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Primary Lyme Disease

What Is Primary Lyme Disease?

Primary Lyme disease is also known as early Lyme disease. Lyme disease is transmitted through tick bites, specifically deer ticks that are infected with the bacterium Borrelia burgdorferi.

People who spend time in wooded or grassy areas are at higher risk for deer tick bites. Ticks are extremely small—roughly the size of a pinhead—and can be difficult to see. They attach themselves to a host and feed on its blood. While feeding, infected ticks can pass bacteria to the host. It takes at least 36 to 48 hours for a tick to transmit the bacteria to your bloodstream, so removing the tick in time can prevent Lyme disease (Cleveland Clinic 2012).

The symptoms of primary Lyme disease are milder than those of advanced Lyme disease and typically include flu-like symptoms. The later stages of Lyme disease can cause more serious symptoms, including neurological and joint problems.

Individuals who receive treatment for primary Lyme disease tend to recover quicker than those receiving treatment for later stages of Lyme disease.

How to Remove a Tick

It can take 36 to 48 hours for a tick to transmit bacteria to your body. Therefore, if you find a tick, it is best to remove it promptly.

Using blunt tweezers, gently remove the entire tick. Try not to crush the tick because this can cause an infection.

After the tick is removed, clean the area with antiseptic and wash your hands thoroughly with soap and water.

Symptoms of Primary Lyme Disease

Usually the first symptom of Lyme disease is a rash. This rash may begin as a small red dot and progress to look like a "bull’s eye" within a few days. Other symptoms tend to resemble symptoms of viral infections. However, Lyme disease symptoms tend to last longer than symptoms of virus.

Symptoms of primary Lyme disease include:

  • a red "bull’s eye" rash
  • fever
  • chills
  • body aches
  • fatigue
  • headache
  • stiff neck

How Is Lyme Disease Diagnosed?

If you have the distinctive bull’s eye Lyme disease rash, your doctor may be able to diagnose Lyme disease based on a physical examination alone. However, not everybody who has Lyme disease develops this rash—according to the Cleveland Clinic, at least one-fourth of the individuals diagnosed with Lyme disease do not develop this rash (Cleveland Clinic 2012).

If you are having symptoms of primary Lyme disease, your doctor will ask you when the symptoms began and if you have been spending time outside.


If your doctor suspects you have Lyme disease, he or she will order an enzyme-linked immunosorbent assay (ELISA) test. This type of blood test looks for antibodies to the bacteria that cause Lyme disease.

An antibody is a protein that your body creates to fight off a certain infection. You may need to wait a few weeks after your symptoms develop to have your blood tested so that antibodies can reach a level that will be detected.

False Positives

Having a positive ELISA test does not mean that you have Lyme disease. The blood test is extremely sensitive and false positives are possible. A false positive result means that you tested positive for a disease or condition you didn’t actually have.

If you test positive on the ELISA test, your doctor will order a test called a western blot test to confirm. This type of blood test looks for antibodies to several different proteins in the bacteria causing Lyme disease. If your western blot test is negative, this usually means that the ELISA test was a false positive.

A positive ELISA and western blot test indicates the presence of Lyme disease. Doctors use these two tests to prevent individuals from being treated for Lyme disease if they do not have it.

Treatment for Primary Lyme Disease

Most cases of primary Lyme disease can be treated with oral antibiotics. Usually, antibiotics are taken for two weeks. However, this depends on your symptoms, the type of antibiotic you are prescribed, and any other medical conditions you have.

Some people continue to experience symptoms (such as fatigue and body aches) after finishing the course of antibiotics. For most people, these symptoms will go away after a few weeks.

If your symptoms progress rapidly, your doctor may prescribe intravenous (IV) antibiotics. However, most people with primary Lyme disease can be treated successfully with oral antibiotics.

Prevention of Tick Bites

The best way to avoid getting Lyme disease is to avoid tick bites. Most cases of Lyme disease occur in the summer, so it is important to take preventative measures during this time of year. Pregnant women should take extra care because Lyme disease can be transmitted to the fetus and can cause miscarriage. Ways to prevent tick bites include:

  • avoiding heavily wooded areas
  • wearing long sleeves and pants
  • using bug repellent containing 20 to 30 percent DEET (the active ingredient in most insect repellent)
  • checking for ticks on yourself, your children, and your pets after being outdoors
  • washing your body and clothes after being outside

Content licensed from:

Written by: Janelle Martel
Medically reviewed : George Krucik, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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