May was National Lyme Disease Awareness Month, and for families that live in areas where Lyme is prominent, it’s a top concern for Spring and Summer. [The Vector Control Program in San Diego County notes, “Although Lyme disease is reported across the U.S. and in most counties in California, it is rare in San Diego County.” However, if your summer plans include travel to areas where Lyme is prevalent, now’s a good time to learn ways to keep your family safe.] The good news? Preventing Lyme disease is relatively straightforward. “The best way to prevent Lyme disease is to avoid tick bites. Wearing long-sleeved shirts and pants and using an appropriate insect repellent or insecticide when outdoors can prevent tick exposure. Bathing or showering shortly after outdoor exposures also reduces the likelihood of tick attachment and allows for careful examination of the skin for any attached ticks or rashes,” advises Kristin Moffitt, physician in infectious diseases at Boston Children’s Hospital.
If you do pull a tick off your child? Don’t panic—or necessarily rush for antibiotics. “Ticks need to be attached for at least 24 hours to transmit the bacteria that causes Lyme disease, so daily skin exams can help prevent infection,” says Dr. Moffitt. Your pediatrician can usually identify if the tick is male (which does not transmit Lyme) or female, and some towns in higher-risk areas have testing programs.
“Remove the tick as soon as possible using clean, fine-tipped tweezers and pulling upward with steady, even pressure,” recommends Dr. Amy Beeson, pediatrician and internal medicine physician and current Epidemic Intelligence Service Officer with CDC’s Bacterial Diseases Branch in the Division of Vector-Borne Diseases.
While antibiotics aren’t always warranted even if you are bitten, you should have a conversation with your pediatrician that will include determining risk of transmission based on your region. “In areas where Lyme disease is common, if you are bitten by a deer tick and a couple of days pass before the tick is noticed and removed, you may be eligible for preventive treatment with a single dose of the antibiotic doxycycline. This is effective to prevent Lyme disease after a high-risk bite when it is taken within 72 hours of tick removal,” says Dr. Beeson. She adds that the CDC has developed a free and easy-to-use online tool called the Tick Bite Bot to assist in removing attached ticks and deciding when you need to see a healthcare provider after a tick bite.
If your child is bitten and shows symptoms, or simply has symptoms of Lyme, it is a clearer indicator that testing and/or treatment is needed. The most common? A bulls-eye rash. “The rash usually occurs at the site of the tick bite and can develop anytime from 3 to 30 days after a tick bite (usually about a week after a bite),” says Dr. Beeson.
Lyme can be sneaky, though, and sometimes there is no rash present, but an illness that seems like a flu. “Other signs and symptoms of early Lyme disease can include fever, fatigue, headache, muscle or joint aches, and swollen lymph nodes,” says Benson.
Unfortunately, more advanced Lyme has more serious effects on the body. “If early Lyme disease is unnoticed or untreated, Lyme disease can go on to cause other problems, including heart problems which can show up as dizziness, shortness of breath, or passing out; neurologic problems such as facial nerve palsy, which can cause facial asymmetry; or joint problems, which can cause joint pain and swelling, particularly in the knees and other large joints. These can occur from days to months after a tick bite,” says Dr. Beeson.
Luckily, treatment for Lyme disease is simple. “Lyme disease is typically treated with a 2- to 4-week course of oral antibiotics, most commonly doxycycline. Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely,” says Moffitt. But remember the common (and more sneaky) symptoms of Lyme, and fill your doctor in on any potential exposure to deer ticks—especially if you’ve been traveling to an area in which they’re more common than where you live.
For more information visit the CDC Lyme Disease page.