Tick Bites and Lyme Disease
That time of the year has come again when we inspect our children after they have played outside searching for the elusive deer tick. There is still a great deal of misunderstanding, and misinformation about how you get and how you treat Lyme Disease. In fact, two infectious disease specialists from UCONN evaluated the accuracy of 19 Lyme Disease web sites. They found only 10 of the 19 gave accurate information. 7 of 8 web sites that used "Lyme" in their title had inaccurate information. They did find that the two web sites with ".gov" both gave accurate information. We hope to dispel some myths and give you solid and up-to-date advice on this issue.
Let's talk about the tick first. The adult deer tick or Ixodes dammini spends the winter most commonly on the white-footed mouse and occasionally on the white-tailed deer. In the spring the adults are active and feed. They lay their eggs and in the summer the eggs hatch into larvae. Interestingly the larvae are not born infected but they become infected when they feed on an infected mouse or deer during the next winter. The next spring the larvae change into the nymph stage. It is this stage in a tick's lifecycle that causes most of the problems, as the nymph appears to be very proficient at transmitting Lyme disease. The ticks, whether they are the nymph or adult, climb to the top of tall grass blades and are sensitive to vibrations from oncoming people or animals. They latch onto whatever comes by and will instinctively climb to a high point on the body. When they find a spot to feed on they will actually bury their mouthparts into the skin and then cement themselves to you-which is why it is so tough to remove them intact. The ticks need to be attached for about 36 hours before they effectively transmit the organism that can cause Lyme Disease. In general the female adult deer tick is orange in color, about the size of a sesame seed, the adult male is black and somewhat smaller, and the nymph is black, much smaller ,about the size of a poppy seed. The more common dog tick, which does not carry Lyme Disease is brown with a stippled white back and half the size of a watermelon seed.
When you find a tick on or in your child-don't panic, you can safely remove it at home. If the tick is not engorged or not embedded in the skin try to identify it and then destroy it. When an embedded tick is found there is only one effective method of removal - using a pair of small tweezers grasp the tick as close to the child's skin as possible and pull upward slowly. You might leave the mouthparts behind - that is okay and unavoidable at times. Please do not coat the tick with Vaseline or use a hot match head to attempt to remove the tick. These methods do not work, may make further removal difficult and could be harmful. The bite area should be observed for the next 30 days watching for a very distinct expanding red rash that may look like a bulls-eye.
The majority of children who develop Lyme will have the rash, so it is important to be on the lookout for it. Other symptoms of early Lyme Disease are flu-like symptoms such as fever, headache, chills, and muscle and joint pain. Fatigue in the absence of other symptoms is not considered Lyme Disease in children by most experts. If your child develops the rash or the symptoms listed above with or without a recent tick bite then it becomes important for the child to be examined by one of our providers. The symptoms listed above do not constitute an emergengy and we will be happy to schedule an office visit for you. Lyme Disease treated at this stage with 14-21 days of Amoxicillin or Doxycycline is unlikely to result in further complications like arthritis or Bells Palsy. Children can have long term effects, but they are uncommon. It is not always reasonable, however, to start antibiotic treatment after a tick bite without the rash or other symptoms. Studies have shown little or no benefit for this method of treatment.
The best way to avoid Lyme Disease is prevention. Prevention is very tedious and time consuming but will pay off. When your kids go out into the woods or your yard to play (ticks like to stay around the junction between grass and woods, they also love rock walls) make sure they are wearing light colored long pants. Parents keep telling us long pants are impractical in the summer because kids get hot. We keep saying that the kids could care less what they wear. The bottom line - if you have ticks in the vicinity where your children play you had better make sure they wear long pants and that the shoes, socks and pants, not the skin, are sprayed with a tick repellent containing DEET. After a long hard day of play it is important to inspect the children for embedded or crawling ticks and remove them promptly. It is an excellent idea to practice the tick removal method described above on your cats and dogs.
Lyme Disease will continue to be a controversial topic as long as there are individuals and organizations who continue to pass along incorrect information and prescribe needless and potentially harmful treatments. Complications can and do occur, but vigilance, cooperation and education are essential ingredients in helping to prevent and treat Lyme Disease.
Helpful links for this topic;
(as mentioned above be very careful-there is a tremendous amount of misinformation on the internet)
American Lyme Disease Foundation
Centers for Disease Control and Prevention