TICK BITES and LYME DISEASE
It’s springtime – time to get outdoors and play! But what about the ticks? We know that certain types of ticks carry diseases and we would like to avoid them as much as possible. There is much information available about ticks and Lyme disease. We recommend the following web sites for current and accurate information on identifying ticks, tick removal, symptoms of Lyme disease, and related topics:

http://www.cdc.gov/ncidod/dvbid/lyme/index.htm


http://www.dhhs.state.nh.us/DHHS/CDCS/lymedisease.htm



Here are some helpful answers to questions that are often asked at our office:

• Do I have to worry about Lyme disease?

Only deer ticks carry Lyme disease. The larger, brown dog ticks do not. Not all deer ticks carry Lyme disease but in New England many do. The chance of getting Lyme disease is very small if the tick has been attached to your skin for less than 36 hours. A good preventive measure is to check your child’s entire body, including the scalp, once every day after they have been outdoors. If you see any ticks, it is likely that they have been there less than 24 hours and should be removed.



• Should we do testing?

Blood testing for Lyme disease is considered to be not very sensitive and may not show positive results until the disease has progressed to the point of showing definite symptoms. You could test negative today but be positive tomorrow. For most circumstances we do not order blood tests for Lyme disease but treat patients based on their symptoms. Current research shows that sending the removed tick to a lab for testing is very poor in predicting the passage of Lyme disease to a person, so this is not recommended.



• What about preventive treatment?

It is best to prevent a tick bite in the first place by using insect repellent and protective clothing. A preventive antibiotic (Doxycycline) can be used after a tick bite under certain circumstances. We will consider this treatment under the following guidelines:

1) The tick is definitely a deer tick.

2) The tick has been attached for over 36 hours.

3) The patient’s age is 8 years or older (Doxycycline causes harmful effects to the teeth of younger children).

4) The treatment must be started within 72 hours after the tick is removed.

Other routine antibiotics are used to treat active Lyme disease, which is easily curable in the early stages. Preventive treatment with these antibiotics for children less than 8 years old has not been studied, so no recommendations exist for this group. We treat these patients based on their symptoms.