By Teresa Alasio MD
Over the past few weeks, ticks carrying Lyme disease have been identified here in New Canaan. That is not unusual for our area, but it serves as a reminder of something many of us tend to underestimate: Lyme disease is not rare, and it does not just happen to people hiking deep in the woods. It can happen in your own backyard, after a walk through tall grass, or even while gardening on a warm afternoon.
It Starts with a Tick Bite
Lyme disease is caused by a bacterium called Borrelia burgdorferi, transmitted through the bite of an infected blacklegged tick, often called a deer tick. These ticks are remarkably small—in their immature form, many are no larger than a poppy seed. This means they can attach to your skin and go unnoticed. Unlike mosquitoes, ticks do not bite and leave. They attach and feed, often for a day or more.
Here is the critical timing: in most cases, a tick must remain attached for at least 24 hours—and more reliably, 36 hours—before the bacteria can be transmitted. That window gives us an opportunity for prevention, but only if we are paying attention.
The Symptoms That Are Easy to Miss
One of the earliest signs of Lyme disease is a skin rash called erythema migrans. It is often described as a bullseye rash, but that is actually uncommon. More often, it appears as a simple, expanding area of redness that may feel warm to the touch but is neither particularly painful nor itchy. This rash can appear anywhere on the body and may gradually enlarge over several days.
Along with the rash, people often experience flu-like symptoms: fatigue, headache, low-grade fever, and muscle or joint aches. It is easy to dismiss these symptoms, especially during a busy week. But this is precisely the stage where early treatment is most effective.
When Something Feels Off
If Lyme disease is not recognized and treated early, it can progress. Weeks to months later, patients may develop more concerning symptoms. Joint swelling, particularly in the knees, is common. Some people experience facial drooping, a condition called Bell’s palsy. Others develop nerve pain, tingling sensations, or significant fatigue that interferes with daily life. In rarer cases, Lyme disease can affect the heart, causing rhythm disturbances.
Diagnosing Lyme disease is not always straightforward. While blood tests are available, they can be unreliable in the early stages of infection, and a negative test does not necessarily rule it out, especially in the first few weeks. For that reason, we often rely heavily on the clinical picture: a known tick bite, a suspicious rash, or the combination of seasonal exposure and flu-like symptoms may be enough to begin treatment.
Why Early Treatment Matters
The good news is that early Lyme disease is usually very treatable. Most patients respond well to a course of oral antibiotics such as doxycycline, particularly when started promptly. Symptoms often resolve over a few weeks.
When treatment is delayed, longer courses of antibiotics or even intravenous therapy may be required, and recovery can take longer. Some patients report lingering symptoms such as fatigue or joint discomfort after treatment. This can be frustrating, but it does not necessarily mean the infection is still active. In most cases, people do improve—especially when the disease is addressed early.
What to Expect After Treatment
For most individuals, recovery is complete, particularly when Lyme disease is caught early. Others may find that it takes time to feel fully like themselves again. Energy levels may lag, or joints may feel stiff longer than expected. This can be unsettling, but gradual improvement is the norm.
The important takeaway: early recognition and treatment significantly reduce the likelihood of long-term complications.
Simple Habits That Make a Difference
Prevention is not complicated, but it does require consistency. Checking your skin after spending time outdoors is one of the most important steps—pay special attention to areas where ticks tend to hide: behind the knees, along the scalp, and under the arms. Showering after coming inside can help remove ticks before they attach. Wearing light-colored clothing makes ticks easier to spot, and using insect repellent provides an added layer of protection.
Keeping grass trimmed and outdoor areas well maintained can also reduce exposure. These are small habits, but they are effective.
Paying Attention Can Protect You
If you do find a tick, there is no need to panic. Remove it carefully with tweezers, grasping close to the skin, and make a note of the date. Over the following weeks, pay attention to how you feel and watch for any changes in your skin. That awareness alone can make a significant difference in catching Lyme disease early, if it develops at all.
A Small Problem, If You Catch It Early
Lyme disease is something we are likely to continue seeing in our community, but it is not something to fear. It is something to respect. With a bit of vigilance and a willingness to act when something does not feel right, most people can avoid serious complications.
In this case, a small amount of attention early on can prevent a much larger problem later.
