How Do You Get Lyme Disease: Ticks, Transmission, and Risk
How do you get Lyme disease? Lyme disease is transmitted through the bite of an infected blacklegged tick. These ticks can also carry other pathogens, meaning a single bite may transmit multiple infections.
Quick Answer: You get Lyme disease from the bite of an infected tick, typically after it has been attached for 36–48 hours, although shorter transmission times may occur.
Learn how Lyme disease spreads, why many people never see a tick, and how to reduce your risk.
One of the most common questions patients ask is: how do you get Lyme disease? Many are surprised to learn that Lyme is caused not just by one pathogen, but often involves multiple infections transmitted by the same tick.
A teacher came to me after two years of fatigue and joint pain. She’d never seen a tick, never had a rash, and lived in the suburbs. “I didn’t think I could get Lyme disease,” she told me. “I’m not a hiker.” But she had Lyme—and Babesia. Understanding how transmission actually works might have saved her two years.
Lyme disease is transmitted through the bite of an infected blacklegged tick, which carries the bacterium Borrelia burgdorferi. However, these same ticks can also carry other pathogens like Babesia, Bartonella, and Anaplasma—making “Lyme disease” a shorthand for a complex set of tick-borne infections.
Who This Page Is For
This resource is for anyone wondering how Lyme disease is transmitted—whether you’ve just found a tick, are experiencing unexplained symptoms, or want to protect your family.
If you’ve been told “you can’t have Lyme” because you don’t fit the stereotype, this page is especially for you.
The Tick That Spreads Lyme and Co-Infections
In the United States, Lyme disease is primarily spread by the blacklegged tick (Ixodes scapularis) in the Northeast, Midwest, and Mid-Atlantic, and by Ixodes pacificus on the West Coast.
Ticks go through three life stages: larva, nymph, and adult. Most human infections occur during the nymph stage, when ticks are tiny and hard to detect.
Nymphs are roughly the size of a poppy seed—small enough to feed undetected for days.
How Ticks Become Infected
Ticks become infected when they feed on animals such as white-footed mice carrying Borrelia and other pathogens. They then transmit infection during later feedings.
How Long Does a Tick Need to Be Attached?
The CDC estimates that Lyme disease risk increases after 36–48 hours of attachment.
However, this is not absolute. Some studies suggest transmission may occur sooner, particularly if the tick was partially fed.
I’ve discussed this further in The 24–36 Hour Tick Bite Myth.
Co-Infections May Transmit Faster
Co-infections such as Babesia or Anaplasma may transmit more quickly—sometimes within hours.
This is one reason Lyme disease often involves multiple infections requiring different treatment approaches.
Can You Get Lyme Disease Without Knowing?
Yes. Most patients do not recall a tick bite.
Nymph ticks attach in hidden areas such as the scalp, groin, or behind the knees. Children are especially vulnerable.
“Most patients with Lyme disease never saw the tick that bit them.”
The Rash Doesn’t Always Appear
The classic rash appears in about 70–80% of cases—but not always clearly or at all.
This contributes to misdiagnosis and dismissal.
Symptoms to Watch For
- Bull’s-eye rash
- Fever and chills
- Fatigue
- Headache
- Muscle and joint pain
- Swollen lymph nodes
How Do You Get Lyme Disease From the Environment?
Ticks thrive in:
- Tall grass and brush
- Leaf litter
- Wooded areas
- Suburban yards
How Ticks Find You
Ticks “quest” by waiting on vegetation and attaching to passing hosts.
Are Other Insects Involved?
Currently, ticks are the only confirmed vector for Lyme disease in the U.S.
Some co-infections may be transmitted through other routes, including blood transfusion.
Is Lyme Disease Contagious?
No. Lyme disease is not spread person-to-person.
Who Is Most at Risk?
- Outdoor exposure
- Pets bringing ticks indoors
- Living near wooded areas
How to Prevent Lyme Disease
Prevention focuses on avoiding tick exposure and early removal.
- Tick repellents
- Protective clothing
- Tick checks
- Prompt removal
If You’ve Been Exposed
Seek medical care promptly if symptoms develop.
Testing may be negative early—clinical evaluation is critical.
Frequently Asked Questions
How do you get Lyme disease?
Through the bite of an infected tick.
Can you get Lyme without seeing a tick?
Yes. Most patients never saw one.
Is Lyme contagious?
No.
The Bottom Line
Lyme disease is transmitted through infected tick bites—often unnoticed—and may involve multiple infections.
Early recognition and treatment offer the best outcomes.
Related Reading
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Dr. Cameron,
I was tested for Alzheimer’s almost 2 years ago. Recognized the symptoms and visited a neurologist 2 years ago. Proved positive with blood test, spinal tap and MRI.
He prescribed donepezil to begin with. I started taking just prior a business trip to Sweden and Estonia. By 3rd day, I was totally disoriented and incapable of working, including waking middle of night in a complete daze. Guessed it was the pills, and tossed them in toilet. Took two days to “recover”.
Went home and switched to Memantine. It worked almost immediately to greatly clear issues of “brain fog”.
However, I wondered if I had longterm Lyme’s disease. Why? Because I live in thick woods with countless ticks, and have taken that old drug to kill it. On more than once case, taking doxycycline. But after having Lyme’s 2 or 3 times, I had to go to 21 days of docycycline. Had Lyme’s maybe 6-8 times the following 20 years.
The past 5 years, I have not “had” Lymes. And I should have, because it is super common in the woods of NW Wisconsin.
Therefore, I wonder if I have Lyme’s and not Alzheimer’s. Because those friends who now Azheimer’s from family members – say my ability to talk, reason and remember history is way above normal. Took 3 IQ tests a few weeks ago and scored top 97% scores and 98% fastest finish.
I have looked for doctors around MN with no interested parties.
Thus my reach out to you – who I noticed researching Lyme’s vs Alzheimer’s.
Best regards, and thanks for the work you do.