Lyme Disease Symptom Checklist

Why a Checklist Matters

Lyme disease is the most common tick-borne illness in New Jersey, spread by the black-legged (deer) tick. Early Lyme disease is highly treatable — but early symptoms are easy to dismiss as a summer cold or overexertion. This checklist helps you recognize the signs and act promptly.

Early Signs (Days to Weeks After a Bite)

Early symptoms typically appear 3 to 30 days after an infected tick bite. Watch for:

• Erythema migrans rash — an expanding red area, sometimes with central clearing (“bull’s-eye”), but it can also be uniformly red. It is usually not itchy or painful and feels warm to the touch.
• Fever and chills
• Fatigue — feeling unusually tired or run down
• Headache
• Muscle and joint aches
• Swollen lymph nodes

These flu-like symptoms during tick season (roughly April through October in NJ) deserve a call to your doctor — especially if you recall a tick bite or spend time outdoors.

Later Signs (Weeks to Months After a Bite)

If early Lyme goes untreated, the infection can spread. Later signs include:

• Severe headaches and neck stiffness
• Arthritis — episodes of joint pain and swelling, often in the knees
• Facial palsy — drooping on one or both sides of the face
• Heart symptoms — palpitations, dizziness, or an irregular heartbeat (Lyme carditis)
• Nerve pain, numbness, or tingling in the hands or feet
• Memory and concentration problems (“brain fog”)
• Inflammation of the brain and spinal cord (less common)

When to Call Your Doctor

• You develop a rash, fever, or flu-like symptoms within a month of a tick bite or outdoor activity in tick season.
• You found an engorged tick (one that had clearly been feeding) attached to you.
• You removed a tick but are unsure how long it was attached.
• Symptoms like joint swelling, facial drooping, or heart palpitations appear weeks or months after possible exposure.

When you call, mention the tick bite: where and when it happened, what the tick looked like if you know, and how long it may have been attached. If you saved the tick, tell your doctor.

A Note About Lyme Testing

Blood tests for Lyme disease detect antibodies, which take several weeks to develop — so tests can come back negative in the first few weeks of infection even when Lyme is present. For this reason, doctors often diagnose and treat early Lyme based on symptoms and exposure history rather than waiting for test results. If you were treated early and still feel unwell, follow up rather than assuming a negative test settles it.

Lyme Disease in Children

Children ages 5 to 14 are among the groups most often diagnosed with Lyme disease, largely because of how much time they spend playing outdoors. The signs are the same as in adults, but younger children may not describe them clearly — watch for unexplained fatigue, irritability, headaches, or a new limp or reluctance to play. Because the rash can hide on the scalp or behind ears, the evening tick-check routine in our Tick Safety for Kids guide is especially important for this age group. As always, a pediatrician should evaluate any concerning symptoms.

After a Bite: Your Next Steps

If you have not already, review What to Do After a Tick Bite: Step by Step for proper removal and 30-day monitoring. And if you spend a lot of time in your yard, our Seasonal Yard Tick Checklist can reduce how often these encounters happen in the first place.