Stony Brook Medicine Health News
Children ticks

Lyme Disease in Children: Symptoms, Treatment & Prevention

As families enjoy time outdoors, the threat of Lyme disease remains a concern to be aware of, with over 2,600 Suffolk County cases reported in 2022 alone. Fortunately, with the right prevention and early action, the impact of an infected tick bite can be greatly reduced.

Arming yourself with tick safety essentials, from proper removal to repellent use, and knowing how to spot symptoms early on, will reduce the risk of Lyme disease in children and adolescents, so your family can reap the benefits of outdoor play while staying safe.

What is Lyme Disease?

Lyme disease is a bacterial infection transmitted by the bite of the blacklegged (deer) tick (Ixodes scapularis).

Children and adolescents have similar risk factors for getting Lyme disease as adults, which is based on outdoor exposures in endemic areas. Lyme disease incidence, however, is highest in children ages 5-14 year. This is likely because of common types of activities among children, which occur near tick habitats, forests and tall grasses.

Causes of Lyme Disease in Children

Lyme disease is transmitted to humans through the bites of infected black-legged ticks, commonly known as deer ticks. It’s the most common vector-borne disease in the U.S.

Ticks that transmit Lyme disease are typically found in wooded and grassy areas, such as on hiking trails, parks and even backyards. They can latch onto humans and animals, including children, bite, in often unnoticed places such as the back or scalp, have their blood meal and fall off unnoticed.

Signs and Symptoms of Lyme Disease in Children

The symptoms of Lyme disease can vary and often mimic other common childhood illnesses, making a diagnosis challenging.

Most Lyme cases occur in late spring and summer months. The disease in children and adolescents will generally present itself in three stages:

  1. Early localized disease presenting 3-30 days after a bite, with a “bull’s-eye rash,” also called erythema migrans. This type of rash appears at the site of the tick bite in about 70-80% of cases and looks like a red circle with a clear center, much like a target.
  2. Early disseminated disease presenting 3-10 weeks after bite, with multiple erythema migrans lesions, meningitis, carditis and facial droop (palsy).
  3. Late disease presenting 2-12 months after a bite, with arthritis symptoms (joint swelling, most commonly the knee).

Additional nonspecific symptoms of Lyme disease in children can include:

  • Fever
  • Headache
  • Muscle aches

Not infrequently, the tick and the initial rash may not be noticed and the disease may progress. Therefore, some children with Lyme disease will develop other forms of Lyme disease as described above.

When to Seek Medical Help for Lyme Disease

If your child develops a fever or experiences flu-like symptoms following a tick bite or potential exposure to tick-infested areas, it’s important to seek medical attention from a pediatrician right away.

Be on the lookout for the telltale bull’s eye rash, which typically appears within a few days to a week after a tick bite.

Your pediatrician can perform a complete medical history and a physical exam, tick identification and follow-up management. Depending on the timing of the bite, appropriate screenings and laboratory tests may be considered to determine if your child might have Lyme disease. Referral of your child’s case to other medical experts, such as an infectious disease specialist, might be necessary.

Lyme Disease Treatment in Children

Treating Lyme disease in its early stages is the best way to prevent the illness from progressing into later stages of the disease.

An antibiotic is the primary treatment for Lyme disease in children. Oral antibiotics such as doxycycline or amoxicillin are often prescribed for 10-28 days, depending on the stage of the disease.

If your child is prescribed antibiotics, be sure to closely follow your healthcare provider’s directions and finish the full course of antibiotics as prescribed to make sure the infection is fully eradicated.

In more severe cases, or if a child is experiencing ongoing symptoms or cannot tolerate oral therapy, intravenous (IV) antibiotics can be prescribed. However, most children are cured with a course of oral antibiotics.

Prevention Tips to Keep Your Child Safe

While Lyme disease treatments are usually very effective, preventing tick bites from occurring in the first place is the best way to keep your child safe.

You can decrease your family’s risk for tick bites by:

  • Using insect repellents (20-30% DEET)
  • Staying on trails when hiking
  • Wearing long sleeve shirts, pants and high socks when in grassy areas
  • Doing regular tick checks after being outdoors
  • Removing ticks immediately and properly, with tweezers

Tick identification and time of attachment are also important. It takes at least 24 hours for the Borrelia bacteria to be transmitted, so risk of infection decreases the earlier the tick is removed.

In addition, children have participated in Lyme vaccine clinical trials, including here at Stony Brook Children’s Hospital. Prevention through vaccination may soon be an opportunity to protect you and your child.

It is important for parents to talk with their child’s doctor about any concerns they have about tick bites and Lyme disease.

The Lyme and Tick-Borne Disease Center at Stony Brook Children’s Hospital provides multidisciplinary, comprehensive diagnosis, treatment, and management of Lyme and other diseases transmitted by ticks. Our center is staffed with board-certified pediatricians with specialty training in pediatric infectious diseases. They have expertise in treating all types of pediatric infectious diseases, including Lyme disease, and are up to date on all relevant tick disease-related treatments and research.

This article is intended to be general and/or educational in nature. Always consult your healthcare professional for help, diagnosis, guidance and treatment.