Ticks and Lyme: What you need to know for your kids
By: Jennifer Shaer, M.D., Eric Levene, M.D., Kerry Fierstein, M.D.
There has been a lot in the news recently about ticks and tick-borne infections, particularly Lyme disease. The CDC has warned that this summer ticks will be at an all-time high. So what can you do to protect your kids from Lyme and other tick-borne infections?
As with most things, the best treatment is prevention. The first and most obvious step is to try to avoid tick bites at all. That means avoiding high grass areas, keeping your body covered, and using insect repellants. The American Academy of Pediatrics and Centers for Disease Control recommend the use of 10%-30% DEET for all children over two months of age. There are different types of insect repellent. The following link discusses the differences and positive and negatives of each. It also discusses how to apply the insect repellent safely. https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx
However, despite your best efforts, a tick or two is likely to find your kids this summer. There are many different ticks out there but it is the deer tick that can carry the bacteria that causes Lyme. Keep in mind that an infected tick needs to be attached for over 36 hours to transmit infection. So your second line of defense is to check your kids for ticks daily. Don’t forget behind the ears, in the armpits, groin, belly button, and in the hair.
If you find a tick on your child, don’t panic. Remove it immediately with a tweezer. Do not use a smoldering match, nail polish, petroleum jelly (eg, Vaseline), liquid soap, or kerosene because they may irritate the tick and cause it to behave like a syringe, injecting bodily fluids into the wound. Don’t worry if a small piece of the tick gets left behind. Any small pieces left behind cannot transmit disease. After removing the tick, wash the skin and hands thoroughly with soap and water. Not all deer ticks carry the bacteria that cause Lyme and even if the tick is infected, not all tick bites will go on to cause disease in the bitten child. Testing the deer tick does not help predict infection and is not recommended.
Your next line of defense is to recognize the signs and symptoms of Lyme because when children are diagnosed, Lyme gets better with antibiotics. Even if you don’t remember a tick bite your child could still have Lyme disease. Typically it is not the tick you find that causes an infection, it is the tick that attaches, feeds, and falls off before you’ve even noticed it. Living or visiting a high-risk area puts your child at high risk for Lyme disease.
Early signs of Lyme include the classic circular rash that you should get familiar with and generalized, flu-like symptoms. The rash can occur 3-30 days after a tick bite. Later signs include multiple circular rashes, joint pain and swelling, and rarely neurologic problems like a facial droop also known as Bell’s palsy.
If your child has symptoms of Lyme, see his pediatrician for an evaluation. Making a diagnosis of Lyme with blood work can be misleading and routine testing is not recommended. Early in the course of disease the blood test can be negative. In addition, after successful antibiotic treatment, the blood test can remain positive for many years or may never even turn positive if the disease was treated early on. Unfortunately, having Lyme once does not protect you from getting it a second time. Your child’s pediatrician will help make the diagnosis and treatment plan based on a combination of a detailed history, physical exam, and blood work when needed.
Finally, sometimes your pediatrician will consider a prophylactic dose of an antibiotic after a tick bite. If a tick has been attached to your child for over twenty-four hours, go see your pediatrician to discuss the pros and cons of this approach. A prophylactic dose needs to be given within seventy-two hours of a bite so don’t wait too long. This is not typically recommended for children under 8 years of age.
Thankfully most cases of Lyme in children respond very well to antibiotics. If your child has been treated for Lyme and still feels sick, something else could be causing his symptoms. Schedule an appointment with his pediatrician for a complete exam.
Have a great summer, enjoy the outdoors but be on the lookout for ticks!