Lyme Disease Testing: What the 2026 Tick Surge Means for You

Emergency department visits for tick bites began rising unusually early in 2026. In April, the Centers for Disease Control and Prevention reported that weekly tick-bite emergency visits were the highest recorded for that time of year since 2017 in every U.S. region except the South Central region.

This finding documents increased tick exposure. It does not yet establish a matching nationwide increase in confirmed 2026 Lyme disease cases because disease surveillance and case reporting take longer to complete.

Mild winters, earlier periods of warm weather, changing habitats, wildlife populations, and increased outdoor activity can all influence when and where ticks are active. Blacklegged ticks may seek hosts whenever temperatures rise above freezing, although the greatest risk of bites generally occurs during spring, summer, and fall.

For people who develop symptoms after a possible exposure, Lyme disease testing may provide useful information. However, selecting the right test and testing at the right time are essential. Testing immediately after every tick bite is usually not useful, and a negative result obtained too early may not rule out an infection.

Ulta Lab Tests provides direct access to many Lyme disease and tick-borne illness tests where available. Laboratory results provide information but do not replace a medical examination, professional diagnosis, emergency care, or individualized treatment advice. Results should be reviewed with a qualified healthcare provider.

Key Takeaways

• CDC data show that tick-bite emergency visits began unusually early in 2026, indicating increased opportunities for tick exposure.
• Lyme disease is caused by Borrelia bacteria transmitted primarily by infected blacklegged ticks.
• Possible symptoms include fever, fatigue, headache, muscle aches, joint pain, swollen lymph nodes, facial weakness, and an expanding rash.
• The recommended laboratory approach generally uses two sequential antibody tests rather than a stand-alone immunoblot or routine blood PCR.
• Lyme antibodies can take several weeks to become detectable, so testing too early may produce a false-negative result.
• A positive antibody result may reflect a current or previous infection and is not considered a test of cure.
• Severe headache, facial weakness, fainting, chest pain, shortness of breath, confusion, or high fever after a tick bite requires prompt medical evaluation.

What Is Lyme Disease?

Lyme disease is a bacterial infection caused in the United States primarily by Borrelia burgdorferi. It is transmitted through the bite of an infected blacklegged tick, which is also commonly called a deer tick.

Not every tick carries Lyme-causing bacteria, and not every tick bite results in infection. The likelihood of transmission depends on several factors:

• The tick species and life stage
• The geographic location of the exposure
• Whether the tick carried Borrelia bacteria
• How long the tick was attached
• How quickly and correctly the tick was removed

Blacklegged tick nymphs can be about the size of a poppy seed, making them difficult to see. Many people who are evaluated for Lyme disease do not remember seeing a tick or being bitten.

Symptoms alone may not tell the full story. Fever, fatigue, headache, muscle pain, and joint discomfort can occur with many infections and noninfectious health conditions. Laboratory testing may provide objective information, but the results must be interpreted alongside symptoms, exposure history, geographic risk, physical findings, and illness duration.

Why the 2026 Tick Surge Matters

Elevated tick-bite activity means that more people may encounter ticks while hiking, gardening, camping, walking pets, working outdoors, or spending time in wooded, brushy, leafy, or grassy environments.

An increase in tick exposure does not mean that every region will experience a corresponding increase in Lyme disease. Disease risk also depends on the local tick species, the percentage of ticks carrying infectious organisms, animal hosts, human behavior, and regional environmental conditions.

In addition to Lyme disease, ticks may transmit other illnesses, including:

• Anaplasmosis
• Babesiosis
• Ehrlichiosis
• Rocky Mountain spotted fever and related rickettsial diseases
• Powassan virus disease
• Alpha-gal syndrome associated with certain tick bites

The organisms transmitted by a tick vary according to the tick species and region. Testing should therefore be selected according to a person’s symptoms, exposure location, likely tick species, and timing rather than automatically ordering every available tick-borne disease test.

Common Lyme Disease Symptoms and Warning Signs

Early Lyme disease symptoms may begin approximately 3 to 30 days after a tick bite. The characteristic erythema migrans rash occurs in many—but not all—infected people. It does not always form a classic bull’s-eye.

