After a cold, dreary winter, summer is finally in sight and many of us can't wait to start spending more time outside. But there are risks to be aware of when you're hanging out outdoors, even if you're not a nature fanatic who spends every summer weekend hiking — like Lyme disease, an illness transmitted through tick bites. The months of May, June, and July are high-risk months for developing the illness, especially if you live or vacation in certain parts of the country. According to the CDC, 96 percent of Lyme disease cases occur in the Northeast and upper Midwest.
1. A Bullseye-Shaped Rash
One of the most common symptoms associated with Lyme disease is a rash in the shape of a bullseye; these photos from the CDC show what some of the typical rashes look like. The "classic" rash is circular, with a "central clearing that slowly expands." Others don't take on the bullseye form — they may appear as lesions, oval-shaped plaques, or bluish rashes without a central clearing. Any sort of skin rash is cause for concern, especially if it's accompanied by other symptoms.
Although the rash is often considered the hallmark symptom of Lyme disease, it's extremely important to remember that not everyone with Lyme disease develops a rash. In fact, various studies have reached vastly different conclusions about this topic, estimating that anywhere between 27 and 80 percent of sufferers develop the rash. Regardless of which number is correct, we do know that not everyone with Lyme disease has it — so even if your skin looks normal, don't let that deter you from seeking a doctor's advice if you exhibit other symptoms.
2. Flu-like Symptoms
Many early symptoms of Lyme disease are flu-like — fever and chills, fatigue, nausea, joint pain, swollen lymph nodes, nausea, and aching muscles. As a result, the illness is frequently dismissed or misdiagnosed as the flu (especially if the rash isn't present).
One to four months after the initial infection, many Lyme disease sufferers enter stage two of the illness. Stage one symptoms intensify, while new symptoms emerge. If a patient does have the rash, it may spread to other parts of the body during stage two.
3. Visual Disturbances
It seems like no part of the body is left untouched by Lyme, including the eyes, which can sustain damage to their deep tissue. Some of the visual symptoms include light sensitivity, "cloudy" vision, image delays, and moving object illusion. There's also "textual bombardment," which makes it nearly impossible to read more than two or three consecutive sentences without losing focus.
The most common visual symptom is "floaters," which means you'll see lines, dots, or streaks in various colors.
4. Heart Problems
Heart palpitations, chest pain, and shortness of breath are all symptoms of Lyme disease, according to the National Library of Medicine.
5. Nerve Pain
Pain or numbness of the nerves is another red flag.
6. Bell's Palsy
Bell's palsy, which is caused by inflammation of the facial nerve, can be a neurological complication of Lyme disease. The condition causes one side of your face to droop and it comes on extremely suddenly (even overnight). Facial drooping is the primary symptom — it may even make it hard to close your eye on the affected side of your face. Other symptoms of Bell's palsy include drooling, loss of taste, numbness in the affected side of the face, and high sensitivity to sound. Although Bell's palsy can occur on its own, it may be a good idea to ask for a Lyme disease test if you develop the condition.
Months or even years after the infection, symptoms of late disseminated Lyme disease can emerge. The hallmark symptoms of this stage are chronic muscle and joint problems — such as numbness, muscle weakness, abnormal muscle movements, and joint swelling. If the illness continues to go untreated, more complications can occur.
When Lyme disease goes untreated, the infection can cause a condition called Lyme encephalopathy or neuroborreliosis. Many of the symptoms are psychological, such as unexplained mood swings, depression, concentration and memory problems, and irritability.
In Lyme disease patients, arthritis most frequently affects the knee. Although it's less common, some people develop chronic Lyme arthritis, which can result in fluid buildup and swelling in one or more joints for up to six months at a time.
9. Heart Problems
Although heart problems often emerge later on, they can sometimes be the first indicator of Lyme disease in a person who has been infected but didn't previously exhibit symptoms. (However, this is uncommon.) Fortunately, these heart problems typically don't cause lifelong damage.
So, What Precautions Can We Take?
Risk of Lyme disease doesn't mean you need to stay indoors during the beautiful summer months — but it's wise to take precautions. If you do enjoy hiking, The National Library of Medicine recommends using strong insect repellent and wearing light-colored clothing so you can easily spot ticks if they land on you. If it's not too hot out, long sleeves and long pants are preferable.
When you return from your hike, do a thorough exam of your body (including your scalp) and your clothing — then take a shower as soon as possible. If you do spot a tick on yourself, remove it with tweezers and make sure that no parts of the tick are left inside you. If you cannot remove the entire tick, get medical help. Once the tick has been removed, be extremely mindful for signs of Lyme disease in the following days and week.
When Should You Seek Medical Help?
If you live in a high-risk area and spend a lot of time outdoors, it can't hurt to make a doctor's appointment if you develop flu-like symptoms that last for more than a few days and show no signs of improvement. And, of course, if you've been bitten by a tick and develop any sort of symptoms, get to a doctor STAT. Unfortunately, there's not exactly a straightforward test for Lyme disease and the tests used can be unreliable during the first weeks of the illness.
The diagnosis is typically made after your doctor reviews your medical history and rules out other conditions. The good news is, patients in the early stages of Lyme disease typically make a quick and full recovery when treated with the right antibiotics. If you feel like your doctor is brushing off your concerns, be assertive — you know your body better than anyone and it's better to be cautious than to let the illness progress to stage two or three.
Editor's note: this post has been modified from its original version.