Lyme disease and tick bites
Now that spring is here and people are spending more time outside, we get lots of questions over the phone or in the office about Lyme disease. I am going to briefly outline answers to our most common questions. Parents often are concerned about preventing Lyme disease. The best way to prevent Lyme disease is to prevent tick bites, or remove ticks promptly. To prevent tick bites we recommend insect repellents that contain 20-30% DEET.
Also, if you spend lots of time outside, especially working in the yard or hiking, consider using clothing that has been pre-treated with 0.5% permethrin. We recommend that after being outside you shower or bathe within 2 hours of coming inside, and that parents perform tick checks on their children at least once a day. If you find a tick the best way to remove it is to grasp it as close to the skin’s surface as possible with tweezers and pull upward. If you are unable to remove the whole body of the tick, do not try to dig in the skin, rather, let the skin heal. Inability to remove the whole body of the tick does not increase the risk of Lyme disease, but trying to dig parts of the tick out of your body could increase your chances of cellulitis or a wound infection.
We often get frantic calls from parents whose children have been bit by a tick, seeking out antibiotics to prevent the onset of Lyme disease. Our office follows recommendations by the Infectious Disease Society of America which do not support the use of a single dose of antibiotic to reduce the risk of Lyme disease. The primary reason we do not give prophylactic antibiotics to prevent Lyme disease are because there have not been in any studies in children which demonstrate the effectiveness or safety of this approach. Secondly, while doxycycline was shown to reduce the risk of Lyme disease following a bite from a tick which was engorged and felt to be present on the skin for at least 36 hours, the overall risk of Lyme disease in the untreated population was a little over 3%, which means the risk of Lyme disease from a single tick bite is less than 5%. Instead of prophylaxis, we recommend educating yourself for the signs and symptoms of Lyme disease and carefully monitoring your child for symptoms after a known tick bite. Lastly, there are other tick borne diseases for which prophylaxis has no known efficacy in preventing. If you would like to learn more about Lyme disease or tick borne diseases, please check out the following links:
mass department of public health: http://www.mass.gov/eohhs/gov/departments/dph/programs/id/epidemiology/ticks/general-information-faqs.html
Centers for Disease Control: https://www.cdc.gov/ticks/
Boston Children’s Hospital: http://www.childrenshospital.org/conditions-and-treatments/conditions/l/lyme-disease/frequently-asked-questions