Lyme disease: What parents should know

family bikingAlong with longer, sun-filled days, the arrival of summer ushers in some seasonal hazards for kids, like tick bites. Although most tick bites don’t cause serious illness, those from the blacklegged tick (often called the deer tick) can, in some cases, cause Lyme disease. Particularly when detected early, Lyme disease is usually successfully treated with antibiotics. Follow these tips from Children’s Hospital Boston’s infectious disease expert Catherine Lachenauer, MD, to minimize your child’s risk of Lyme disease.

Take steps to prevent tick exposure

Ticks like low-level shrubs and grasses, particularly at the edges of wooded areas. If you are hiking, try to stay in the center of the trail and avoid bushwhacking. Tucking pant legs into socks can help prevent ticks from getting on your skin, says Lachenauer. Wearing light colored clothing also makes spotting ticks easier.

Lachenauer recommends parents frequently check their children for ticks, making sure to look in the armpits, backs of the knees, groin areas and scalp. Deer ticks can be extremely tiny and can measure less than one millimeter across, so search meticulously. Lyme disease is usually not transmitted when the tick has been attached for less than 48 hours, so the earlier ticks are discovered, the better.

Insect repellents containing DEET are effective against ticks. However the concentration of DEET varies among products, so it’s crucial to read the label. The maximum concentration currently recommended for infants and children is 30 percent.

Remove the tick with tweezers

If a tick is discovered on a child, Lachenauer advises parents to remove the tick using a fine-tipped pair of tweezers. Grasp the body of the tick and pull in an upward motion until the tick comes out. Do not squeeze or twist the tick body. It’s not necessary to go to a doctor after a tick bite, but if you have questions or want a consult, see your child’s pediatrician. Take note of the size and color of the tick, as well as your estimate of the time it has been attached and whether or not it is engorged.

In a minority of cases, a single dose of medication may be prescribed to prevent Lyme disease after a tick bite. This is recommended only when the tick is a deer tick, it is estimated to have been attached for at least 36 hours, antibiotics can be given within 72 hours of tick removal, and the patient is at least 8 years of age and can otherwise take doxycycline. Courses of other antibiotics are not generally recommended for prevention of Lyme disease following a tick bite.

Watch for symptoms

After a tick bite, watch your child for developing symptoms. A red circular rash at the site of the tick bite, often referred to as a bull’s eye rash, is an early sign of Lyme disease. Some patients have multiple ring lesions. Non-specific symptoms that may signal Lyme disease include fever, headache and fatigue, and muscle and joint aches. If your child develops any of these symptoms, call your child’s pediatrician to ensure proper diagnosis. If your child has Lyme disease, a course of antibiotics typically resolves the illness.

9 thoughts on “Lyme disease: What parents should know

  1. Lyme disease is a very scary thing. Whenever a child or anybody including your pets come out of the woods they should always be check for ticks right away.

  2. With kids aged 3, 7, and 9, we’ve had to remove our share of ticks already (we hike and camp a lot). Do we need to clean the area of the tick bite with antibiotic ointment or is it enough to remove the tick asap?

  3. Thanks, Matt! I forgot to say–we usually use rubbing alcohol. Can’t remember if I saw a guideline somewhere or if our pediatrician told us to do that . . . or if I made it up myself 😉

    1. Hi Dave,
      Here’s a response from Ken McIntosh, MD, an infectious disease specialist here at Children’s: “Antibiotic ointment is not necessary. Just removing the tick removes the risk of Lyme transmission from that point in time on. Per Dave’s later comment, it would do no harm to clean the site, and alcohol would seem to be fine.”
      Thanks for your question!

  4. Do you recommend long term antibiotic treatment for Lyme for a 16 month old child? Thank you

    1. Hi Linda,
      Here’s a response from Ken McIntosh, MD, an infectious disease specialist here at Children’s: “A 16-month old child should be no different from anyone else, and the recommended 2-3 week treatment for early Lyme disease should be adequate.”
      Thanks for your question!

  5. I have a 6 year old daughter,and just found out she has Lyme disease.She is starting medication,but I am unsure when the symtoms will subside. Her knee joint is very sore. I am just wondering when that will get better.

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