Symptom or Risk Factor	What It May Suggest	Tests or Next Steps That May Help
Expanding red or oval rash after tick exposure	Erythema migrans and possible early Lyme disease	Prompt clinical evaluation; Lyme antibodies may not yet be detectable
Fever, headache, fatigue, or body aches	Early Lyme disease or another infection	Lyme Disease Antibody Test with Reflex to Blot IgG/IgM, when timing is appropriate; supportive Complete Blood Count with Differential and Platelets and Comprehensive Metabolic Panel
Facial weakness or facial droop	Possible neurologic Lyme disease or another neurologic condition	Prompt medical assessment and clinician-directed Lyme testing
Palpitations, fainting, chest pain, or shortness of breath	Possible Lyme carditis or another cardiac emergency	Immediate medical evaluation; do not rely on direct-access testing alone
New swelling in one or more large joints	Possible Lyme arthritis or another inflammatory or infectious condition	Two-tier Lyme serology and additional clinical evaluation
High fever with low white blood cells or platelets	Possible anaplasmosis or ehrlichiosis	Complete Blood Count with Differential and Platelets, Comprehensive Metabolic Panel, and pathogen-specific evaluation
Fever, drenching sweats, anemia, jaundice, or dark urine	Possible babesiosis or another condition affecting red blood cells	Malaria/Babesia/Other Blood Parasites Blood Test and other clinician-directed Babesia testing
Tick attached for an extended period in a higher-risk region	Increased exposure risk	Contact a healthcare professional promptly; immediate testing of an asymptomatic person is generally not recommended

Safety note: Seek urgent medical care for difficulty breathing, chest pain, fainting, confusion, severe headache, stiff neck, facial drooping, rapidly worsening weakness, high fever, unusual bleeding, jaundice, or dark urine.

The Role of Lyme Disease Testing

What Lyme Disease Blood Tests Measure

Most routine Lyme disease blood tests detect antibodies produced by the immune system in response to Borrelia burgdorferi. These tests do not directly count bacteria in the blood.

The CDC recommends a two-step testing process using FDA-cleared assays:

1. An enzyme immunoassay or another approved first-step antibody test
2. A second antibody test when the first result is positive or equivocal

In standard two-tier testing, the second test is an immunoblot. In modified two-tier testing, two different enzyme immunoassays are used. The overall result is considered positive only when the required first and second steps meet the laboratory’s reporting criteria.

Ulta Lab Tests offers both a Lyme Disease Antibody Test with Reflex to Blot IgG/IgM and a Lyme Disease Antibody Test with Reflex to Immunoassay IgG/IgM. The most appropriate option depends on the laboratory algorithm, exposure, symptoms, and guidance from a healthcare provider.

What Lyme Testing Cannot Establish by Itself

A Lyme disease blood test cannot independently determine:

• Exactly where or when the exposure occurred
• Whether nonspecific fatigue or pain is caused by Lyme disease
• Whether a previously treated infection has been eliminated
• Whether every current symptom is related to a positive antibody result
• Whether a person should begin, stop, or change medication

Why Test Timing Matters

Antibodies may not reach detectable levels during the first several weeks after infection. As a result, an early antibody test may be negative even when an infection is present.

A person with a clinically typical expanding rash and a plausible exposure should seek prompt medical care rather than waiting for a blood test to become positive.

Once antibodies develop, they can remain detectable for months or years. Persistent antibodies do not necessarily indicate continuing infection, and repeat antibody testing is not generally used to determine whether treatment was successful.

