Lyme Disease

What to Look For | Getting Treated | Keeping Your Kids Safe

Lyme disease is caused by the bacteria Borrelia burgdorferi and is transmitted from the bite of a deer tick. Deer ticks are much smaller than your typical dog tick — approximately the size of a poppy seed — and are brown.

“If you find a deer tick on your child, the first thing to do is observe whether the tick has become engorged,” explains Milagritos Tapia, M.D., associate professor of pediatrics. “An engorged tick is one whose body has become large from feeding on the child. That’s important because it will speak to risk of the bite.” If a physician visit becomes necessary, you’ll be asked whether the tick was engorged. 

After examining the tick, the next step is to remove it. Use tweezers to grasp the head or mouthparts of the deer tick — not the body — and pull firmly and steadily outward.

Not all deer ticks are cause for concern. “You don’t need to call your doctor every time you find a tick,” says Dr. Tapia. “If a tick wasn’t even attached or engorged, there is no issue. We know from studies that the tick has to be attached for at least 24 hours in order for there to be a risk of transmission. So, if you check your children daily and didn’t find anything yesterday and you find something today, chances are that doesn’t mean much. That’s why a daily check is a good idea.”

What to Look For

  • Rash at the site of the bite
  • Flu-like symptoms
  • Pain or swelling of the joints
  • Heart palpitations
  • Light headedness
  • Chest pain
  • Facial droop

“It takes about three days to see any initial symptoms of Lyme disease,” says Dr. Tapia. “The first sign is generally a rash at the site. But, it’s important to note that you can easily provoke a rash at the site when you remove the tick. So, if you remove a tick, and there’s some redness there that day, it probably doesn’t mean anything. If there is a new rash or it enlarges three to seven days after a tick was present, that’s when you should seek medical attention.”

“There are different syndromes that can develop based on where the Lyme disease spreads — such as meningitis syndrome and arthritis syndrome,” explains Dr. Tapia. “With the meningitis syndrome, children often experience a stiff neck and headaches." 

Getting treated

When Lyme disease is caught in the very early stage, with a simple rash, your pediatrician may decide not to do a blood test and instead begin treatment right away.

Treatment varies depending on how the Lyme disease has presented itself in the child. If it is early on in the disease, treatment involves prescription oral antibiotics, typically doxycycline, amoxicillin and cefuroxime. Your child may also be prescribed a nonsteroidal anti-inflammatory drug, such as ibuprofen or naproxen, for symptoms of pain and inflammation. Children treated for early-stage Lyme disease generally recover rapidly and completely. If a child has later-stage Lyme disease, he or she may require intravenous (IV) antibiotics, and the treatment takes a bit longer, generally between 14 and 28 days. Specific treatments are determined by the areas of the body to which the Lyme disease has spread.

Keeping your kids safe

  • Check for ticks after outdoor play or during bath time. Pay special attention to the scalp and even covered areas of skin.
  • Wear long sleeves and pants, weather permitting.

Remember, it’s not just in the woods that ticks may lurk. “One of my more recent patients who had Lyme disease was a Baltimore city child who frequented a local park,” says Dr. Tapia. “That’s not something that we’re used to seeing, but it can of course happen. In general, if they’re going out to the park, children should wear long pants and long sleeves if weather permits. Insect repellent also helps keep ticks away. But the best defense is to do ‘tick checks’ on your child after play is over.”