June 26, 2000 -- When Duchess County, New York, resident Sally picked up 14-year-old Amy from a summer program last year, she noticed that her daughter seemed unusually fatigued. A couple of weeks later, Sally was shocked to discover that the side of Amy's face had begun drooping. Sally immediately suspected what her doctor confirmed: Despite having taken what the family thought were adequate precautions against ticks, the girl had developed facial nerve palsy, a symptom of untreated Lyme disease.
While numbers are on the rise among all age groups, the increase is particularly worrisome to people with children. The Centers for Disease Control and Prevention (CDC) found that the percentage of Lyme sufferers under age 16 -- one of the groups that spend the most time outdoors and have the highest rate of diagnosis -- has been gradually rising, from 21.7% in 1992 to 26.1% in 1998. "It's definitely an issue, especially for people whose houses are near wooded areas," says Lisa, a mother of two in suburban New Jersey. "Parents see it as a real problem."
The disease is also a growing concern to people living in the most heavily affected regions of the country -- the Northeast and upper Midwest -- though epidemiologists have confirmed cases in nearly every state. "In the last several years, the numbers have ranged between 12,000 and 16,000," says David T. Dennis, MD, coordinator of the Lyme Disease Program at the CDC.
Lyme disease is transmitted to humans by deer ticks and black-legged ticks. Initial symptoms, which show up three to 32 days after the bite, are flu-like in nature; most, but not all, sufferers develop a bull's-eye rash at the site of the bite. Facial nerve palsy, like Amy had, can also occur. Sufferers who aren't treated soon enough after the tick bite can suffer chronic problems ranging from joint pain to heart problems to neurological disorders.
While experts warn people to take precautions during the spring and summer months, when the risk for contracting Lyme disease peaks, they aren't calling for extreme measures. "Parents shouldn't worry so much that they prevent their children from playing outside," advises Henry M. Feder, MD, a professor of family medicine and pediatrics at the University of Connecticut Health Center. "Even if you do get a tick bite, in most areas chances are only one in 100 to one in 1,000 that you'll get the disease."
In order to minimize chances of being bitten in the first place, experts recommend the following:
- Keep a tidy yard. Lyme-carrying ticks are usually found in wooded areas, fields, and other "wild" areas (though they can also live at the seashore or in a suburban backyard). Experts advise keeping grass and brush trimmed and placing barriers, like a fence, between your property and "unkempt" areas.
- Dress your kids in anti-tick garb. Have them wear long sleeves and long pants that fit tightly around the ankles and wrists (or tuck pants into their socks) when playing in wooded or shrubby areas. This dress code can be tough to enforce, especially on a hot day; you'll have to decide for yourself how great the danger is in a given area and whether these precautions are worth the discomfort. Also, consider having your child use insect repellent with less than 10% DEET (see Insect Repellents for Kids).
- Check your kids for ticks daily. A Lyme-carrying tick has to be attached to its host for at least 24 hours in order to transmit the disease, says Feder, so by doing full-body checks (including scalp) at the end of each day, you can prevent transmission even after your child has been bitten. The types of ticks that transmit Lyme disease are very small -- they may resemble a freckle or speck of dirt -- so be sure to inspect closely. Also, launder clothes at the end of the day and dry them in a hot cycle to kill any ticks that may have crawled onboard.
- If you do find a tick, use fine-point tweezers to grasp it gently, without squeezing, as close to the skin as possible; then pull it straight out without twisting, says the American Lyme Disease Foundation. (If any part of the tick remains in the skin, it still might transmit disease.) If you don't have tweezers available, wear gloves or use tissue or even a leaf to avoid contact with the tick. Apply antiseptic to the bite site and the tweezers, and wash your hands. According to the American Academy of Pediatrics (AAP), it isn't necessary to save the tick for testing, since that isn't an effective way of predicting whether or not your child will contract the disease.
In the best cases you will have headed off trouble -- but if you notice any symptoms of the disease (a rash, headache, stiff neck, fever, muscle aches, and general tiredness), call your doctor immediately.
And don't despair if your child is diagnosed with Lyme disease. According to Feder, the disease is highly treatable with antibiotics, if taken early. Late treatment may require longer-term antibiotics administered through an IV tube, but recovery rates are good. Sally's daughter is nearly recovered a year after contracting the disease. Still, Sally wishes they had been more vigilant. "We probably weren't cautious enough about having our daughter check herself," she says. "In areas like ours, you really have to be careful."