Lyme Disease on the Rise—Ticks Surging After Warm Winter Put More People at Risk

If you feel like you’re hearing about ticks surging everywhere this summer, you’re not imagining it. Multiple outlets reporting CDC data say emergency-department visits for tick bites in Summer 2025 are at their highest levels in years, especially in the Northeast—where Lyme disease in the Northeast remains a significant public health concern. A warm winter, shorter cold seasons, and shifting habitats are helping ticks thrive and expand their range, raising the risk of Lyme disease and other tick-borne infections.

The good news: Lyme disease testing and other targeted lab tests can help you and your clinician move from worry to a plan. Through Ulta Lab Tests, you can order comprehensive blood tests—often the same evidence-based assays doctors use—to check for Lyme disease and common coinfections, all without insurance requirements or a doctor’s office visit up front.

Lyme Disease in the Northeast

The Northeast remains one of the hardest-hit regions for Lyme disease in the United States. Warmer winters and expanding tick habitats have extended the active season for blacklegged ticks (Ixodes scapularis), increasing the number of tick bites and tick-borne infections.

If you live in or visit states like Maine, Massachusetts, New York, Pennsylvania, New Jersey, or Connecticut, it’s critical to check for ticks after spending time outdoors in grassy, wooded, or brushy areas.

U.S. States with Highest Incidence of Lyme Disease

While the Northeast is well-known for Lyme risk, several other states also report consistently high case numbers.

14 High-Incidence States

According to CDC and Mount Sinai data, about 95% of all reported Lyme disease cases are concentrated in these 14 states:
Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin.

Within these, Maine, New Hampshire, and Vermont—particularly in northern New England—have seen especially sharp increases in Lyme incidence recently.

Upper Midwest: Expanding Risk Zone

In addition to the traditionally high-risk states, the upper Midwest (notably Minnesota and Wisconsin) remains endemic. Risk is also expanding into Iowa, Illinois, Indiana, and Michigan.

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Summary Table: High-Risk Areas

Region	States Included
Northeast	CT, DE, ME, MD, MA, NH, NJ, NY, PA, RI, VT, VA
Upper Midwest	MN, WI (with expansion into IA, IL, IN, MI)

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Key Takeaway

Lyme disease isn’t just a Northeast concern—it also hits hard in the upper Midwest and continues to encroach into neighboring regions. This broader geographic risk highlights the importance of prevention and accessible Lyme disease lab testing—especially during peak seasons.

U.S. States with Highest Incidence of Lyme Disease

While the Northeast is well-known for Lyme risk, several other states also report consistently high case numbers.

14 High-Incidence States

According to CDC and Mount Sinai data, about 95% of all reported Lyme disease cases are concentrated in these 14 states:
Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin.

Within these, Maine, New Hampshire, and Vermont—particularly in northern New England—have seen especially sharp increases in Lyme incidence recently 

Upper Midwest: Expanding Risk Zone

In addition to the traditionally high-risk states, the upper Midwest (notably Minnesota and Wisconsin) remains endemic. Risk is also expanding into Iowa, Illinois, Indiana, and Michigan 

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Summary Table: High-Risk Areas

Region	States Included
Northeast	CT, DE, ME, MD, MA, NH, NJ, NY, PA, RI, VT, VA
Upper Midwest	MN, WI (with expansion into IA, IL, IN, MI)

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Key Takeaway

Lyme disease isn’t just a Northeast concern—it also hits hard in the upper Midwest and continues to encroach into neighboring regions. This broader geographic risk highlights the importance of prevention and accessible Lyme disease lab testing—especially during peak seasons.

Stay proactive:

• Wear light-colored clothing to spot ticks more easily.
• Use EPA-approved insect repellent.
• Perform thorough tick checks on yourself, children, and pets after outdoor activities.
• If you develop symptoms—such as fever, fatigue, rash, or joint pain—consider ordering a Lyme disease lab test through Ulta Lab Tests to detect infection early.

