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Ask Dr. Sue
TICKS AND LYME DISEASE
Dear Dr. Sue,
I found a tick on my daughter the evening after a hike
through the woods last weekend. I
was able to get it off, but now I wonder how worried I
should be about Lyme's disease, or
other things ticks might carry. Should she be
tested? How can I protect her against these
diseases?
Concerned Mom
Dear Mom,
The good
news is that removing ticks promptly is one of the best
protections against disease. A
tick is unlikely to be able to transmit the bacteria
that cause disease if it is removed within 24 hours of
attaching to your child's skin. There are also
several other ways you can help protect your daughter.
First, dress her appropriately when she is likely to be
exposed to ticks. Appropriate dress is
light-colored, lightweight, long-sleeved shirts and long
pants, with pants tucked into boots or
knee-length socks. The light color allows you to
see ticks crawling on her clothing and remove
them; the other precautions make it a lot harder for the
ticks to find her skin. In spite of legend, ticks
don't jump from trees, but rather hang out in tall
grasses and brush at about knee height, waiting for
their next victim to walk by. (They are incredibly
patient, too. One female tick that was being
studied sat on the same blade of grass for two months
until she finally found a meal!)
Consider using insect repellent. If you do use it
on your daughter, use it safely. Never apply it to
her hands, since hands often end up in children's
mouths. Never spray it onto her face; instead,
spray it onto your hand and apply to her neck and
cheeks, carefully avoiding her eyes and lips.
Don't use any spray containing more than 10% DEET
(Skedaddle is one that has only 6.5% DEET.) Don't apply
under her clothing, though you can lightly spray the
clothing itself. Don't apply to sunburned skin.
Don't use DEET at all on children under two years of
age. Wash your own hands after applying the
repellent, and bathe your child as soon as she comes
indoors at the end of the day.
Know ticks usual habitat. They especially like
moist areas covered with grasses, small bushes or
shrubs. They love to frequent unused farm fields,
weedy ditches, overgrown vacant lots and the tall
grasses beside trails. They can also be found in
parks and even in your own back yard; in fact, its
estimated that seven out of ten Lyme disease victims
were bitten in their own back yards. Try to keep
your yard free from tall brush and keep the grass cut.
Stack firewood away from the house, since mice like to
live in woodpiles, and ticks like to feed off of mice.)
When you are in settings that seem likely to harbor
ticks, look your daughter (and yourself) over every two
or three hours, picking off roaming ticks when you find
them. Look carefully; the deer tick that carries
Lyme disease is only as big as the head of a pin or a
sesame seed. The larger dog ticks can carry Rocky
Mountain Spotted Fever, but that illness is rare in our
area. If you find a tick that has already
attached, remove it. If you don't have tweezers on
your hike (see advised removal technique below) a pocket
knife can be used to scrape away the smaller deer ticks.
The larger dog ticks can be removed with your fingers,
preferably protected by a Kleenex or handkerchief.
Whether you've seen a tick while you're outdoors or not,
when you get home it's time for a
full-body check. Pay special attention to the
following: her scalp (part her hair carefully and check
ALL of it), behind her ears, in the groin area, and any
other skin folds including between toes and fingers and
around her belly button. If you need to remove a
tick, DO NOT, in spite of what you may have heard, touch
it with a hot match, or apply oil or Vaseline to it, any
of which can make regurgitation of bacteria into the
wound more likely. Instead, use the most slender
pair of tweezers you can find, lie them flat against the
skin so that you are grasping the tick as close as
possible to the skin, and squeezing the tick's body as
little as possible. Then, using slow, steady
pressure, pull the tick STRAIGHT OUT, with no rocking or
twisting. If some mouth parts remain, remove them
with the tweezers or a needle. Finally, scrub the
area (and your hands) with antibacterial soap.
Save the tick in a container with a little rubbing
alcohol or mineral oil, so that if your child should
become sick it can be identified. Label the
container with the date, where it was on your child, and
the location you were walking around in.
If you've removed any ticks within 24 hours of their
attachment, any illness is quite unlikely. Still,
its wise to keep an eye on the site: if a red,
ring-like mark appears at the site within two to
thirty-two days, see your pediatrician, and take the
tick with you. Do the same if your child becomes
sick with a fever or different rash or other symptoms
within the next week.
Lyme disease is most easily recognized by the
distinctive ring-like rash, which usually, but not
always, occurs at the site of the bite. Actually,
many times there is no rash at all. Flu-like
symptoms may occur without the rash; including fever,
chills, sore throat and aches and pains. Treatment with
antibiotics is usually very successful at this stage,
but the blood test for Lyme disease can be negative even
in the presence of the disease, so antibiotics are
sometimes used as a precaution if the symptoms are
suggestive and there has been a known tick bite (and
always if the characteristic rash shows up).
Untreated, Lyme disease can lead to neurological
symptoms including fainting, numbness, weakness, stiff
neck, and headache, and it can also cause chronic muscle
pain, arthritis, chronic fatigue, or an irregular
heartbeat. This disease is still relatively rare
in our area compared to some areas, but you are wise to
take precautions and to respond to any suspicious
changes in your daughter after a tick bite.
 
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