Related Lyme and Tick-Borne Disease Tests

Test	What It Measures	Why It May Be Relevant	Important Limitations
Lyme Disease Antibody Test with Reflex to Blot IgG/IgM	Antibodies against B. burgdorferi, with reflex confirmatory testing when required	A practical starting option when standard two-tier serologic testing is appropriate	May be negative early; antibodies may persist for years; false-positive reactions can occur
Lyme Disease Antibody Test with Reflex to Immunoassay IgG/IgM	Lyme antibodies using a modified two-tier immunoassay process	Provides a CDC-accepted two-step antibody testing approach when performed with FDA-cleared assays	Test timing and clinical probability remain essential to interpretation
Lyme Disease IgG/IgM Antibodies Immunoblot Test	Antibody reactivity to specific Borrelia proteins	May serve as the second step in standard two-tier testing	Should not generally be used as a stand-alone screening test
Lyme Disease IgG Antibody Immunoblot Test	IgG antibody response to specific Lyme antigens	May provide additional information later in the illness when used within an appropriate testing strategy	A positive IgG result may reflect a current or previous infection and does not determine whether infection is active
Lyme Disease DNA Qualitative Blood Test	Borrelia DNA in a blood specimen	A direct-detection option that may be considered in selected circumstances	Blood PCR has limited sensitivity and is not the routine first-line test for Lyme disease
Lyme and Tick Borne Panel	Multiple markers related to Lyme disease and selected tick-borne infections	May be considered when symptoms and geographic exposure suggest more than one possible infection	Broad panels can produce complex or incidental findings; review the current panel components before ordering
Babesia Microti IgG/IgM Antibodies Test with Reflex to Titers	Immune response to Babesia microti	May help evaluate possible exposure to the parasite associated with babesiosis	Antibodies alone do not reliably prove active parasitemia; a smear or molecular test may be needed
Malaria/Babesia/Other Blood Parasites Blood Test	Blood parasites visible through microscopic examination	May help identify active babesiosis and estimate the proportion of affected red blood cells	A single negative smear may not rule out infection when parasite levels are low
Anaplasma Phagocytophilum IgG/IgM Antibodies Test	Antibodies against Anaplasma phagocytophilum	May help evaluate possible anaplasmosis after a compatible exposure and illness	Antibodies may be absent during the first week; acute PCR testing is typically clinician-directed
Ehrlichia Chaffeensis IgG/IgM Antibodies Test with Reflex to Titer	Antibodies against Ehrlichia chaffeensis	May help evaluate ehrlichiosis when symptoms and geographic exposure are compatible	Early results may be negative; isolated IgM findings may be unreliable
Complete Blood Count with Differential and Platelets	Red cells, white cells, hemoglobin, hematocrit, differential counts, and platelets	May identify anemia, low white blood cells, or low platelets associated with some tick-borne illnesses	Abnormalities are nonspecific and cannot identify the infectious organism
Comprehensive Metabolic Panel Test	Liver enzymes, kidney markers, electrolytes, glucose, proteins, and bilirubin	May identify liver or organ abnormalities during a systemic illness	Abnormal results have many possible causes and do not diagnose a tick-borne infection
C-Reactive Protein Test	C-reactive protein, a nonspecific marker of inflammation	May show that inflammation is present	Does not identify Lyme disease or another specific cause
Sed Rate Test	The erythrocyte sedimentation rate, another nonspecific measure of inflammation	May provide complementary information about inflammatory activity	Can be affected by age, anemia, pregnancy, autoimmune disorders, infection, and other conditions

Recommended Testing Approach

Essential Testing

Consider two-tier Lyme antibody testing when the following factors are reasonably present:

• Possible exposure in a region where Lyme disease occurs
• A realistic opportunity for tick contact
• Symptoms compatible with Lyme disease

The Lyme Disease Antibody Test with Reflex to Blot IgG/IgM or Lyme Disease Antibody Test with Reflex to Immunoassay IgG/IgM may provide a more complete testing pathway than ordering an isolated immunoblot.

Testing an asymptomatic person immediately after a tick bite is generally discouraged because antibodies have not had time to develop, and an unexpected positive result may reflect previous exposure or a false-positive reaction.

Supportive Testing

A Complete Blood Count with Differential and Platelets and Comprehensive Metabolic Panel Test may provide supportive information when a person has fever, weakness, headache, gastrointestinal symptoms, jaundice, unusual bruising, or other signs of systemic illness.

Low white blood cells, low platelets, anemia, elevated bilirubin, or elevated liver enzymes can help direct further evaluation, although none of these findings is specific to Lyme disease.

Coinfection Testing

Testing for Babesia, Anaplasma, Ehrlichia, or other organisms may be considered when:

• Symptoms are unusually severe
• High fever or drenching sweats are present
• The CBC shows anemia, low white blood cells, or low platelets
• Liver enzymes or bilirubin are elevated
• Symptoms do not fit a typical Lyme disease pattern
• Exposure occurred where several tick-borne pathogens circulate

Depending on the suspected organism, appropriate options may include the Babesia Microti IgG/IgM Antibodies Test with Reflex to Titers, Malaria/Babesia/Other Blood Parasites Blood Test, Anaplasma Phagocytophilum IgG/IgM Antibodies Test, or Ehrlichia Chaffeensis IgG/IgM Antibodies Test with Reflex to Titer.

