease diagnosed?
Prompt diagnosis is crucial. Doctors usually base the diagnosis on the characteristic rash, a known tick bite or travel history to an endemic area. If early signs go unrecognised, blood tests may be needed once additional symptoms emerge.
What is the treatment for Lyme disease?
When caught within weeks of the bite, most infections respond to a course of oral antibiotics.8 In later stages, treatment often involves intravenous antibiotics over two to three weeks.9 For chronic symptoms lasting more than six months, care focuses on relieving symptoms, as extended antibiotic use lacks clear benefit and may cause harm.10 While recovering, you should:
- Follow a balanced diet, limiting high-sugar foods
- Get plenty of rest
- Manage stress effectively
- Take pain relief as prescribed
What are the complications of Lyme disease?
Without treatment, the infection can spread via the bloodstream, leading to cardiac or neurological complications and ongoing joint inflammation.11 About 10–20 percent of people continue to have symptoms after antibiotic therapy, a condition called post-Lyme disease syndrome, which may impair mobility and cognitive function; most recover over months to years.12
How can you prevent Lyme disease?
The best protection is to wear long sleeves, long pants and socks in grassy or wooded areas and to apply DEET-based insect repellent.13 After being outdoors, thoroughly check your body for ticks, especially:
- Scalp and hairline
- Behind the ears
- Between fingers and toes
- Neck and other hidden areas
How should I remove ticks?
If available, use a tick-freezing spray to kill the tick, follow the product instructions carefully. Do not use tweezers to pinch or twist the tick, as this can leave mouthparts embedded. Avoid home remedies such as petroleum jelly, nail polish, oils, spirits or heat, which may cause the tick to burrow deeper.14 If spraying fails to remove the tick, seek professional help. Those with known tick allergies should ask a healthcare provider for the safest removal method and advice on when to seek medical attention. A first-time severe allergic reaction (anaphylaxis) requires immediate emergency care; watch for swelling and breathing difficulties.15
When to see your doctor?
If you’ve been bitten by a tick or suspect Lyme disease, particularly after overseas travel, consult your doctor for evaluation and possible testing. There is no definitive allergy test for ticks; diagnosis of tick allergy relies on observing your reaction to bites.16