Early symptoms may include an expanding red rash (called erythema migrans), fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes, among others. Untreated infections may progress to affect the joints, heart, and nervous system. Infection in humans is typically divided into three stages: early disseminated stage, late disseminated stage, and, in a small percentage of people, post-treatment Lyme disease syndrome. The latter two stages may or may not occur, depending on successful treatment and other factors. These stages may overlap clinically, but can also occur independently, with apparent recovery between stages.

A rash similar to the rash of Lyme disease has been described in humans following bites of the lone star tick, Amblyomma americanum, a tick very common in Texas. The rash may be accompanied by fatigue, fever, headache, and muscle and joint pains. This condition has been named southern tick-associated rash illness (STARI). The cause of STARI is not known. In the cases of STARI studied to date, the rash and other symptoms have resolved following treatment with an oral antibiotic, but it is unknown whether this medication speeds recovery.

Monitor your health closely after any tick bite, and talk to your health care provider if rash, fever, headache, muscle or joint pains, or swollen lymph nodes develop within 30 days of a tick bite. These can be signs of a number of tick-borne diseases.

• Centers for Disease Control and Prevention (CDC) Lyme Disease Information
  Lyme Disease Home Page
   
• Testing Information
  • Two-step Laboratory Testing Process for Lyme Disease
  • Tick-borne Relapsing Fever (TBRF) is another tick-borne infection transmitted by Borrelia sp. spirochetes. Patients with TBRF will typically test positive for Lyme disease. Texas is a low incidence state for Lyme disease, so it is important that TBRF be considered in the differential for patients who test positive for Lyme disease and have no history of travel to high incidence areas.
     
• Tick Identification
  • DSHS Tick Submission and Testing
    Instructions and form for submitting ticks for identification and testing
  • Texas A&M University Tick App
  • Tickborne Diseases of the United States
    A reference manual for healthcare providers with information on recognition, diagnosis, and treatment of tickborne diseases that occur in the United States 

Texas is a low incidence state for Lyme disease. From 2000 to 2020, an average of 85 human cases/year (min=11; max=276) were reported in Texas. The majority of these cases were acquired in a high incidence state or country, primarily from a state in the northeastern United States. View a breakdown of Lyme disease cases reported by Texas county and area of disease acquisition (2014-2020). 

• Centers for Disease Control and Prevention (CDC)                
  National Lyme Disease Data and Statistics