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Lyme Disease in Children & Teens

Symptoms of Lyme Disease

Lyme disease is hard to diagnose because its symptoms can vary greatly from person to person. Early symptoms are usually mild and often overlooked. No single symptom appears in all cases, and there’s no predictable time frame or sequence of symptoms.

  • Red raised bull’s-eye rash at the site of the tick bite that expands over several days and can last for weeks (about 75 percent of cases)
  • Flulike symptoms, including chills, fever, headache, lethargy, and muscle pain
  • Stiff neck
  • Inflammation in large joints, especially the knees, if the disease is untreated and allowed to progress over months

What Is Lyme Disease?

Lyme disease is a tickborne infection that can cause flulike symptoms and joint inflammation. First identified as a form of arthritis in 1975 in the woodlands around Lyme, Connecticut (hence its name), cases are known to have occurred in most states, predominantly in the Northeast and upper Midwest, and on the Pacific coast. The ticks tend to thrive in those areas where suburban lawns meet woodlands.

Deer, whose population has grown in the East in recent years, help spread infected ticks to new areas. Migratory birds have brought Lyme disease to the South. Even city dwellers may develop Lyme disease. All it takes is a weekend excursion to the countryside for you—or your dog—to meet up with an infected tick.

Although this disease has received the most publicity in the United States, it has existed in Europe at least since the beginning of the twentieth century (though its assorted symptoms were often not attributed to a single disorder). Lyme disease is found today on all continents except Antarctica.

While the peak periods may vary from region to region, this is primarily a summer disease. You’re most likely to be bitten by a deer tick between May and September, when immature ticks, or nymphs, are active. That’s also when people are outdoors the most. The risk of being bitten is lower in April, October, and November, and lowest from December through March.

Even if you’re certain you’ve been bitten by a deer tick and that the tick was infected, it’s unlikely that you’ll develop Lyme disease. The chance of infection is very low (less than 1 percent), even in areas where Lyme disease is prevalent. A tick has to feed on a human for 24 to 48 hours before the disease can be transmitted.

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What Causes Lyme Disease?

Lyme disease, caused by a corkscrew-shaped bacterium known as a spirochete (Borrelia burgdorferi), is transmitted primarily via certain species of deer ticks. These are smaller than the common dog tick, though it is often difficult to tell the two types of ticks apart.

A deer tick, before it becomes engorged with blood, looks like a mole or a blood blister. While the eight-legged adults are less than one-tenth of an inch long, the nymphs are about the size of a pinhead, and the larvae are nearly invisible. The male is black and the female is dark red and black. When filled with blood, the tick becomes gray and increases in size three- to fivefold.

Although deer can become infected, in the eastern United States white-footed field mice serve as the main host for both the bacteria and the young ticks. The adult ticks usually feed and mate on deer, then drop off to lay eggs. These in turn hatch into minuscule larvae, which become infected by feeding on white-footed mice. The larvae molt and become infected nymphs. (In the West, the culprit is the closely related black-legged tick, also carried by wood rats.)

Both nymphs and adult ticks feed on a variety of animals. The nymphs are the chief threat to humans—about 70 to 90 percent of all cases are caused by nymph bites. Adult ticks are generally less of a threat to humans because they’re large enough to be seen and removed before they transfer the bacteria.

The nymphs and adults wait on low vegetation in wooded areas and adjacent grasslands and transfer themselves to whatever brushes by; they don’t fly or jump. Dogs and cats can carry the ticks to your home and property. (Horses and household pets can get Lyme disease but cannot transmit it to humans; rather, they bring ticks close to humans.)

Ticks prefer dark, moist areas on people, typically the back of the knees, the groin area, and under the arms.

What if You Do Nothing?

Without treatment, Lyme disease runs its course, which can last anywhere from a few weeks to years. However, ignoring or delaying treatment can lead to chronic arthritis or heart problems, as well as skin and nervous system abnormalities that may be difficult to treat successfully. It’s clearly better to get yourself properly diagnosed and attend to the ailment as early as possible.

Home Remedies for Lyme Disease

There are no home remedies for Lyme disease. If you think that you’ve been bitten by a tick in an area where Lyme disease is present or that you’ve developed symptoms, you should see a physician for diagnosis and treatment.

Prevention of Lyme Disease

There is now a three-shot vaccine for Lyme disease that has been shown to prevent disease in anywhere from 68 to 92 percent of people—though without the third shot, this drops to about 50 percent. But it is still better to avoid being exposed to the disease, since the vaccine is not perfect. (The vaccine does not protect against other tickborne diseases.)

To lessen your risk of contracting Lyme disease, take these precautions:

  • Wear long trousers and a long-sleeved shirt with buttoned cuffs. Tuck the shirt into your pants and your pants into your socks or boots. Wear hard-finished, light-colored fabrics. It’s easier to spot ticks on white or tan trousers than on black ones.
  • Apply insect repellent to your pants, socks, and shoes. Repellents containing the substance called DEET are approved for warding off ticks. Be careful if you put any on your skin, since DEET can be hazardous if too much of it is absorbed through skin, which can happen if you apply high concentrations. Most states permit the sale of permethrin, which is an excellent tick repellent. Permethrin should be applied only to clothing.
  • Avoid tick habitats. Try to stay near the center of trails in overgrown country.
  • Check occasionally for ticks when you’re in underbrush or wooded areas. Later do a thorough check of your entire body. Have someone look at your back and head if possible. Remove ticks promptly and properly. The sooner you remove a tick, the better your chance of avoiding infection. If an infected tick is on you for less than 24 hours, you probably won’t develop the disease.
  • Check your pets. When pets come indoors, inspect them closely for ticks.

When to Call Your Doctor about Lyme Disease

Contact your physician if you think you may have contracted Lyme disease. You will also need to see your doctor if you want to be vaccinated against Lyme disease.

What Your Doctor Will Do

Lyme disease is difficult to diagnose because its symptoms mimic other illnesses. And while some people get a rash after they are infected, as many as 25 percent do not.

Current tests remain poor at best. The results of the tests vary from lab to lab, and the meaning of the results is not standardized. This greatly compounds the problems of diagnosis.

Newer, more reliable tests are in the experimental stage, but it will probably be several years before they are available for clinical use.

Lyme disease is treatable and almost always curable, especially in its early stage. If you have—or had—the characteristic rash, your doctor will probably prescribe a course of antibiotics.

Similarly, if you live in an area with a high incidence of the disease and find a tick on you that your doctor or the local health department identifies as a deer tick, or a western black-legged tick if you live in California, you’ll probably be put on antibiotics.

For More Information about Lyme Disease

  • American Lyme Disease Foundation

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Original Date of Publication: 29 Jul 2010
Reviewed by: the Editorial Staff at
Last Reviewed: 29 Jul 2010

Lyme Disease, Lyme Disease in Children & Teens reprinted with permission from
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