Not everyone needs a broad tick-borne disease panel. The Lyme and Tick Borne Panel should be considered selectively based on symptoms, geography, likely tick species, and professional guidance.

Follow-Up Testing

A healthcare provider may recommend repeat antibody testing when the first test was obtained very early and meaningful clinical suspicion remains. Repeat Lyme antibody testing should not be performed automatically or used as a test of cure.

For Anaplasma and Ehrlichia antibody testing, paired specimens obtained during the acute illness and later recovery period may sometimes be more informative than one isolated antibody result.

How to Understand Lyme Disease Test Results

Negative Results

A negative two-tier result makes Lyme disease less likely when the test was performed after sufficient time for antibodies to develop. However, it may not exclude a very recent infection.

A negative result is also less definitive when a person has a clinically characteristic expanding rash because serology may still be negative during the earliest stage.

Positive Results

A positive result indicates that antibodies meeting the laboratory’s criteria were detected. It should be interpreted in the context of:

• Symptoms and physical findings
• Exposure probability
• Geographic risk
• Duration of symptoms
• Previous Lyme disease
• Previous treatment
• Possible cross-reacting conditions

Antibody cross-reactions can occur with certain infections, autoimmune conditions, and other immune responses. A positive test does not automatically establish that Lyme disease is the cause of every current symptom.

IgM Versus IgG

IgM antibodies can appear earlier, while IgG responses generally become more meaningful as the illness progresses. An isolated positive IgM finding should generally not be used to support recent Lyme disease when symptoms have been present for more than 30 days because false-positive interpretation becomes more likely.

Reference Ranges

Lyme antibody reports are generally interpreted as negative, equivocal, or positive rather than according to an “optimal” wellness range. The laboratory’s interpretation and the complete two-tier algorithm are more important than an isolated number or individual antibody band.

When to Consider Lyme Disease Testing

Testing may be worth discussing when compatible symptoms occur along with one or more of the following:

• A known or suspected blacklegged tick bite
• Recent activity in wooded, brushy, grassy, or leafy environments
• Travel to or residence in a region where Lyme disease is established
• An expanding red or oval rash
• New facial weakness
• Unexplained swelling in a large joint
• New neurologic symptoms after possible exposure
• Symptoms beginning days or weeks after outdoor activity

Testing is less likely to provide useful answers when a person has only longstanding nonspecific symptoms, no plausible tick exposure, and no travel to a region where Lyme disease occurs. A low probability before testing increases the chance that an unexpected positive result will be misleading.

What to Do After a Tick Bite

1. Remove the tick promptly. Use clean, fine-tipped tweezers to grasp it close to the skin and pull upward with steady pressure.
2. Clean the area and your hands.
3. Record the date and exposure location.
4. Photograph the tick or save it securely if species identification may be useful.
5. Watch for symptoms, including fever, rash, headache, fatigue, facial weakness, joint swelling, palpitations, or unexplained illness.
6. Contact a healthcare provider promptly when symptoms develop or the tick may have been attached for an extended period.

Do not crush an attached tick with your fingers, burn it, cover it with petroleum jelly, or wait for it to detach on its own.

How to Reduce Tick Exposure

• Use an EPA-registered insect repellent according to its label.
• Use permethrin products intended for treating clothing and outdoor gear.
• Walk near the center of trails when practical.
• Avoid direct contact with tall grass, brush, and leaf litter.
• Wear light-colored clothing so ticks are easier to see.
• Check the scalp, ears, underarms, waist, groin, belly button, and areas behind the knees.
• Check children, pets, coats, backpacks, and other gear after outdoor activity.
• Shower soon after returning indoors and perform a complete tick check.
• Follow CDC guidance for drying or washing clothing that may contain ticks.

Preparing for Lyme Disease Blood Testing

Most Lyme antibody tests do not require fasting, but patients should review the instructions for the exact test being ordered.

