Lyme Disease is said to affect more people in the U.S. than HIV, AIDS and even breast cancer. Early symptoms range from flu-like pain and exhaustion, to localized paralysis and memory loss. A startling 40% of those who contract Lyme disease, however, will suffer long-term complications, too—such as infertility, debilitating joint pain, daily fatigue, even depression. If not detected and treated early, Lyme can lead to permanent neurological impairment, heart damage and, in rare cases, even death. Here are 9 more frightening things you might not know about Lyme disease:

1. LYME-CARRYING TICKS CAN BE THE SIZE OF THE PERIOD AT THE END OF THIS SENTENCE.

Ticks have four life stages: egg, larvae, nymph, and adult. Although not fully developed at the nymph stage, these immature ticks can still spread Lyme disease. Worst yet, nymphs are essentially invisible. For perspective, the average nymph is smaller than the size of a grain of salt or pepper, smaller even than a pinhead (approximately 4/100 of an inch).

2. THIS COULD BE THE WORST YEAR FOR LYME DISEASE WE'VE EVER SEEN

The CDC reports that on average the United States experiences 330,000 new cases of Lyme disease each year—that’s 38 cases per hour. And those figures are only getting worse. Since 1982, the number of reported cases has increased 25X—that’s 2,500%!

3. LESS THAN 20% OF LYME DISEASE SUFFERERS DEVELOP THE INFAMOUS BULL'S EYE RASH

The most well known Lyme disease symptom is the bull’s eye rash. In fact, most people use this symptom to tell whether they’ve contracted the disease or not. However, only about 20% of people with Lyme ever develop this rash.

4. CHILDREN ARE MOST AT RISK

As scary as Lyme disease can be, the thought that children are at the highest risk of contracting the disease is even worse. The CDC reports those between the ages of 3-14 are the most likely to suffer from Lyme. The elderly are the second most vulnerable.

5. ON AVERAGE, IT TAKES 2-3 YEARS TO PROPERLY DIAGNOSE LYME DISEASE

Lyme disease is often called ‘The Great Imitator’ because of how difficult it is to accurately identify. Its wide array of symptoms often leads to misdiagnosis. In fact, it’s not uncommon for Lyme sufferers to visit several doctors before a correct diagnosis is made.

"My patients have usually been around the block by the time I assess them—this means dozens of physicians, prescriptions, and misdiagnoses," says Neurologist and Clinical Neurophysiologist Dr. Elena Frid.

6. LYME MEDICATIONS CAN CAUSE EVEN MORE PAIN THAN THE DISEASE

Although relatively uncommon, about 15% of patients seem to experience an adverse side effect to Lyme antibiotics called the Jarisch-Herxheimer reaction. As the medication begins to eliminate Lyme bacteria, the disease responds by releasing inflammation-causing proteins. Flu-like symptoms—fever, aches, chills—and both acute and general pain often result. While only lasting a short time, this reaction can leave you bed ridden for days.

7. LYME DISEASE AFFECTS EVERY STATE IN THE U.S.

Think because you live in the South you’re safe from ticks? Think again. Although over 90% of Lyme cases occur in the Northern U.S., cases have been reported in all 50 of the United States. In fact, contracting Lyme disease in Southern regions can be even worse since the disease is far more likely to be misdiagnosed.

8. LYME DISEASE CAN LEAD TO DEPRESSION, BRAIN FOG, AND PSYCHOSIS

While temporary memory loss and lowered cognitive function are common symptoms in those with lyme disease, long-term symptoms can be much worse. Brain fog, life-threatening depression, and psychosis have all been linked to Lyme disease. These symptoms are sometimes said to last for as long as a decade.

9. TESTING FOR LYME DISEASE IS OFTEN UNRELIABLE

The Elisa test is perhaps the most administered test for Lyme disease across the country. Unfortunately, reports indicate 35% of tests report a false negative. Other sources have shown upwards of 70% of all blood tests for Lyme result in either false negatives or false positives.

Corinna Henderson