St. Mary's County Warns of 62 Lyme Cases as Tick Season Raises Alpha-Gal Risk

Q: With Lyme disease tests failing most early cases, how can you know if you're truly infected after a tick bite?

You usually cannot know for sure from an early Lyme test alone. In the first days to weeks after a tick bite, Lyme is often diagnosed clinically — from the bite history, the type of tick exposure, and symptoms — because standard antibody tests can miss most early infections. The clearest early sign is an expanding red rash, called erythema migrans, appearing days to a month after the bite. It is not always a classic bull’s-eye; it may simply spread outward and often does not itch or hurt. Taking daily photos can help show whether it is enlarging. Many early cases also look like a summer virus, with fever, fatigue, headache, chills, body aches, joint pain, or swollen lymph nodes. A runny nose or strong cough is less typical for Lyme. Risk also depends on the tick and how long it was attached. Lyme is mainly spread by black-legged ticks, and transmission usually becomes more likely after roughly 36 to 48 hours of attachment. Removing a tick promptly lowers the risk, though other tick-borne illnesses can spread faster. If you develop a spreading rash or flu-like illness within about 1 to 4 weeks after a bite, doctors generally advise seeking care promptly rather than waiting for a positive test. In some high-risk black-legged tick bites, a clinician may consider a preventive antibiotic dose within 72 hours of tick removal. If early testing is negative but suspicion remains high, repeat testing later may be needed.

2 articles · Updated · Bay Net · Jul 1

St. Mary’s County health officials warned residents that tick season has intensified with summer outdoor activity, urging prevention and early symptom checks rather than avoiding parks, yards and trails.
62 Lyme disease cases were reported in the county in 2025, and officials said that likely understates infections; Lyme remains the area’s most commonly reported tick-borne illness.
3 Rocky Mountain spotted fever cases had already been recorded in early 2026—matching the county’s typical annual total—while doctors also reported rising patient questions about Alpha-gal syndrome linked to lone star ticks.
Alpha-gal is not a reportable disease in Maryland, despite St. Mary’s having one of the state’s highest rates of alpha-gal-specific lab findings, prompting the county to ask the state to add it to the reporting list.
EPA-registered repellents, long clothing, prompt tick removal, showering after outdoor activity and checking children and pets were the main precautions, with officials advising medical care for fever, rash, aches or delayed allergic reactions after red meat.