Summer in Maryland brings warm weather and more time outdoors. For many people, that means hiking, gardening, camping, yard work, and walks through wooded areas.
But there is another part of summer that deserves attention: ticks.
Lyme disease in Maryland is a significant health concern. The Maryland Department of Health reports that Lyme disease is the most common tick-borne disease in the state, with more than 3,000 cases reported in 2024.
The tricky part is that Lyme disease may not initially look like a tick-borne illness. It can begin with fatigue, headache, fever, chills, muscle aches, or joint pain. In other words, you may think you’ve caught a summer flu.
Knowing what to watch for can help you seek care sooner.
Why Lyme Disease Matters in Maryland
Ticks are found throughout Maryland. The black-legged tick, also known as the deer tick, can transmit the bacteria that causes Lyme disease. Maryland also has other tick species that can carry other illnesses.
Lyme disease is caused by the bacterium Borrelia burgdorferi. It is mainly spread through the bite of an infected black-legged tick.
You don’t have to be hiking deep in the woods to encounter a tick. Ticks can be found in areas with leaf litter, tall grass, shrubs, and other vegetation.
When Are Ticks Most Active?
Ticks are especially active during warmer months, making late spring, summer, and early fall important times for prevention. The Maryland Department of Health encourages residents to take precautions before, during, and after outdoor activities.
That doesn’t mean you need to avoid the outdoors.
It simply means you should know how to protect yourself.
What Is Lyme Disease?
Lyme disease is an infection caused by specific bacteria transmitted through infected ticks.
A tick has to attach to your skin to transmit Lyme disease. Not every tick carries the bacteria, and not every tick bite results in infection.
How Lyme Disease Spreads
The black-legged tick is very small. Young ticks can be particularly difficult to spot.
That’s one reason prevention and careful tick checks are so important.
If you spend time outdoors in areas where ticks may live, check your clothing and skin when you return home.
Why You May Not Remember a Tick Bite
Here’s the frustrating part: you may never remember being bitten.
Ticks can be tiny, and their bites may go unnoticed. A person may develop symptoms days or weeks later without connecting those symptoms to outdoor exposure.
That’s why your recent activities matter when you’re feeling unwell.
If you’ve recently spent time hiking, gardening, camping, or walking through areas with tall grass or woods, tell your health care provider.
7 Early Signs That May Look Like the Summer Flu
Early Lyme disease can resemble several common illnesses.
According to the CDC, early symptoms can include an expanding rash, fatigue, chills, fever, headache, muscle and joint pain, and swollen lymph nodes.
1. Fever and Chills
A fever can be easy to blame on a routine infection.
But if fever or chills appear after possible tick exposure, Lyme disease and other tick-borne illnesses should be considered.
2. Unusual Fatigue
Everyone gets tired.
The concern is fatigue that feels unusual, persistent, or difficult to explain.
You might sleep normally but still feel drained. You may find everyday activities harder than usual.
Fatigue can have many causes, so it isn’t proof of Lyme disease. However, when it occurs alongside other symptoms and recent tick exposure, it’s worth discussing with a provider.
3. Headache
A headache can occur with many common illnesses.
When paired with fever, fatigue, body aches, or a possible tick bite, it may be another clue that deserves attention.
4. Muscle Aches
Some people with early Lyme disease develop muscle aches that feel similar to the body aches associated with the flu.
Again, context matters.
If you’ve recently been outdoors in Maryland and develop flu-like symptoms without an obvious explanation, mention the possible tick exposure when seeking care.
5. Joint Pain
Joint aches can occur early in Lyme disease and may also appear later.
Persistent or unusual joint symptoms should not automatically be blamed on exercise, aging, or a busy week.
6. Swollen Lymph Nodes
Swollen lymph nodes may occur during infections, including Lyme disease.
They are not specific to Lyme disease, but they can add to the overall picture when combined with other symptoms.
7. An Expanding Rash
The classic Lyme disease rash is called erythema migrans, or EM.
It often appears between 3 and 30 days after an infected tick bite. The rash gradually expands over several days and may develop a target or “bull’s-eye” appearance.
But here’s an important point: not everyone with Lyme disease develops the classic bull’s-eye rash.
So don’t rule out Lyme disease simply because you don’t see one.
What Happens If Lyme Disease Goes Untreated?
