The Canadian pop sensation, Justin Bieber, explained to the public that people who have said he looked like he was on drugs "failed to realize I've been recently diagnosed with Lyme disease." Lyme disease is a tick-borne illness that can cause joint pain, rashes, fever, chills, fatigue, depression, and neurological problems and is often misunderstood. He has been battling this illness for over a year but is overcoming with treatments. While some 30,000 cases of Lyme disease get reported annually, the CDC in the USA suggests the actual number of diagnosed cases may be 10 times that amount as many never identify it and get it diagnosed.

According to the Mayo Clinics, Lyme disease is caused by four main bacteria species: Borrelia burgdorferi and Borrelia mayonii (United States), Borrelia afzelii and Borrelia garinii (Europe and Asia). Lyme disease is the most common tick-borne illness in these regions which is transmitted by the bite of an infected black-legged tick, commonly known as the “deer tick”.

One is more likely to get exposed to Lyme disease in grassy and heavily wooded areas where ticks carrying Lyme disease thrive. It is important to take common-sense precautions in tick-infested areas by:    

• Using an insect repellent such as permethrin on your body and clothes.
• Staying in the middle of the trail instead of going through high grass or heavily wooded areas. 
• Wearing closed shoes or boots, long-sleeved shirts, and long pants. 
• Wearing light-colored clothing to help you see ticks more easily with contrast.
• Showering and washing hair right after being outside to remove ticks before they attach.
• Removing ticks right away.

The symptoms of Lyme disease vary with stages, which can overlap. Initially, a small, red bump appears at the site of a tick bite or tick removal and resolves over a few days. This normal occurrence does not necessarily indicate Lyme disease. However, the following symptoms can occur within a month after if you have been infected:

• Rash (Erythema migrans). From three to 30 days after a tick bite infection, an expanding rash might appear that sometimes clears in the center, resulting in a bull's-eye pattern. The rash expands slowly over a period of days and can spread to 12 inches or 30 centimeters in diameter. While it is usually not itchy or painful, it may feel warm to the touch. Although not everyone with Lyme disease develops such a rash, some people develop this rash at more than one place on their bodies.
• Other symptoms. Body aches, chills, fatigue, fever, headache, neck stiffness, and swollen lymph nodes can accompany the rash.

If left untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months which may include:

• Erythema migrans. The rash may appear on other areas of your body.
• Joint pain. Periods of severe joint pain and swelling around the knees, but the pain can shift from one joint to another.
• Neurological issues. Weeks, months or even years after infection, one may develop inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in limbs, and muscle movement problems.

If been bitten by a tick and symptoms appear:

While only a minority of tick bites leads to Lyme disease, the longer the tick remains attached to the skin, the greater the risk of getting Lyme disease. Generally speaking, infection is unlikely if the tick is attached for less than 36 to 48 hours.

If one has been bitten and has signs and symptoms of Lyme disease, especially if it happened in an area where Lyme disease is prevalent, consult a doctor is highly recommended. Treatment success is more likely if treated early. 

If time passed and symptoms disappear, still consult a doctor - the absence of symptoms does not mean the disease is gone. Untreated, Lyme disease can spread to other parts of the body for several months to years after infection, leading to arthritis and nervous system issues. Ticks can also transmit other illnesses, such as babesiosis (a rare life-threatening infection of the red blood cells usually spread by ticks) and Colorado tick fever (aka “CTF”, which causes fever, chills, headache, body aches, weariness, sore throat, vomiting, abdominal pain, and skin rashes.

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