Learn more & order tests: Lyme Disease Tests at Ulta Lab Tests

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Signs & Symptoms to Watch For

Lyme disease (Borrelia burgdorferi)

• Early localized (3–30 days): fever/chills, headache, fatigue, erythema migrans (EM) rash (often—but not always—“bull’s‑eye”), swollen lymph nodes.
• Early disseminated (weeks–months): multiple EM rashes, facial palsy, meningitis‑like headache/neck stiffness, shooting pains/radiculopathy, palpitations from Lyme carditis.
• Late (months–years): intermittent or persistent arthritis (commonly knees), neuropathy, cognitive complaints.

Important timing fact: in general, a tick typically needs to be attached for more than 24 hours (often 36–48 hours) to transmit Lyme, so prompt removal matters.

Common coinfections transmitted by the same ticks

• Anaplasmosis (Anaplasma phagocytophilum): high fever, severe headache, muscle aches; labs often show leukopenia, thrombocytopenia, and elevated liver enzymes.
• Ehrlichiosis (Ehrlichia chaffeensis): fever, chills, headache, muscle aches; can be severe; lab clues include low white count, low platelets, and elevated transaminases.
• Babesiosis (Babesia microti): malaria‑like illness with hemolytic anemia, fatigue, sweats; may show thrombocytopenia and elevated bilirubin/LDH; diagnosis can involve blood smear or PCR.

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How Lab Tests Help—and When to Test

Serology (antibody testing) is the cornerstone for Lyme diagnosis in the U.S. The CDC and medical societies recommend a two‑tier approach:

• Standard two‑tier testing (STTT): an initial enzyme immunoassay (EIA/ELISA) followed by an immunoblot (Western blot) if positive/equivocal.
• Modified two‑tier testing (MTTT): a second EIA instead of a Western blot—FDA‑cleared in 2019 and increasingly used by labs.

Timing matters. Antibodies can be negative in the first week after a bite. If your first test is negative but symptoms started recently, your clinician may advise retesting in 7–14 days. And after 30 days of illness, IgM results should generally be ignored because they often become false positives—IgG becomes the meaningful marker.

What not to use tests for: CDC guidance cautions not to use Lyme antibody tests to monitor treatment response; improvement is judged by clinical symptoms, not by declining antibody levels.

Urgent care note: For suspected rickettsial illnesses (e.g., Rocky Mountain spotted fever) or severe anaplasmosis/ehrlichiosis, clinicians treat immediately—don’t wait for labs—because early doxycycline saves lives.

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Individual Test Breakdowns (Quest Diagnostics through Ulta Lab Tests)

Tip: You can order these tests directly; most are collected at a nearby Quest Diagnostics Patient Service Center. Links go straight to the test pages.

1) Lyme Disease Antibody with Reflex to Blot (IgG, IgM)

• What it is: The recommended first‑line screening EIA with automatic Western blot (immunoblot) reflex if needed.
• What it measures: Antibodies (IgM and IgG) against Borrelia burgdorferi.
• Why it matters: Aligns with CDC two‑tier strategy; the reflex confirmatory step improves specificity.
• How it helps you: If your screening is positive, the reflex confirmation happens without another blood draw.
• Order: Lyme Disease Ab with Reflex to Blot (IgG, IgM). (Quest)

2) Lyme Disease Antibodies (IgG, IgM) Immunoblot (Western Blot)

• What it is: The confirmatory second tier in STTT; sometimes ordered on its own if your clinician wants confirmation.
• What it measures: Specific IgG and IgM antibody bands to Lyme antigens.
• Why it matters: Confirms true positives and helps interpret IgM (<30 days) vs IgG (≥30 days).
• How it helps you: Provides band‑level detail your clinician can use alongside symptoms and timing.
• Order: Lyme Disease Antibodies (IgG, IgM) Immunoblot or Lyme Disease IgG Antibody Immunoblot. (Quest)

3) Lyme Disease (Borrelia spp) DNA, Qualitative, Blood (PCR)

• What it is: Molecular assay looking for Borrelia DNA in blood.
• What it measures: Presence/absence of Borrelia genetic material.
• Why it matters: May be considered in select situations, though serology remains preferred for most suspected Lyme disease.
• How it helps you: Occasionally useful early on or in special clinical contexts; discuss with your clinician.
• Order: Lyme Disease (Borrelia Spp) DNA, Ql, Blood. (Quest)

4) Lyme and Tick‑Borne Panel

• What it is: A clinician‑designed panel bundling Lyme immunoblot with common coinfection tests (e.g., Babesia, Bartonella, Ehrlichia/Anaplasma).
• Why it matters: The same tick can transmit multiple pathogens; a bundled approach can save time.
• Order: Lyme and Tick Borne Panel. (Quest) – see page for included assays.