Early recognition matters because untreated Lyme disease can spread beyond the initial site of infection.
The CDC notes that later symptoms may involve the joints, nervous system, or heart.
Joint Problems
Lyme arthritis can cause significant pain and swelling, often involving one or more large joints.
The knee is a common location.
A person who develops unexplained joint swelling weeks or months after possible tick exposure should discuss the history with a health care provider.
Nervous System Symptoms
Lyme disease can affect the nervous system.
Possible symptoms include nerve pain, numbness, facial weakness or paralysis, meningitis, severe headache, and neck stiffness.
These symptoms deserve prompt medical attention.
Heart-Related Symptoms
In some cases, Lyme disease can affect the heart.
Possible symptoms can include irregular heart rhythms, dizziness, or other heart-related problems.
Seek prompt medical evaluation for concerning symptoms, especially if they occur after possible tick exposure.
How Lyme Disease Is Diagnosed
Lyme disease isn’t diagnosed from one symptom alone. A health care provider may consider:
- Your symptoms
- Where you’ve been
- Possible tick exposure
- Whether you noticed a rash
- The timing of symptoms
- Other possible causes
- Laboratory test results when appropriate
This broader picture is important because many early Lyme symptoms overlap with other illnesses.
Why Timing Matters for Blood Tests
Blood testing can be helpful, but timing matters.
Many Lyme tests look for antibodies produced by the immune system. Those antibodies may not be detectable during the earliest stage of infection.
The CDC notes that people infected for a shorter period can have a negative blood test even when Lyme disease is present.
That means a negative early test does not always settle the question.
Your provider may use your symptoms and exposure history when deciding what to do next.
How Lyme Disease Is Treated
Most Lyme disease cases can be treated successfully with appropriate antibiotics, especially when treatment begins early.
Common antibiotics used for Lyme disease include doxycycline, amoxicillin, and cefuroxime axetil, depending on the clinical situation.
Treatment decisions should be made by a qualified health care professional.
Don’t start leftover antibiotics on your own. Don’t share medication with another person. And don’t assume that every fever after a tick bite requires the same treatment.
If symptoms continue after treatment, talk with your provider. Persistent symptoms can have different causes and deserve an appropriate evaluation.
How to Protect Yourself From Ticks
Prevention is one of the best ways to reduce your risk.
The Maryland Department of Health recommends practical steps such as using EPA-registered insect repellents, wearing protective clothing, checking for ticks, and taking precautions in tick habitats.
Before going outdoors:
- Consider an EPA-registered repellent.
- Wear long pants and long sleeves when practical.
- Consider treating clothing and gear with permethrin according to product directions.
- Stick to marked trails when hiking.
- Avoid brushing against tall grass and dense vegetation.
What to Do After Being Outdoors
A tick check can take only a few minutes. When you come inside:
- Check your clothing.
- Check your body carefully.
- Pay attention to areas such as the scalp, behind the ears, armpits, waist, groin, and behind the knees.
- Shower soon after returning indoors.
- Check children and pets, too.
Maryland health officials recommend showering after outdoor exposure and checking the body for ticks.
What If You Find a Tick?
Don’t panic.
Remove it promptly using fine-tipped tweezers.
Grasp the tick close to the skin and pull upward with steady pressure. Avoid twisting or jerking it. Maryland health guidance also advises against using petroleum jelly, nail polish, or a hot match to remove a tick.
After removal, wash the bite area and your hands with soap and water.
If you develop symptoms afterward, contact your health care provider.
Conclusion
Summer fatigue can have many explanations. Maybe you’ve been working outside in the heat. Perhaps you’ve been traveling or simply haven’t been sleeping well.
But if flu-like symptoms appear after spending time in Maryland’s woods, tall grass, or other tick habitats, don’t automatically shrug them off.
Lyme disease in Maryland can begin with symptoms that look surprisingly ordinary: fatigue, headache, fever, chills, muscle aches, joint pain, or an expanding rash.
Early attention matters.
You don’t need to live in fear of ticks or stop enjoying Maryland’s outdoors. Instead, make tick prevention part of your routine. Use appropriate protection, check yourself and your family after outdoor activities, remove ticks promptly, and know the symptoms to watch for.
And if you become ill after possible tick exposure, tell your health care provider about it.
