Northampton Area Pediatrics, LLP
193 Locust Street 
Northampton, MA 01060
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July 07, 2019
Category: Uncategorized
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If you, your children, or your dogs have been outside in the past few months, you’re surely aware that tick season is back. And if you have spent much time here in New England, you are likely well aware of Lyme disease. Caused by a bacteria known as Borrelia burgdorferi, Lyme is one of several diseases that can be transmitted after a tick bite. Here are a few things to know about ticks and Lyme, and some trusted resources to review:

Signs and symptoms– The most well-known symptom of Lyme is likely the bullseye rash known as erythema migrans. This rash shows up within several weeks after a tick bite, but is not itchy or raised so it can be easily missed. Other symptoms can be flu-like symptoms (fever, headache, fatigue) that occur 2-4 weeks after a tick bite. Later symptoms of Lyme can include Lyme arthritis (typically swelling and pain in one larger joint, commonly a knee), Lyme meningitis (severe headache, fever, and neck stiffness), or Bell’s palsy (a facial paralysis that causes drooping of one side of the face and an asymmetric smile). These symptoms can occur months after a tick bite

Prevention – There are a number of things you can do to prevent ticks – check yourself, your children, and your pets after coming in from being outdoors. Use insect repellant when going outdoors, and wear long sleeved light clothing when you can. 

In order for Lyme to be transmitted, all of the following things need to happen:

  1. A patient needs to be bitten by a deer tick (other ticks such as the larger dog ticks do not carry Lyme)
  2. The deer tick needs to be carrying Lyme disease (according to researchers at UMass, about 30% of the deer ticks in the area carry Borrelia burgdorferi– which means 70% do not)
  3. The tick needs to be attached for 36-48 hours (while it may be theoretically possible for a tick to transmit disease sooner, this is thought to be quite unlikely). 

Treatment– If you find a tick on you or your child, take the following steps.

  1. Don’t panic.
  2. Using fine nosed tweezers or a device such as a ‘Tick Key’, grasp the tick as close to the skin as possible and slowly pull back until the tick is removed. Wash the area with soap and water and remove what you can, but do not worry about getting every last bit of the tick out.
  3. If the tick has been attached for longer than 36 hours, or is engorged, and you are reasonably certain that it is a deer tick, it may be worthwhile to provide a single dose of prophylactic antibiotics. Call our office for details. We do not recommend a weeks-long course of antibiotics for a tick bite alone without other symptoms.
  4. If the tick has not been attached that long, or is not engorged, simply keep an eye on the area over the next few weeks looking for the typical bullseye rash. Also be alert to any unusual flu-like symptoms (fever, headache, fatigue) in the next two to four weeks
  5. If you notice a typical bullseye rash, even without a history of a tick bite, contact our office as many times we will proceed with treatment of Lyme simply based on symptoms.

Testing– The lab at UMass can provide testing of ticks to determine if they carry Borrelia burgdorferior a number of other disease-causing agents. While this data can be helpful for research, and while a negative test can be reassuring that the tick you found did not carry a disease, we do not generally recommend starting treatment based on a tick test alone. For this reason, it is not essential to send ticks in for testing.

My child was diagnosed with Lyme – will they be OK?– We see many cases of Lyme disease each year, and children tend to respond quite well to antibiotics, particularly when identified early on (ie when the bullseye rash is seen). Depending on symptoms, a course of antibiotics usually runs 2 to 4 weeks. The New York Times recently published an article describing one family’s experience with Lyme treatment.  

Where can I find more information?  The Centers for Disease Control page on Lyme has a ton of information on Lyme disease and current research

In Summary:

  1. If you’re going outside this summer, use insect repellant and make sure to check yourself and your children for ticks regularly.
  2. If you find a tick, remove it immediately with tweezers or a tick key. If it is an engorged deer tick that was attached for more than 36 hours, give us a call. If it’s not, keep an eye out for the typical bullseye rash or other flu like symptoms over the next 2 weeks
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