5) Babesia microti IgG/IgM Antibodies

• What it measures: Antibodies to Babesia microti (a malaria‑like parasite).
• Why it matters: Babesiosis causes hemolytic anemia and can be severe in asplenic or immunocompromised people; additional blood smear/PCR may be needed if positive or highly suspected.
• Order: Babesia Microti IgG/IgM Antibodies Test. (Quest)

6) Anaplasma phagocytophilum IgG/IgM Antibodies

• Why it matters: Helps evaluate anaplasmosis, which often presents with high fever plus low WBC/platelets and elevated liver enzymes.
• Order: Anaplasma phagocytophilum IgG/IgM Antibodies. (Quest)

7) Ehrlichia chaffeensis IgG/IgM Antibodies

• Why it matters: Evaluates ehrlichiosis—can become severe; early treatment is critical.
• Order: Ehrlichia chaffeensis IgG/IgM Antibodies. (Quest)

8) Malaria, Babesia & Other Blood Parasites (Smear)

• What it is: Microscopy for intra‑erythrocytic parasites (e.g., Babesia).
• Why it matters: Useful when babesiosis is strongly suspected; also helps quantify parasitemia.
• Order: Malaria/Babesia/Other Blood Parasites Blood Test. (Quest)

9) Supportive tests your clinician may use

• Complete Blood Count (CBC) with Differential and Platelets: looks for leukopenia, anemia, thrombocytopenia—patterns suggestive of anaplasmosis/ehrlichiosis or hemolysis in babesiosis.
• Comprehensive Metabolic Panel (CMP): checks liver enzymes and kidney function; transaminitis is common in anaplasmosis/ehrlichiosis.
• Inflammation markers: C‑Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) can reflect overall inflammatory burden.

Explore all Lyme‑related offerings here: Lyme Disease Tests.

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Summary Table: Lyme & Tick-Borne Disease Lab Tests

The key Lyme & Tick-Borne Disease Lab Tests  are organized into three clear categories for diagnosis, confection and supportive monitoring.

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Diagnosis (Initial Screening)

Test Name	What It Measures	Why It Matters	Link
Lyme Disease Antibody with Reflex to Blot (IgG, IgM)	Detects IgG and IgM antibodies to Borrelia burgdorferi, with reflex Western blot confirmation if positive/equivocal	Aligns with CDC two-tier testing; reflex saves time by avoiding a second blood draw	Lyme Disease Ab with Reflex to Blot (IgG, IgM)
Lyme Disease Antibodies (IgG, IgM) Immunoblot (Western Blot)	Identifies specific antibody bands to confirm Lyme infection	Confirms positives and distinguishes early (IgM) vs late (IgG) infection	Lyme Disease Antibodies (IgG, IgM) Immunoblot
Lyme Disease IgG Antibody Immunoblot	Detects IgG antibodies only	Used for infections >30 days old; avoids false-positive IgM results	Lyme Disease IgG Antibody Immunoblot
Lyme Disease (Borrelia spp) DNA, Qualitative, Blood (PCR)	Detects Borrelia DNA in blood	Useful in select cases when serology is inconclusive	Lyme Disease (Borrelia Spp) DNA, Ql, Blood
Lyme and Tick-Borne Panel	Includes Lyme antibody testing plus coinfections	Saves time by testing for multiple pathogens in one panel	Lyme and Tick Borne Panel

