Lyme disease is an infection caused by the bacteria Borrelia burgdorferi. It is transmitted through the bite of an infected Ixodes tick or blacklegged tick. The ticks are typically found in wooded or grassy areas, though they can also be carried by animals, like deer, to other areas such as lawns and gardens. A tick usually needs to be attached to the skin for 36 to 48 hours before transmitting the Lyme disease bacteria. Not all ticks carry Lyme disease, and different ticks can carry different infections. In the United States, Lyme disease is most common in the Northeast, but is found in other states as well. Symptoms vary depending on the length of time a person has been infected with Lyme disease. In the days to weeks following the bite of an infected tick, a person may have flu-like symptoms, including fever, chills, headache, and joint and muscle pain. Some people may develop a rash which looks like a bullseye. Sometimes, there may be no early symptoms at all. Long-standing Lyme disease may cause other problems, including arthritis, heart complications, and issues with the nervous system. In people with a characteristic rash, Lyme disease may be diagnosed based on history and symptoms alone. Other manifestations of Lyme disease are diagnosed with blood tests. There are two types of blood tests that are regularly used to diagnose Lyme disease – a screening test (EIA or IFA) and a confirmatory test (Western Blot). If only the screening test is positive, and the confirmatory test is negative, a patient is not considered to have Lyme disease. It may take up to six weeks after infection for testing to be positive. In patients with significant arthritis (swelling and inflammation of a joint), a doctor may take a small sample of the joint fluid to check for Lyme disease and other causes. Lyme disease is treated with antibiotics. The most commonly used antibiotics are amoxicillin in young children, and doxycycline in older children and adults. Other antibiotics may be used if a patient is allergic to these medications. Often, Lyme disease is treated with four weeks of oral antibiotics, but this may differ depending on the level of infection and which body systems are affected. If the infection is affecting the nervous system or the heart, intravenous (IV) antibiotics may be required. There are many strategies that can decrease the likelihood of being bitten by a tick and developing Lyme disease. When in a wooded area, covering exposed skin by wearing pants, socks and long-sleeved shirts can prevent ticks from attaching to the skin. Wearing white or brightly colored clothing makes it easier to see ticks that have attached themselves. The use of appropriate bug repellent is advised; always remember to read the product instructions to determine whether a bug spray or liquid is safe to use on children. After spending time outdoors, tick checks should be performed all over the body. Ticks like to hide in dark warm areas, including the armpits, behind the knees and the scalp. If you find a tick on yourself or your child, please read the below instructions for safe removal. To safely remove a tick, you will need:How to remove a tick: