Tick Bite/Lyme Disease

Video courtesy of NYSDOH.

Rochester and its surrounding areas are now considered endemic to the deer tick that carries lyme dz, or the bacteria called B. burgdoerferi. This is new within the past 5 years and we are taking lots of calls from parents with questions about tick removal and treatment. Here is some useful information that we have gathered that will hopefully answer some questions.

And as always, call the office if you have further questions or need an appointment.

-The duration of tick attachment is important in assessing the risk of transmission of Lyme disease. B. burgdorferi are rarely transmitted within the first 48 hours of tick attachment

-Ticks detach and fall off after becoming engorged from a blood meal. Engorged ticks are larger and have a globular shape. Thus, if a patient reports finding an engorged tick (on their body or in their home), the risk of disease transmission is probably higher.

Engorged Tick

Image of an attached, engorged, tick.

The proper technique for removal of the attached tick includes the following steps:

  • If available, use tweezers or small forceps to grasp the tick as close to the skin surface as possible. In the absence of tweezers, use paper or cloth to protect the fingers during tick extraction.
  • Pull straight up gently but firmly, using steady pressure. Do not jerk or twist.
  • Do not squeeze, crush, or puncture the body of the tick, since its fluids may contain infectious agents.
  • Disinfect the skin thoroughly after removing the tick and wash hands with soap and water.
  • If sections of the mouthparts of the tick remain in the skin, they should be left alone as they will normally be expelled spontaneously.
  • After the tick removal and the skin cleansing, the person bitten (or the parents) should observe the area for the development of rash for up to 30 days following exposure. Components of tick saliva can cause transient erythema that should not be confused with the lyme disease rash (erythema migrans).
  • Since the tick usually needs to be attached for two to three days before transmission of the Lyme disease agent occurs, removal of the tick within this time frame often prevents the infection.

-Antibiotic prophylaxis can sometimes be used in certain situations. Although, it has not been studied in kids, therefore, we do not routinely offer prophylaxis. Parents should watch for a rash for up to 30 days after the tick bite and call the office if a rash does appear.

Bulls Eye Rash - Lyme

Bulls-eye rash of erythema migrans associated with Lyme

Erythema Migrans

Erythema migrans without the bulls-eye appearance

How can I prevent Lyme disease?

If you live or work in a region where Lyme disease is a problem, or if you visit such an area, the following are ways to protect your family from the ticks that carry the disease:

  • Avoid places where ticks live. Whenever possible, avoid shaded, moist areas likely to be infested with ticks.
  • Cover arms and legs. Have your child wear a long-sleeved shirt and tuck his pants into his socks.
  • Wear a hat to help keep ticks away from the scalp. Keep long hair pulled back.
  • Wear light-colored clothing to make it easier to spot ticks.
  • Wear enclosed shoes or boots. Avoid wearing sandals in an area where ticks may live.
  • Use insect repellent. Products with DEET are effective against ticks and can be used on the skin. However, large amounts of DEET can be harmful to your child if it is absorbed through the skin. Look for products that contain no more than 30% DEET. Wash the DEET off with soap and water when your child returns indoors. Products with permethrin can be used on clothing, but cannot be applied to the skin.
  • Stay on cleared trails whenever possible. Avoid wandering from a trail or brushing against overhanging branches or shrubs.
  • After coming indoors, check for ticks. This will only take a couple minutes. Ticks often hide behind the ears or along the hairline. It usually takes more than 48 hours for a person to become infected with the bacteria, so removing any ticks soon after they have attached themselves is very effective for reducing the chances of becoming infected.

Keep in mind, ticks can be found right in your own backyard, depending on where you live. Keeping your yard clear of leaves, brush, and tall grass may reduce the number of ticks. Ask a licensed professional pest control expert about other steps you can take to reduce ticks in your yard.

As always, feel free to call the office with any questions.

-derived from UTD and healthychildren.org