Lyme disease is a tick-borne illness caused by bacteria spread through the bites of infected black-legged ticks, often called deer ticks. One of its hallmark signs is a red, circular “bull’s-eye” rash, along with symptoms like fever, headache, and fatigue. You can get Lyme disease more than once because a past infection does not give you immunity.

According to public health estimates, tens of thousands of cases are diagnosed each year, with actual numbers likely much higher. The majority of infections occur between April and October, when ticks are most active.

Can You Get Lyme Disease Twice?

Yes, it’s entirely possible to get Lyme disease more than once. Unlike some infections, Lyme disease does not confer long-lasting immunity after recovery. Antibodies produced in response to Lyme disease do not protect you from getting it again in the future.

This lack of long-term immunity is one of the reasons why developing a vaccine has been difficult. Until an effective vaccine is available, your best protection is avoiding tick bites and removing ticks promptly when discovered.

Symptoms of Lyme Disease

Symptoms typically appear between 3 to 30 days after a tick bite. While not everyone develops a rash, many people with Lyme disease experience a red, circular rash resembling a bull’s-eye.

Additional symptoms may include:

  • Fever

  • Chills

  • Fatigue

  • Headache

  • Muscle and joint pain

  • Swollen lymph nodes

A blood test can confirm the presence of Lyme disease. With prompt antibiotic treatment, symptoms often resolve within two to four weeks. However, untreated cases can lead to more serious complications that may require longer treatment.

What Causes Lyme Disease?

Lyme disease is caused by the bacteria Borrelia burgdorferi, which is transmitted to humans by the bite of an infected black-legged tick. For the bacteria to be transmitted, the tick usually needs to stay attached to the skin for 36–48 hours.

The bacteria enter the body through the tick’s saliva during feeding and begin to spread from the bite site. The longer the tick remains attached, the higher the chance of infection.

Other Transmission Myths

Only black-legged ticks can transmit the bacteria that cause Lyme disease. Despite some misconceptions, Lyme disease is not transmitted through:

  • Sexual contact

  • Breastfeeding

  • Eating meat from infected animals

  • Scratches or bites from pets

Although Lyme bacteria have been found in bodily fluids, there’s no evidence of transmission through sexual contact or blood transfusions. Rarely, the infection may be passed from a pregnant person to their fetus through the placenta. However, antibiotics can help prevent complications during pregnancy.

Is Lyme Disease Hereditary?

Lyme disease is not inherited. However, certain genetic traits may make some people more likely to experience complications like Lyme arthritis. For example, variations in HLA genes that regulate immune response may influence how the body reacts to Lyme bacteria, increasing the likelihood of joint inflammation and pain.

How Is Lyme Disease Diagnosed?

To diagnose Lyme disease, healthcare providers typically assess symptoms, evaluate tick exposure, and rule out other illnesses. A blood test that detects antibodies to Lyme bacteria is commonly used, but it may take a few weeks after infection for antibodies to appear, which can delay diagnosis.

Who Is at Risk for Lyme Disease?

Anyone can contract Lyme disease, but some groups have higher risk factors, such as:

  • Children (ages 5–14) and middle-aged adults (ages 45–55)

  • People living in the Northeastern U.S. or upper Midwest

  • Outdoor workers, such as landscapers, farmers, and park rangers

  • Males, who make up a slightly higher percentage of confirmed cases

Risk Factors for Contracting Lyme Disease

Beyond demographics, certain behaviors and environments increase your risk of being bitten by infected ticks:

Spending Time Outdoors

Gardening, hiking, hunting, and other outdoor activities, especially in warm and humid conditions, raise the risk of exposure to ticks.

Having Pets

While pets themselves don’t spread Lyme disease, they can bring ticks into the home. Ticks can transfer from your pet to you. Although dog ticks usually don’t carry Lyme bacteria, areas where your pets pick up ticks are likely areas where you’re at risk, too.

Walking in Grassy or Wooded Areas

Ticks thrive in tall grasses, woods, and leaf piles. To reduce risk, stay on trails and avoid brushing up against vegetation when walking outdoors.

Treatment for Lyme Disease

A standard 10–14 day course of antibiotics is often effective in treating Lyme disease. The sooner treatment begins, the better the outcome. Delayed treatment can lead to more severe symptoms and complications.

How To Prevent Lyme Disease

Prevention is the best approach. Consider these precautions:

  • Check your body, clothing, pets, and children for ticks after being outside

  • Wash your clothes immediately after outdoor activities

  • Stick to trails and avoid grassy, brushy areas

  • Wear light-colored clothing, long sleeves, pants, and hats

  • Use insect repellent containing DEET on skin and clothing

Ticks are often very small, especially nymphs, which are the most likely to transmit the infection. Since nymphs are hard to see, frequent and thorough tick checks are essential.

If you find a tick attached to your skin, use fine-tipped tweezers to grasp it close to the skin and pull steadily upward. Clean the area afterward. If the tick has been attached for more than 24 hours, consult a healthcare provider. They may prescribe a short course of antibiotics to prevent infection.

A Quick Review

Lyme disease is a common illness caused by bacteria spread through tick bites. You can get Lyme disease more than once, as past infection does not provide immunity.

Prevention is key—stay out of tick-heavy areas, wear protective clothing, and check yourself and your pets after spending time outdoors. With early diagnosis and treatment, most people recover fully from Lyme disease, though delays can lead to more serious complication.