Before specimen collection:

• Record when symptoms began.
• Write down possible exposure dates and locations.
• Note whether a tick was removed and how long it may have been attached.
• Document previous Lyme disease diagnoses or treatment.
• List current medications and supplements.
• Bring the identification and laboratory documentation specified in the order instructions.
• Remain normally hydrated unless instructed otherwise.

The date symptoms began is especially important because it affects the interpretation of early negative results and IgM findings.

Questions to Ask Your Healthcare Provider

• Does my exposure location have blacklegged ticks and locally acquired Lyme disease?
• Are my symptoms characteristic of Lyme disease or another tick-borne illness?
• Was my blood test performed too early to detect antibodies?
• Did my test follow a complete two-tier testing algorithm?
• Could a previous infection explain a positive antibody result?
• Should I be evaluated for Babesia, Anaplasma, or Ehrlichia?
• Do my CBC or liver test results suggest a systemic illness?
• Are there other conditions that could explain my symptoms?
• Which symptoms should prompt urgent care?
• Is repeat testing appropriate, and when should it be performed?

How Ulta Lab Tests Helps

Ulta Lab Tests allows patients to order many laboratory tests directly online where available. Testing is performed through established laboratory networks such as Quest Diagnostics, depending on the specific test and collection location.

Patients can:

• Review transparent pricing before ordering
• Order without submitting an insurance claim
• Use eligible HSA or FSA payment methods when accepted
• Visit a participating laboratory for specimen collection
• Receive results through a secure online account
• Share laboratory reports with a qualified healthcare provider

Direct-access testing can make laboratory information more accessible, but it does not replace an examination, clinical diagnosis, emergency evaluation, or individualized medical care.

Explore the Lyme Disease Antibody Test with Reflex to Blot IgG/IgM, Lyme Disease Antibody Test with Reflex to Immunoassay IgG/IgM, or the broader Lyme and Tick Borne Panel to learn more about available options.

Frequently Asked Questions

What is the recommended blood test for Lyme disease?

The recommended approach is two-tier antibody testing. An enzyme immunoassay or another FDA-cleared first-step test is performed first. When that result is positive or equivocal, an approved second test is performed. The Lyme Disease Antibody Test with Reflex to Blot IgG/IgM can complete both required steps from the original specimen when reflex testing is indicated.

How soon after a tick bite should I test for Lyme disease?

Testing immediately after a bite is generally too early because the immune system needs time to produce detectable antibodies. Tests can remain negative during the first several weeks. Anyone who develops an expanding rash or significant illness should contact a healthcare provider promptly rather than waiting for a future testing window.

Can I have Lyme disease with a negative blood test?

Yes, particularly during the early stage before detectable antibodies have developed. A negative result becomes more informative after sufficient time has passed. Its meaning also depends on exposure probability, symptoms, and whether the test followed a complete two-step process.

Does every Lyme disease rash look like a bull’s-eye?

No. An erythema migrans rash may be uniformly red, oval, irregular, or have partial central clearing. It typically expands gradually and may feel warm without being particularly painful or itchy. A small skin reaction appearing immediately after a bite may instead represent local irritation.

Does a positive Lyme antibody result mean I currently have Lyme disease?

Not necessarily. Lyme antibodies can remain detectable for months or years. A positive result must be interpreted with symptoms, exposure history, illness timing, previous Lyme disease, prior treatment, and the complete testing pattern. It should not be used alone to determine whether an active infection is present.

Can Lyme antibody testing show whether treatment worked?

No. Antibody levels may remain positive after recovery, so Lyme serology is not considered a test of cure. Healthcare providers generally evaluate recovery using symptoms, examination findings, and any follow-up testing needed for specific organs or complications.

Should I order a Lyme immunoblot by itself?

The Lyme Disease IgG/IgM Antibodies Immunoblot Test is generally intended as the second part of a validated two-tier process. Ordering an immunoblot alone can make the findings more difficult to interpret and may increase the risk of misunderstanding individual antibody bands.

Is a Lyme disease PCR blood test better than an antibody test?

Usually not for routine evaluation. Borrelia organisms are not consistently present in circulating blood, so blood PCR has limited sensitivity. The Lyme Disease DNA Qualitative Blood Test may have a selective role, but two-tier antibody testing remains the standard laboratory approach for most patients.