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Coinfection Detection

Test Name	What It Measures	Why It Matters	Link
Babesia microti IgG/IgM Antibodies	Detects antibodies to Babesia microti	Babesiosis can cause anemia and be severe in high-risk patients	Babesia Microti IgG/IgM Antibodies Test
Anaplasma phagocytophilum IgG/IgM Antibodies	Detects antibodies to Anaplasma	Helps diagnose anaplasmosis, often with low WBC and high LFTs	Anaplasma phagocytophilum IgG/IgM Antibodies
Ehrlichia chaffeensis IgG/IgM Antibodies	Detects antibodies to Ehrlichia chaffeensis	Important for diagnosing ehrlichiosis, which can be severe if untreated	Ehrlichia chaffeensis IgG/IgM Antibodies
Malaria, Babesia & Other Blood Parasites (Smear)	Microscopic identification of blood parasites	Useful for diagnosing babesiosis and estimating parasite load	Malaria/Babesia/Other Blood Parasites Blood Test

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Supportive Monitoring

Test Name	What It Measures	Why It Matters	Link
Complete Blood Count (CBC) with Differential and Platelets	Measures red and white blood cells, platelets	Detects anemia, leukopenia, and thrombocytopenia common in tick-borne illnesses	CBC with Differential and Platelets
Comprehensive Metabolic Panel (CMP)	Evaluates liver, kidney, and electrolyte status	Detects transaminitis and other organ effects from tick-borne illness	Comprehensive Metabolic Panel (CMP)
C-Reactive Protein (CRP)	Measures systemic inflammation	Elevated in many active infections	C-Reactive Protein (CRP)
Sed Rate by Modified Westergren (ESR)	Measures inflammation speed in blood	Often elevated in chronic infection or inflammation	ESR Test

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What to Expect from Your Results

• Early negative? Antibodies may take time to develop. If you tested within the first week after symptom onset and results were negative, your clinician may recommend repeat testing in 7–14 days.
• IgM vs IgG: Use IgM only in the first 30 days after symptoms begin; beyond that, rely on IgG because IgM often yields false positives.
• After treatment: Antibodies can remain positive for months or years; don’t re‑test to prove cure—improving symptoms are what matters.
• Coinfections: If your course is more severe than expected (e.g., high fever, drenching sweats, hemolysis, low platelets), ask about Babesia, Anaplasma, and Ehrlichia testing.

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When to Talk to Your Doctor (Right Away)

• Red‑flag symptoms: chest pain, fainting or palpitations (possible Lyme carditis), severe headache/neck stiffness, confusion, facial droop, shortness of breath, or high fevers with low blood counts.
• If you removed an Ixodes tick and it was likely attached ≥36 hours in an endemic area, ask about single‑dose doxycycline prophylaxis within 72 hours (adults 200 mg once; children 4.4 mg/kg up to 200 mg).

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Why Activity Is So High This Summer

CDC‑tracked ER visits for tick bites have surged in 2025, with the Northeast especially affected. Climate‑linked shorter winters appear to expand tick survival and season length, allowing range expansion and more human exposure.

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Conclusion / Next Steps

Ticks are having a big year. The sooner you understand your risk and testing options, the faster you can act. Ulta Lab Tests connects you to Quest Diagnostics lab testing so you can order online, walk in for your blood draw, and share results with your clinician.

• Start with the Lyme Disease Ab with Reflex to Blot (IgG, IgM).
• Concerned about coinfections? Consider the Lyme and Tick‑Borne Panel or add Babesia Microti IgG/IgM, Anaplasma IgG/IgM, and Ehrlichia IgG/IgM.
• Need a basic screen? Order your CBC test here.

FAQ

1) How soon after a tick bite should I test for Lyme?
Antibodies take time to appear. If you test within the first week and it’s negative, retesting in 7–14 days is reasonable if symptoms persist.

2) Do I need antibiotics right after any tick bite?
Not always. Single‑dose doxycycline may be offered within 72 hours only after high‑risk Ixodes bites (endemic area, attached ≥36 hours). Ask your clinician.

3) My test shows IgM positive but I’ve been sick for over a month—does that mean Lyme?
Probably not. Ignore isolated IgM after 30 days because false positives are common. Look for IgG or retest.

4) Can I use tests to see if I’m “cured”?
No. Antibodies may stay positive long after recovery and should not be used to monitor treatment response; your clinician follows symptoms.

5) What if I have night sweats, dark urine, or very low platelets?
Ask about Babesia and other coinfections; babesiosis often causes hemolytic anemia and may need blood smear or PCR.