Lyme Disease

If you live near the coast in the northeast part of the United States, the mid-Atlantic region, Wisconsin, Minnesota, California, or some parts of Europe or Asia, you may have heard about Lyme disease as most cases occur in these areas. Read on to learn more about the risks and how you can lower the chance of getting it.

What is Lyme disease?

Lyme disease is a bacterial infection that's caused by the bite of an infected tick. The name "Lyme" comes from the town of Lyme, Connecticut where the illness was first recognized back in the mid 1970's. Ticks most often live in tall grass or in heavily wooded areas. Although it's a year round problem, April - October is said to be "tick season" (in the United States). Symptoms can be mild to severe, but most people get better with treatment.

Who is at risk for Lyme disease?

Anyone can get Lyme disease, but there are some people that are more likely to get it than others.

People who are at higher risk for Lyme disease include:

• People who have more exposure to ticks because of the activities they do
• People who have pets that are likely to bring ticks home
• People who walk in the woods

What causes Lyme disease?

Lyme disease is caused most often by a bite from an infected deer tick. The deer tick is much smaller (about the size of a freckle) than the dog tick. There are other illnesses that are caused by ticks, but Lyme disease is definitely the most common type of tick-borne illness in North America and Europe.

A tick becomes infected when it attaches itself and feeds off the blood of an infected host (person or animal). Lyme disease is spread when an infected tick attaches itself to the next host and releases the bacteria in the bloodstream. Not every tick bite leads to Lyme disease, but the longer an infected tick stays attached to the host, the greater the risk of getting it.

What happens if I've been bitten by a tick?

If you've been bitten by a tick and the tick is attached to your skin, tell your parent/guardian so they can help you remove the tick as soon as possible.

Do:

1. Use sharp pointed tweezers or "tick tweezers".
2. The person holding the tweezers (you or your parent/guardian) should use the tweezers to grab the tick as close to the skin as possible-near the tick's mouth.
3. Grab the tick with the tweezers and hold tightly and pull the entire tick out with a slow, steady motion.
4. Place the tick into a glass jar with a tight lid. Take it with you when you see your health care provider.

Don't:

• Do not use alcohol, nail polish remover, petroleum jelly, or other ointments on your skin - these won't remove the tick!
• Do not burn the tick out-this does not work and it can burn your skin and cause scarring.
• Do not twist the tick out-this may cause the tick to break apart and not come out completely.

Make an appointment with your health care provider (HCP) and bring the tick jar with you. Not every tick carries Lyme disease, but it's important to watch for any symptoms and get early treatment. If your HCP feels you are risk of getting infected (the tick was attached for at least 36 hours, you are over 8 years old and you are not pregnant or breastfeeding), you may need to have a blood test and/or take an antibiotic.

Only ticks that are attached to the skin can release the bacteria into the host. The longer the tick is attached to the skin, the more risk of getting infected with Lyme disease.

What are the symptoms of Lyme disease?

A person can get bitten by an infected tick and not get sick. On the other hand, there are people who have symptoms. If you develop Lyme disease, you may notice a small red bump (where the tick attached) within a couple of days (or even up to a month) of being bitten. The bump is often warm to the touch and slightly sore.

The bump usually spreads into a rash that looks like a "bull's-eye" - pink in the center and deeper red on the outside.

Other signs can appear several days or weeks and are similar to flu symptoms:

• Chills
• Fever
• Headache
• Body aches
• Feeling tired

Later, more advanced symptoms may include:

• Itching
• Tiredness
• Weakness
• Sore, inflamed joints
• Stiff neck
• Eye problems
• Problems with balance
• Irregular heart rhythm

How is Lyme disease diagnosed?

Lyme disease can be hard to diagnose because not everyone has symptoms. The most common symptom is a rash, but 20% of people with Lyme disease don't have one. Therefore, diagnosis is usually based on symptoms, history of a tick bite, and/or recent time spent in areas where Lyme disease is common.

Diagnosis must be confirmed by a health care provider. A blood test(s) is usually done to check for antibodies. However, because our bodies don't make antibodies until a few weeks after an infection, the blood test will be negative if checked too early.

What is the treatment for Lyme disease?

The usual treatment for Lyme disease is antibiotics taken by mouth for up to 21 days. Intravenous antibiotics can be prescribed if the Lyme disease has gotten worse. The Food and Drug Administration (FDA) warns people not to take an injectable medicine called "Bismacine" for Lyme disease which is sometimes prescribed by alternative medicine practitioners.

How can you prevent Lyme disease?

If you spend time in areas where Lyme disease is common, you can lower your risk by protecting yourself.

• Wear long sleeve shirts and long pants if you know you will be spending time outside in wooded areas or near tall grass.
• Walk on clear paths and paved roads whenever possible when you are in wooded and high grass areas.
• If you have pets, check them for ticks when they come in from outside.
• Check yourself and have someone look at areas of your skin and scalp that you can't see, especially behind your knees, between fingers and toes, underarms, and groin.
• Use insect repellants that contain DEET safely. These products do not kill ticks, but work to keep ticks off.
• Take a shower after all outdoor activities are over for the day. (Showering will help remove any unattached ticks.)

Know when you are at risk and protect yourself against Lyme disease. If you are bitten by a tick, tell your health care provider and get treated.

Written and reviewed by the CYWH Staff at Children's Hospital Boston

Updated: 6/15/2011

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