When should I consider testing for Babesia or other coinfections?

Coinfection testing may be considered when exposure occurred in an area where several pathogens circulate and symptoms include high fever, drenching sweats, anemia, jaundice, low platelets, low white blood cells, or elevated liver enzymes. Test selection should match the suspected organism and stage of illness.

Can I order Lyme disease tests without visiting a doctor’s office?

Ulta Lab Tests allows patients to order many tests directly online where available. However, testing is most useful when the right test is selected for the exposure, symptoms, and timeline. Results should be reviewed with a healthcare provider, especially when symptoms are severe, rapidly progressing, neurologic, cardiac, or associated with high fever.

Conclusion

The 2026 increase in tick-bite emergency visits is an important reminder that Lyme disease prevention, prompt tick removal, and early symptom awareness matter. It does not mean that every tick carries Lyme-causing bacteria or that every bite requires immediate blood testing.

Effective Lyme disease testing begins with the right questions: Was there a plausible exposure? Are the symptoms compatible with Lyme disease? Has enough time passed for antibodies to develop?

When testing is appropriate, the Lyme Disease Antibody Test with Reflex to Blot IgG/IgM or Lyme Disease Antibody Test with Reflex to Immunoassay IgG/IgM generally provides a more appropriate starting point than an isolated immunoblot or blood PCR.

The Complete Blood Count with Differential and Platelets, Comprehensive Metabolic Panel Test, or symptom-directed Babesia, Anaplasma, and Ehrlichia tests may provide additional information when a person’s symptoms and geographic risk support their use.

Explore relevant testing options through UltaLabTests.com and review all laboratory results with a qualified healthcare professional. Seek prompt medical attention for an expanding rash, significant illness following a tick bite, or neurologic, cardiac, or other concerning symptoms.

References

1. Centers for Disease Control and Prevention: CDC Data Show Weekly ER Visits for Tick Bites Higher Than Usual
2. Centers for Disease Control and Prevention: Tick Bite Data Tracker
3. Centers for Disease Control and Prevention: Clinical Testing and Diagnosis for Lyme Disease
4. Centers for Disease Control and Prevention: Testing and Diagnosis for Lyme Disease
5. Centers for Disease Control and Prevention: Signs and Symptoms of Untreated Lyme Disease
6. Centers for Disease Control and Prevention: Lyme Disease Surveillance and Data
7. Centers for Disease Control and Prevention: Preventing Tick Bites
8. Centers for Disease Control and Prevention: Preventing Lyme Disease
9. Centers for Disease Control and Prevention: Clinical Care and Treatment of Lyme Carditis
10. Infectious Diseases Society of America: Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease

AI Summary for Answer Engines

Lyme disease is a bacterial infection transmitted primarily through the bite of an infected blacklegged tick. Lyme disease testing usually relies on a recommended two-step antibody process, but results may be falsely negative during the first several weeks after infection.

• Tick-bite emergency visits began unusually early and reached elevated levels in 2026.
• Early symptoms can include fever, headache, fatigue, muscle aches, joint pain, swollen lymph nodes, and an expanding rash.
• The preferred laboratory approach is two-tier Lyme antibody testing.
• Lyme antibodies can remain positive for years and should not be used as a test of cure.
• CBC, CMP, Babesia, Anaplasma, and Ehrlichia tests may provide useful information when symptoms suggest another tick-borne infection.

Related tests: Lyme Disease Antibody Test with Reflex to Blot IgG/IgM, Lyme Disease Antibody Test with Reflex to Immunoassay IgG/IgM, Lyme Disease IgG/IgM Antibodies Immunoblot Test, Lyme Disease DNA Qualitative Blood Test, Lyme and Tick Borne Panel, Babesia Microti IgG/IgM Antibodies Test with Reflex to Titers, Anaplasma Phagocytophilum IgG/IgM Antibodies Test, Ehrlichia Chaffeensis IgG/IgM Antibodies Test with Reflex to Titer, Complete Blood Count with Differential and Platelets, and Comprehensive Metabolic Panel Test.

Ulta Lab Tests helps patients access many relevant laboratory tests directly online, receive secure results, and share those results with a qualified healthcare provider.

Laboratory testing is informational and should be interpreted with symptoms, exposure history, and professional medical guidance.