What You Need To Know

Justin Timberlake during the concert at the Iconica Santalucia Fest. On May 30, 2025 in Seville, Andalusia, Spain. h

Europa Press via Getty Images

Pop star Justin Timberlake revealed on Friday that he has been battling Lyme disease throughout his recent world tour, describing it as “relentlessly debilitating” and explaining how he experienced a “massive amount of nerve pain” and “crazy fatigue” while performing. His announcement puts a spotlight on a disease that the Centers for Disease Control and Prevention estimates to affect hundreds of thousands of Americans every year, making it the most common vector-borne illness in the United States.

Despite the prevalence of Lyme disease, many remain unaware of this potentially serious condition until it’s too late. Understanding Lyme disease—its causes, symptoms, testing, and prevention—could make the difference between a quick recovery and years of chronic health problems.

What Causes Lyme Disease?

Lyme disease is caused by the bacteria Borrelia burgdorferi, which is transmitted to humans through the bite of infected Ixodes species ticks, also known as deer ticks. These ticks, often no larger than a sesame seed, pick up the bacteria when they feed on infected animals, such as mice or deer. When an infected tick later attaches to a human and feeds for at least 36-48 hours, it can transmit the bacteria into the bloodstream.

The disease is most common in the northeastern, mid-Atlantic, and north-central United States, where these ticks thrive in wooded and grassy areas. Peak transmission occurs during warmer months when ticks are most active and people spend more time outdoors.

Recognizing the Symptoms

Lyme disease symptoms typically appear in stages, though not everyone experiences all phases. Early recognition and diagnosis is critical for effective treatment.

Early Stage (3-30 days after bite): The hallmark sign of Lyme disease is erythema migrans, a distinctive “bull’s-eye” rash that appears at the bite site in 70-80% of cases. This circular rash, often with a clear center, gradually expands outward and may have the characterstic bull’s-eye appearance. However, the rash may be uncharacteristic and appear as a solid red patch.

Other early symptoms may include a fever, chills, headache, fatigue, and muscle and joint pain. These flu-like symptoms are often dismissed, allowing the infection to progress.

Later Stages (days to months later): If untreated, the bacteria can spread throughout the body, causing severe headaches, neck stiffness, facial palsy (loss of muscle tone on one side of the face), arthritis with severe joint pain and swelling, irregular heartbeat, and nerve pain.

Late Stage (months to years later): If untreated, chronic symptoms can include severe arthritis and neurologic symptoms, such as numbness and tingling in hands and feet and problems with concentration and memory.

Testing for Lyme Disease

Diagnosing Lyme disease can be challenging because symptoms often mimic other infections. There’s no single definitive test, and early-stage infections may not be detected by standard blood tests.

The CDC recommends a two-step serologic testing process for Lyme disease to identify antibodies that have been produced in response to the infection. These antibodies may take 10-14 days to become detectable, which limits the ability to diagnose early infections.

The most common diagnostic approach uses a two-step testing process:

1. ELISA (enzyme-linked immunosorbent assay): This initial screening test detects antibodies against the bacteria causing Lyme disease. However, it can produce false positives, and screening may be negative in the initial days after symptom onset.
2. Western blot: If the ELISA is positive or equivocal, this more specific test is used to help confirm the presence of Lyme antibodies.

These tests detect the body’s immune response to the infection, not the bacteria itself, which means they may remain positive for months or years after successful treatment. For this reason, doctors typically diagnose based on symptoms, potential tick exposure, and physical examination, using blood tests as supporting evidence. Molecular, or PCR-based tests are also available, but have limited sensitivity for diagnosing the infection.

In early-stage disease with the characteristic rash, doctors often begin treatment immediately without waiting for test results, as early treatment is most effective.

Prevention: Your Best Defense

The good news is that Lyme disease is preventable with the use of proper precautions:

Avoid tick habitats: When hiking, stay in the center of trails, avoid tall grass and brush, and choose open, sunny areas for outdoor activities, when possible.

Dress appropriately: Wear long pants, a long-sleeved shirt, and closed shoes. Tuck your pants into socks and consider wearing light-colored clothing, which makes ticks easier to spot.

Use repellents: Apply EPA-registered insect repellents containing DEET, picaridin, or permethrin. Treat clothing and gear with permethrin-containing products.

Perform daily tick checks: Examine your entire body after outdoor activities, paying special attention to the underarms, in and around ears, belly button, behind knees, between legs, around the waist, and in your hair. Check your children and pets too.

Remove ticks promptly: Use fine-tipped tweezers to grab the tick close to the skin and pull upward with steady pressure. Do not place anything hot, such as an extinguished match on the tick, as this may actually increase the chances of acquiring the infection. Clean the bite area with rubbing alcohol or soap and water.

While Lyme disease can be serious if left untreated, early detection and appropriate antibiotic treatment typically lead to a complete recovery. Patients who are not diagnosed and treated early may experience prolonged symptoms, but after receiving the recommended treatment, persistent symptoms are not believed to be due to continued infection. Clinical trials of new vaccines are currently underway. By taking simple preventive measures and knowing what to watch for, you can enjoy the outdoors this summer while protecting yourself from this increasingly common disease.