Princeton's Ask the Doctor May/June 2019

EVALUATE YOUR CHILD'S RISK OF LYME DISEASE THIS SUMMER By Dr. Steven Dowshen In warm weather, the threat of Lyme disease might make you think that your kids would be safer in your living room than in the great outdoors. Though a child's risk of getting Lyme disease after being bitten by a tick is only about 1%-3%, it's important to consider the factors that affect Lyme disease risk. It's true that Lyme disease is the leading tick-borne disease in the United States, with 20,000 to 30,000 cases reported to the Centers for Disease Control and Prevention (CDC) each year. Most cases of Lyme disease occur in the Northeast, upper Midwest, and Pacific coast areas of the United States. And Monmouth County New Jersey is one of the hardest hit states where incidences has been reported. Most Lyme disease cases occur between April and October, particularly in June and July. OUTDOOR ACTIVITIES AND PETS: Besides living in one of these areas, other factors that might increase a child's tick risk include: • Spending a lot of time outdoors in tall grass, brush, shrubs, or wooded areas • Having pets that may carry ticks indoors • Participating in activities such as landscaping, hiking, camping, fishing, or hunting in tick-infested areas SAFETY TIPS: So your teen got a job as a landscaper this summer and you're planning a family camping trip — does that mean Lyme disease is in your family's future? No, but it does mean that you should take some precautions to protect your family — such as using insect repellent and wearing light-colored clothing when outdoors to make spotting ticks easier — and know how to remove a tick, just in case. IF YOU FIND A TICK: 1. Call your doctor, who may want you to save the tick after removal for identification as the type that may carry Lyme disease or another type of illness. You can put the tick in a sealed container to preserve it. 2. Use tweezers to grasp the tick firmly at its head or mouth, next to the skin. 3. Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in the skin, don't worry, it will even- tually come out — although you should call your doctor if you notice any irritation in the area or symptoms of Lyme disease. 4. Swab the bite site with alcohol. 5. One note of caution: Don't use petroleum jelly or a lit match to kill a tick — they're not effective. These methods won't get the tick off your skin and might just cause the insect to burrow deeper and release more saliva (which increases the chances of disease transmission). 6. It's important to remove the tick as soon as possible. The longer the tick is attached, the greater the chance that Lyme disease will be transmitted. Usually, bacteria from a tick bite will enter the bloodstream only if the tick stays attached to the skin for 24-48 hours or longer. If the tick is removed within 1-2 days, it is less likely to have transmitted Lyme disease. SEEK MEDICAL CARE IF: • The tick might have been on the skin for more than 24 hours. • Part of the tick remains in the skin after attempted removal. • A rash of any kind develops (especially a red-ringed bull's-eye rash or red dots on wrists and ankles). • The bite area looks infected (increasing warmth, swelling, pain, or oozing pus). • Symptoms like fever, headache, fatigue, stiff neck or back, or muscle or joint aches develop. THINK PREVENTION: • After kids play outside, check their skin and hair — especially the scalp, behind the ears, around the neck, and under the arms. • When playing in wooded areas, kids should wear long-sleeved shirts and pants and tuck pant legs into their socks. • Use an insect repellant with at least 10% to 30% DEET for protection against bites and stings in kids older than 2 years, always carefully following the directions for application. • Avoid tick-infested areas. Dr. Steven Dowshen is the Chief medical Editor of KidsHealth.gov

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