Zoonotic Disease  

Lyme Disease

About Lyme Disease

  • Lyme disease is the most common tickborne disease in Maryland and the United States
  • Lyme disease is cause by the bacterium Borrelia burgdorferi.
  • Lyme disease fact sheet​

Transmission of Lyme Disease

  • Lyme disease is transmitted by the bite of infected blacklegged ticks (Ixodes scapularis, sometimes called deer tick).
  • In most cases, ticks must be attached for at least 36 hours before the Lyme disease bacterium can be transmitted
  • Most human infections of Lyme disease are caused by immature ticks, called nymphs. They are difficult to see due to their size (less than 2mm) and feed during the spring and summer months. Adult ticks can also transmit the Lyme disease bacteria, but they are much larger and are more likely to be discovered and removed before they have had time to transmit the bacteria.
tick life cycle.jpg 
Lifecycle of blacklegged ticks that can transmit Lyme disease
  • ​Ticks can attach to any part of the human body but they are often found in hard-to-see areas such as the groin, armpits, and scalp.


Symptoms of Lyme Disease

  • ​Typical symptoms of Lyme disease include fever, rash, facial paralysis, and arthritis.
  • Symptoms of Lyme disease may vary depending on the stage of infection. Early signs and symptoms (3 to 30 days after tick bite) can produce:
    • fever
    • chills
    • headache
    • fatigue
    • muscle and joint aches
    • swollen lymph nodes
    • Erythma Migrans (EM)​ rash occurs in approximately 70 to 80 percent of infected persons. The rash can expand over several days to up to 12 inches and may resemble a bull's eye.
  • Late signs may include: severe headaches and neck stiffness, additional EM rashes on other areas of the body, arthritis with severe joint pain and swelling, particularly in the knees and other large joints, facial palsy (loss of muscle tone or drooping on one or both sides of the face), intermittent pain in tendons, muscles, joints, and bones, heart palpitations or an irregular heart beat (Lyme carditis), episodes of dizziness or shortness of breath, inflammation of the brain and spinal cord, nerve pain, shooting pains, numbness, or tingling in the hands or feet, and problems with short-term memory.
  • If untreated, Lyme disease may progress to involve the joints, nervous system, and cardiac system.
  • Contact your health care provider if you develop any of these symptoms after a tick bite, live in an area known for Lyme disease, or recently traveled to an area where Lyme disease occurs.

Treatment of Lyme Disease


Public Health Reporting

Like other reportable communicable diseases listed in COMAR, health care providers, hospitals and laboratory directors are required to report diagnosed or suspected cases of Lyme disease to the health officer or commissioner in the county where the provider cares for that person.

Lyme Disease Continuing Medical Education for Clinicians 

As a service to clinicians, CDC has supported the development of an online CME Case Study Course on the Clinical Assessment, Treatment, and Prevention of Lyme Disease.  This free, interactive course consists of a series of case studies designed to educate clinicians regarding the proper diagnosis and treatment of Lyme disease. Each case is accredited for .25 CME credits, for a maximum of 1.5 CME. There is no cost for these credits.

Educational Materials​

​Posters and brochures are available