Symptoms of early localized Lyme disease (Stage 1) begin days or weeks after infection. They are similar to the flu and may include:

• Chills
• Fever
• General ill feeling
• Headache
• Joint pain
• Muscle pain
• Stiff neck

There may be a "bull's eye" rash, a flat or slightly raised red spot at the site of the tick bite. Often there is a clear area in the center. It can be large and expanding in size. This rash is called erythema migrans. Without treatment, it can last 4 weeks or longer.
Symptoms may come and go. Untreated, Lyme disease can spread to the brain, heart, and joints.
Symptoms of early disseminated Lyme disease (Stage 2) may occur weeks to months after the tick bite and may include:

• Numbness or pain in the nerve area
• Paralysis or weakness in the muscles of the face
• Heart problems, such as skipped heartbeats (palpitations), chest pain, or shortness of breath

Symptoms of late disseminated Lyme disease (Stage 3) can occur months or years after the infection. The most common symptoms are muscle and joint pain. Other symptoms may include:

• Abnormal muscle movement
• Joint swelling
• Muscle weakness
• Numbness and tingling
• Speech problems
• Thinking (cognitive) problems

Anyone who has been bitten by a tick should be watched closely for at least 30 days.
A single dose of doxycycline may be offered to someone soon after being bitten by a tick, if all of these conditions are true:

• The person has a tick that can carry Lyme disease attached to his or her body. This usually means that a nurse or physician has looked at and identified the tick.
• The tick is thought to have been attached to the person for at least 36 hours.
• The person can begin taking the antibiotics within 72 hours of removing the tick.
• The person is over 8 years old and is not pregnant or breastfeeding.

A 10 day to 4-week course of antibiotics is used to treat people who are diagnosed with Lyme disease, depending on the choice of drug.

• The choice of antibiotic depends on the stage of the disease and the symptoms
• Common choices include doxycycline, amoxicillin, azithromycin, cefuroxime, and ceftriaxone

Pain medications, such as ibuprofen, are sometimes prescribed to relieve joint stiffness.

Take precautions to avoid direct contact with ticks. Be extra careful during warmer months. Whenever possible:

• Avoid wooded or bushy areas, or areas with high grasses and leaf litter.
• Walk in the center of trails.
• Check yourself and your pets frequently during and after your walk or hike.

When walking or hiking in wooded or grassy areas, spray all exposed skin and your clothing with insect repellant.
See also: Bug repellent safety
You may also treat clothing, such as boots, pants, and socks, with a product that contains permethrin. It remains protective for several washings.
Ticks that carry Lyme disease are so small that they are very hard to see. After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp. Shower soon after coming indoors to wash off any unseen ticks

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