Caused by infection by Borellia, mainly B. burgdorferi, B. afzelii and B. garinii, but other strains have been included because they may also cause problems, many of which are probably not medically documented. Borrelia is transmitted to humans by the bite of infected ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system.

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