Justin Timberlake recently revealed he had been battling Lyme disease for months before receiving a proper diagnosis. The 44-year-old singer, currently on his two-year Forget Tomorrow world tour, initially dismissed the fatigue and body pain as effects of ageing and a demanding schedule. However, his experience turned out to be a case of Lyme disease — a tick-borne illness known to cause symptoms such as nerve pain, chronic fatigue, cognitive difficulties, and long-term complications if left untreated.
Interestingly, Justin isn’t the only celebrity to have battled this illness. Others, including Justin Bieber, Bella Hadid, Avril Lavigne, and Amy Schumer, have publicly shared their struggles with Lyme disease. But this raises an important question: should people living in tropical regions like India be concerned?
What is Lyme disease?
“Lyme disease is a bacterial infection caused by Borrelia burgdorferi, transmitted through the bite of infected black-legged ticks, commonly called deer ticks. It is the most frequently reported tick-borne illness in North America and parts of Europe, but it’s relatively uncommon in India,” explains Dr Shraddha Sanghani, consultant, internal medicine at Renova Century Hospitals.
Dr Shivaraju, senior consultant – physician & diabetology, KIMS Hospitals, Secunderabad, says, “In India, Lyme disease is sometimes associated with the Ixodes tick found in the Himalayan region, but this is not definitive.”
Signs and symptoms
According to Dr C Hemanth, senior consultant – general medicine, CARE Hospitals, Hitec City, the most common early sign of Lyme disease is a red, circular rash resembling a bull’s-eye, known as erythema migrans. Other early symptoms include fever, body aches, fatigue, and headaches.
“If not treated early, the infection can spread to the joints, heart, and nervous system, leading to more severe and long-term issues. Fortunately, Lyme disease can be effectively treated with antibiotics if diagnosed early. Most people recover completely, though delayed treatment can result in persistent symptoms like joint pain and tiredness,” he says.
Dr Hemanth also notes that with increasing international travel and changes in climate, a few isolated cases are being reported in India. “While the risk remains low here, awareness is key, especially for those who travel to regions where Lyme disease is prevalent or spend time in wooded or grassy areas,” he notes.
Preventive measures
If you’re planning outdoor activities such as trekking or camping, especially in areas known for Lyme disease, here are precautions you should take:
Wear long sleeves and tuck pants into socks.
Use insect repellent on exposed skin and clothing.
After returning indoors, inspect your body for ticks — especially in warm, hidden areas like behind the knees, underarms, groin, and scalp.
If you find a tick, remove it gently with tweezers and clean the area thoroughly.
“Anyone who develops flu-like symptoms or a rash after a possible tick bite should seek medical attention promptly,” advises Dr Hemanth, adding that early treatment can prevent complications.”
How it spreads
Dr Shraddha explains that for Borrelia bacteria to enter the bloodstream, an infected tick must remain attached to the skin for 36–48 hours. “Nymph-stage ticks, which are very small and hard to detect, are mainly responsible for most infections. Once inside the body, the bacteria can affect multiple systems — skin, joints, heart, and nervous system — and the disease progresses in stages,” she shares.These include:
Early localised stage (3–30 days post-bite): Often marked by the erythema migrans rash in 70–80% of cases.
Disseminated stage (weeks to months later): May involve facial palsy, meningitis, Lyme arthritis (especially in knees), or heart arrhythmias (Lyme carditis).
Late stage: Can cause chronic neurological or joint issues, sometimes termed post-treatment Lyme disease syndrome.
It’s important to note that antibodies take time to develop Testing too early might result in a false negative, which is why doctors sometimes rely on symptoms and clinical judgement for early treatment decisions. While Lyme disease remains rare in India, it’s important to stay informed, especially if you’re an avid traveller or nature lover. With awareness, preventive steps, and timely treatment, the risks can be managed effectively
How Lyme disease is diagnosed
Dr Shraddha explains that diagnosis is based on clinical suspicion, exposure history, and lab testing:
Clinical diagnosis: In early cases with the classic rash, doctors may diagnose based on physical symptoms alone
ELISA (Enzyme-Linked Immunosorbent Assay): A blood test that detects antibodies against Borrelia burgdorferi. It is sensitive but can give false positives
Western blot test: Used to confirm ELISA results by detecting specific antibodies. A positive Western blot confirms the diagnosis