Advice: Tick bites

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Tick Bites and Lyme Disease

Tick bite basics

Six types of ticks are endemic to Maryland and the surrounding region. The Blacklegged Deer Tick (ixodes scapularis) is the only of these six to carry the bacteria that causes Lyme disease, Borrelia burgdorferi. Deer ticks are most active in the late spring and summer.
Ticks that are attached for more than 36 hours, that are engorged, or difficult to remove have a higher risk of disease transmission. Your child may be eligible for preventative antibiotics if they meet this criteria. If a tick is attacked for less than 36 hours and/or it was not engorged there is a VERY LOW risk of Lyme disease and no preventative treatment is necessary.
Lyme disease is one of several types of infection that is caused by a tick bite. Symptoms include:
Common/Early findings: Bullseye rash – Found in 70-80% of those infected. The rash is classically a spreading, circular, red rash that is shaped like a bullseye. This is usually, but not always, at the site of the bite and starts within 1-2 weeks.
Less common/later findings: Joint pain and/or swelling, fatigue, low grade fever and chills, swollen lymph nodes
Uncommon/late findings: one sided facial droop (Bell’s Palsy), severe headache, neck stiffness, heart palpitations, syncope (passing out).
Lyme disease is a clinical diagnosis where testing is not usually needed. It is also not recommended to check the tick for bacteria.
Lyme disease is treated with antibiotics. The duration of treatment ranges based on your child’s symptoms.

Tick bite prevention

Wear long sleeves, pants, hats, and socks during high risk activities like hiking or camping
Apply DEET containing bug spray to skin and clothing (as long as your child is at least 2 months old)
Consider treating clothing with permethrin if you are in wooded or other high risk areas often
Do ‘tick checks’ after your child is near fields or wooded areas. Ticks love crevasses so take extra care in areas like armpits, between the legs, in/near the hair, around the ears, and in the belly button

How to Remove a tick

Use clean, fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
Pull upward with steady, even pressure. Don’t twist or jerk the tick.
If a small piece breaks off, leave it. The body will push it out on its own.
After removing the tick, clean the area and your hands with rubbing alcohol or soap and water.
Dispose of a live tick by putting it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet.

Treatment

Most tick bites need no intervention. If a tick is attached to the skin for more than 36 hours and is engorged upon removal you should contact your doctor about starting a preventative antibiotic.
If there are any concerns for Lyme Disease a course of antibiotics is needed. If your child is experiencing any of the symptoms above, please make an appointment.
Wound care: Wash the site of the bite with soap and water. You may also apply an over-the-counter triple antibiotic ointment.
Allergy Medications: If your child’s asthma symptoms are related to allergens like pollen or animals, they may also benefit from antihistamines like Zyrtec or Allegra

Additional Resrouces

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