There are three stages of Lyme disease with distinct signs and symptoms occurring in each stage, according to the Pennsylvania Department of Health.

Early stage

In the first three to 30 days after a tick bite, people could develop:

• Erythema migrans, a red, oval or round rash.

Although EM is often described as a “bull’s eye rash,” the bull’s eye appearance is not common. The rash may be round or oval with no clearing, it may have a red ring with clearing in the center, it may appear bluish in color. The first EM rash usually appears at the site of the tick bite, but may progress to multiple EM rashes anywhere on the body.

A rash occurs in 70-80% of cases in some form, bull’s eye appearance is less common.

First EM rash typically appears within 3-30 days, the average is about 7 days.

The rash mays increase in size to around 12 inches.

May feel warm to the touch, but is rarely itchy or painful.

• Fever, chills, headache, muscle and joint pain, swollen lymph nodes. Most Lyme cases in Pennsylvania occur in the late spring and summer months when flu is rare. Lyme and other tickborne diseases should be considered when you have a flu-like illness in the summer.

Later stage • Severe headaches and neck stiffness

• Additional EM rashes on other areas of the body

• Arthritis with severe joint pain and swelling, particularly the knees and other large joints.

• Facial palsy (loss of muscle tone or droop on one or both sides of the face)

• Intermittent pain in tendons, muscles, joints, and bones

• Heart palpitations or an irregular heart beat

• 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

• Problems with short-term memory

Diagnosis

Lyme disease is diagnosed through a blood test. Your blood samples will be sent to a lab which will run a screening test.

The screening test looks for antibodies to Lyme disease, however, it can react to antibodies to other diseases and conditions.

That is why if this test is positive, a second test must be done to determine if the antibodies are due to Lyme disease.

Both of these tests must be positive to be considered a Lyme case.