Myth or Fact: Lyme Disease

Lyme disease cases are becoming more common across the United States, but misinformation about how the illness spreads — and how it should be diagnosed and treated — continues to create confusion for patients. In this installment of “Myth or Fact,” Andrew Forster, M.D., an internal medicine physician with Baptist Health South Florida, helped separate fact from fiction when it comes to Lyme disease risk, symptoms, prevention and treatment.

One of the biggest myths Forster addressed is the idea that simply seeing a tick on your body means you are at immediate risk for Lyme disease. He explained that a tick must actually attach to the skin and begin feeding before transmission can occur. In fact, the blacklegged tick that spreads Lyme disease generally needs to remain attached for at least 24 to 48 hours before the bacteria can be transmitted. That’s why checking yourself carefully after spending time outdoors is so important.

Forster also discussed the well-known “bullseye rash,” also called erythema migrans. While many patients associate Lyme disease with this rash, not everyone notices it. According to Forster, about 80% of people develop the rash, but it may appear in hard-to-see places like the back, meaning some patients miss it entirely. Early Lyme symptoms can also resemble the flu, including fatigue, headaches, fever and body aches, making diagnosis more challenging.

Another major misconception is that Lyme disease is only a concern in the Northeast. Forster explained that due in part to climate change, the blacklegged tick’s habitat has expanded southward and westward into areas including the Midwest and parts of the South. He also noted that Lyme season is no longer limited to summer months, with cases now appearing in spring and fall as well.

He also explored complications of untreated Lyme disease. While many people think only of joint pain, Forster emphasized that Lyme disease can also affect the heart, brain and nervous system, potentially leading to heart rhythm abnormalities, facial paralysis and neurologic symptoms.

Finally, Forster addressed persistent myths surrounding chronic Lyme disease treatment. He stressed that long-term antibiotic use is not recommended for persistent symptoms, noting that expert guidelines show prolonged antibiotics may actually worsen outcomes. Instead, prevention, early recognition and proper medical care remain the best tools for reducing Lyme disease complications.