Two weeks after your camping trip, you notice a circular rash on the back of your thigh. You feel achy and tired. Your head hurts. You are running a slight fever and note that your lymph nodes are swollen.

Is it the flu? Maybe, but the circular rash is usually a dead giveaway that you may have contracted something more serious during your vacation – Lyme disease.

Lyme disease was first observed near Lyme, Connecticut in 1977. Bacteria called Borrelia burgdorferi, which is transmitted to humans by the bite of infected deer ticks, cause it.

Deer ticks are very small – much smaller than the commonly known wood tick. In its nymph state, a deer tick is about the size of a pinhead. Lyme disease is usually spread by ticks in this early stage of development, probably because adult ticks are larger and more likely to be seen and removed before they have a chance to transmit the infection.

It typically takes about 24 hours for a tick to attach to the skin and begin feeding. Your risk of developing Lyme disease increases if the infected tick stays attached to your skin for 36 to 48 hours. Once infected, you may experience the first symptoms of Lyme disease within a few days or weeks.

Not everyone who is bitten by a tick will get Lyme disease. Only a small fraction of ticks are infected with the bacteria that cause the illness.

As noted earlier, one of the most common, and notable first symptoms is a circular rash at the site of the tick bite. In about 40 percent of cases, this rash has a pale center, surrounded by a bright red rim. It appears one to four weeks after being infected.

The rash is accompanied by flu like symptoms about 50 percent of the time. The most common of these is fatigue. Others include headache, stiff neck, fever, chills, muscle and joint pain, and swollen lymph nodes.

Some people have the rash and flu like symptoms. Others – as many as 25 percent -- have no rash. Some have no symptoms at all.

If Lyme disease isn’t detected early, the infection will spread to the skin, joints, nervous system and heart. During the second stage of the disease – which occurs from one to four months after being infected -- symptoms may include pain, weakness or numbness in the arms or legs, inability to control facial muscles, fainting, poor memory, reduced ability to concentrate, pink eye, palpitations or heart problems, and additional skin rashes.

If the disease remains untreated for months or even years, symptoms will progress and become more persistent. They may include swelling or pain of the joints, especially the knees, numbness and tingling in the hands, feet, or back, severe fatigue, partial facial nerve paralysis, and neurologic changes such as problems with memory, mood, sleep, and speaking.

Anyone can get Lyme disease. There are about 17,000 cases reported in the U.S. each year.

However, there are certain factors that increase your risk. One of them is living here in northern Minnesota where deer ticks are present. Young children (between the ages of 5 to 9) and older adults 50 to 59 years old also have a higher prevalence of the disease. This is probably due to greater exposure and less use of protective measures. Spending time outdoors during the summer months, especially in grassy or wooded areas, also increases your risk of exposure. Having pets that spend part of the time outdoors increases risk. Pets can carry ticks from outside to inside a house or cabin.

Early diagnosis and treatment is key to combating Lyme disease. When diagnosed early, antibiotic treatment is often effective in getting rid of the infection quickly and completely. In rare cases, Lyme disease that is left untreated can cause permanent damage.

To lessen your risk, apply an insect repellent, which is effective against ticks. Check for ticks whenever you come in from a wooded or grassy area. Check your entire body, including your head and underarms. Check children and pets as well. Take a daily shower after being in the woods or areas where ticks are likely to live. Using a washcloth over your entire body will help to brush off any ticks that haven’t yet attached themselves to your skin. Remember, it takes about 24 hours for a tick to attach and begin feeding. If you do find a tick on your body, remove it if you can.   If you find a tick attached to your body and you are unable to remove it entirely, call your doctor. Also, contact your doctor if you develop a circular rash that expands in size over the course of several days, or if you have symptoms of fatigue, joint pain, irregular heartbeats, severe headache, or neck pain.

Lyme disease can be very serious, and early treatment is crucial to a complete recovery.  Minnesota summers are hard to resist, and you don’t want to let the fear of Lyme disease keep you from enjoying your favorite outdoor activities this year. If you spend time outdoors in the summer, take precautions to protect yourself from ticks. If you do develop a rash, make an appointment to see your physician as soon as possible.

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Dr. Luehr is a board certified family practice physician at Raiter Clinic in Cloquet.