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The incubation period from infection to the onset of symptoms is usually one to two weeks, but can be much shorter (days), or much longer (months to years).

Early localized infection can occur when the infection has not yet spread throughout the body.

If untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pains, severe headaches with neck stiffness, or heart palpitations, among others.

Months to years later, repeated episodes of joint pain and swelling may occur.

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