Q and A: What you need to know about ticks and Lyme disease

With summer on the way, you and your family will probably be spending more time outdoors. You may be taking walks, playing in your yard or a park, biking, or camping. But before you head outside, it’s important to take precautions to reduce your children’s risk for a common tick borne illness, Lyme disease.

Dr. Rebekka Levis, a Boston Children’s Health Physicians pediatrician with General Pediatrics at Saw Mill, answers some frequently asked questions about tick bites and Lyme disease. She also offers some simple steps you can take to protect your children during tick season.

What is Lyme disease?

Lyme disease is an illness that is caused when someone gets bitten by a deer tick (a type of tick) that is infected with the bacteria Borrelia burgdorferi. 

Who is at risk?

Anyone can be at risk for Lyme disease. People who spend time outdoors and in heavily wooded areas can be at increased risk, but children can even get bitten by an infected tick in your yard or on a playground. Pets can also bring ticks into your house. This makes it important to check your pet’s fur for ticks every time they come inside.

What are the symptoms of Lyme disease?

Lyme disease symptoms typically begin between three and 30 days after someone is bitten by an infected tick. They can include:

• fever
• headache
• tiredness
• joint pain
• swollen glands
• a rash that looks like a bullseye or solid patch at the site of the bite
• rashes in other locations on the body 

If your child has any of these symptoms, be sure to call your pediatrician. If left untreated, they can become more severe over time.

How is Lyme disease treated?

Several antibiotics can treat the bacteria that causes Lyme disease. If your child has Lyme disease, your pediatrician will prescribe an antibiotic.

How can you prevent tick bites?

To prevent tick bites, dress your child in pants, long sleeves, socks, and shoes when playing in grassy or wooded areas or going for a hike.

For children over the age of 2 months, you may use a bug repellant containing either DEET (no more than 30 percent) or lemon eucalyptus oil. (DEET is not recommended for babies under 2 months.)The repellent should be sprayed on the clothes as much as possible rather than the skin. Also steer clear of spraying on the hands and face. 

Avoid bug repellant bracelets because they don’t protect the areas that are most exposed, such as the legs and the body. There is also the danger that a child could put the bracelet in their mouth. A combination sunscreen and bug spray is also not a good idea since bugspray only needs to be applied once a day while sunscreen should be reapplied multiple times throughout the day. 

What should you do if you find a tick?

Don’t panic. Stay calm and follow these steps:

• Remove the tick with tweezers. Get as close to the skin as you can and try to pull out the entire tick. Don’t squeeze it. Make sure the tick is out completely.
• Pay attention to how engorged it is. That will give you a good idea of how long it was on. If you find a very flat tick that is not embedded deeply, the likelihood of disease is very low. Most of the time a tick has to be on the skin for a good 36 to 72 hours to transmit disease. 
• Flush the tick down the toilet. 
• Wash that area of your child’s skin with soap and water.
• Ask your doctor if your child needs to take one dose of an antibiotic to prevent Lyme disease (this is only recommended in cases when the risk is high).

Should I have the tick tested?

Testing the tick is usually not recommended since the test results are often not very reliable. Even if a tick is infected with the bacteria that causes Lyme disease, the vast majority of tick bites do not result in infection. 

After Labor Day, do ticks go away?

No. The risk of tick bites continues into the fall until there is a frost. Therefore, it’s important to continue to take precautions against ticks until winter comes.

Learn more about Lyme disease and our Division of Infectious Diseases.