TICK BITES AND LYME DISEASE
We live in New England, and exposure to ticks and the diseases they carry is guaranteed. We can’t (and shouldn’t) keep our children indoors all the time, so the question is, what SHOULD we do to prevent bites and illness. Long pants, preferably light in color, and long socks are a must when walking in the woods. Bug spray containing DEET should be applied to clothing and exposed skin of the ankles, neck, arms, when tick exposure is likely. Permethrin compounds should never be applied directly to the body or sprayed near children. However, it is an excellent treatment for clothing especially for avid hikers, and children heading to summer camp (think! capful permethrin to load of summer camp clothes).
Of all the measures you can take to prevent lyme disease, the most important, perhaps, is a daily tick check. It’s the tick you don’t find that causes all the trouble. Once you find a tick, there is no need to panic! You should remove it immediately, please don’t wait to have this done at our office. You can easily do it at home with your fingers or a tweezer. Use a fine-tipped tweezers to grasp the tick on its head as close to the skin surface as possible. Pull upward with steady, even pressure. You may feel you are “tenting” the skin – that is ok. If the head does not come off with the tick, you can briefly attempt to pull it out, but if it does not come out easily, leave it alone. We will not attempt to remove the head at the office either. After removing the tick, clean the area with soap and water. You can use some over-the-counter antibacterial ointment if desired – this is not necessary. As with any insect bite, the area around a tick bite may become slightly red and swollen. This should improve in 2-3 days. The CDC does not recommend testing ticks, we do not collect or send samples from our office.
If ticks are removed within 36 hours, the risk of lyme disease transmission is low. If the tick was on for an uncertain amount of time or definitely longer than 36 hours, a single dose of medication may be indicated. Patients who can be considered for lyme “prophylaxis” include: children 8 years of age or older who are not allergic to doxycycline, and who are seen at the office within 72 hours of tick removal.
Symptoms of lyme disease can develop weeks to months after exposure. Typical symptoms include rash, unexplained fever, persistent headache, and joint pain or swelling (usually the hip or knee). If you believe your child has this combination of symptoms, we will see them in the office to discuss treatment and/or further testing.