Lyme Disease is often misunderstood and misdiagnosed so here is some information that should help reassure you as well as guide you as to when you should seek medical attention.
What is Lyme Disease?
Many people know that Lyme is a disease spread by tick bites – but what is less commonly know is that not all ticks carry the bug that causes Lyme disease. Deer ticks are the culprits – and most cases of Lyme disease in the U.S. occur in the Northeast (from southern Maine to northern Virginia.) The disease was initially identified in the 1970s in Lyme, CT – thus it’s name. But the actual name of the bacteria that causes the disease is called Borellia burgdorferi.
Lyme Disease can occur in people of all ages – but children aged 5 to 9 years are most at risk, partially because they are the most likely to be exposed to ticks. Such places include wooded areas, marshes, high grasses and gardens. Which means – kids that are camping, hiking, digging, gardening and frankly, just being kids – are exposed. And because deer ticks are extremely small – about the size of a poppy seed – they can be hard to spot!
But don’t worry – despite a lot of misinformation that gets passed around about this disease, Lyme Disease is actually not all that common and is quite easy to diagnose and to treat!
What are the symptoms?
To diagnose – and to treat – Lyme Disease, one must be able to recognize the symptoms:
In the early stages of Lyme Disease (typically 3-30 days following a tick bite), 70-80% will develop a rash at the site of the bite. The rash is very distinctive and very characteristic – it is circular and red with slightly raised borders and pale in the center – often resembling a “bull’s-eye”. If untreated, the rash will expand over several days then usually resolves on it’s own. The rash gradually expands over several days and can reach up to 12” in diameter. Keep in mind, the ticks that transmit Lyme are typically so small that most people don’t even know a tick has bitten them – so if you see this rash, call the doctor – even if you never saw the tick!
Along with the rash, other symptoms may develop, including, fever, headache, muscle and joint aches, fatigue, swollen lymph nodes and mild neck stiffness.
Less commonly, other symptoms may develop up to 2 months later, including temporary paralysis of the facial muscles (Bell palsy), meningitis, pain and swelling in large joints such as the knee and carditis (inflammation in the heart resulting in abnormal heart rhythms which can cause dizziness)
How to diagnose Lyme?
Making a diagnosis of Lyme disease depends largely on whether your child:
1) Lives in or has travelled to an area where Lyme disease is prevalent; and 2) has symptoms consistent with Lyme Disease. The rash is enough to make the diagnosis without further testing, but many of the other symptoms of Lyme can overlap with other illnesses. There are blood tests that can be done to help clinch a diagnosis, however, these tests require that several weeks have elapsed since the initial tick bite – and even then, the tests are typically unreliable. Therefore, these tests should not be performed to “screen” children with vague and non-specific symptoms. Additionally, many people that live in an area where Lyme disease is prevalent may have a positive test – but will be disease-free. And many people that have had Lyme Disease and have been cured with appropriate treatment may still have positive tests. This is not unique to Lyme – in fact, many other diseases that kids get (or get vaccinated against) such as chickenpox, measles and mumps will have a “positive” test even after the disease has resolved. It is also NOT recommended to have the tick itself tested for Lyme as even if it tests positive for Lyme that does not mean that Lyme was transmitted. Similarly, negative results can lead to false reassurance as you may have unknowingly been bitten by a tick that was carrying Lyme. Also, if you have contracted Lyme you should typically develop symptoms before results of the test would be available
How to Treat Lyme?
There is no need to be fearful of Lyme Disease as the treatment is very effective with the appropriate antibiotics! Though the type and duration of antibiotics depends on what symptoms your child has.
How do I reduce my child’s risk of getting Lyme Disease?
- If you have a home in a Lyme-Disease area, you can reduce the number of ticks in the vicinity by keeping your grass short and removing leaf litter and woodpiles in your yard. Clear trees and brush in your yard to reduce the likelihood that deer, rodents, and ticks will live there.
- If your child spends time in a tick-infested area, he should wear light, protective clothing. ** This is actually the BEST way to protect against Lyme**! Long sleeve shirts, long pants, socks, shoes and hats. Tuck pants into socks and tuck shirts into pants. Light-colored clothing helps to keep kids cooler in the warm weather – but also makes it easier to spot ticks that may be hanging onto clothes.
- Clothes and bags that were outside can go in the dryer on high-heat for about an hour to kill any unseen ticks that may be clinging to the material.
- Do REGULAR tick checks! Check your children for ticks after they have spent time in a tick-infested area. Don’t forget to look on the scalp, under the arms, in the belly-button, in the groin, between the toes and behind and in the ears!
If you find a tick: Remove ticks promptly! Using blunt tweezers to grasp the tick as close to the skin as possible and pull straight up with steady pressure. Don’t twist or jerk the tick; this can cause the mouthparts to break off and remain in the skin. If this happens, remove the mouthparts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water. Do NOT: burn the tick, use nail polish remover or petroleum jelly to cover it – these myths about tick removal may actually make things worse – not better!
- Pets can bring ticks indoors too – so if you have pets that go outside, remember to check them daily for ticks too! Remove them from your pet as described above.
- Insect repellents can be used – though they only provide temporary and minimal protection. Do not put repellent on your child’s face, hands, or any irritated skin or open sores. Once your child returns indoors, wash the sprayed areas of the skin with soap and water to minimize how much of gets absorbed through the skin.
When Lyme Disease is diagnosed and treated appropriately, the outcome is excellent! So don’t be afraid to get outside with your children and enjoy the great outdoors! Just remember if you spend time in a Lyme Disease area to be diligent about keeping yourself and your kids covered with light, long clothing and check yourself, your children and your pets daily for ticks!
And of course, call us with any questions or concerns!
2) “Principles and Practice of Pediatric Infectious Diseases: Lyme Disease”, Shapiro, E.
3) http://www.healthychildren.org/English/health-issues/conditions/from-insects-animals/Pages/Lyme-Disease.aspx and