Ticks that carry the Lyme bacteria are common in this area; approximately 40% of ticks from Needham and nearby towns carry the Lyme bacteria. . Patients in Dover and Medfield seem to have the highest risk of exposure, although we have seen patients acquire cases in Westwood, Needham, Natick, Wellesley, and Weston as well. Nonetheless, the vast majority of tick bites (about 98%) do not lead to Lyme Disease. That is, even if a tick does carry Lyme, the likelihood of the bacteria being transmitted to a person via a tick bite is very small. So, please do not panic if you discover a tick on yourself or your child.
In general, the risk of acquiring Lyme Disease is minimal if the tick has been attached for less than 24 hours. Once you have removed the tick's body from the skin (even if a little biting part remains stuck in the skin), there is no ongoing risk of transmission of the Lyme bacteria. So, if you are confident that the tick has been attached for less than 24 hours, there is very little reason to worry.
In general, no medication, testing of the tick, or testing of the patient is recommended after a tick bite. Prophylactive (preventive) treatment with a single dose of antibiotics is an option for children older than 2 years of age who had a tick attached for more than 36 hours. If you think your child might be a candidate for this form of prophylaxis, please contact our office.
For all tick bites, our main recommendation is to watch for symptoms or signs of Lyme Disease and to visit us if these symptoms or signs appear. The earliest sign is an expanding flat red ring around the site of the bite. This rash typically appears 3-7 days after the tick bite but can appear even a couple of weeks later. (Earlier small red marks at the site of the tick bite are usually simple inflammatory reactions to the tick bite itself and not a sign of Lyme Disease).
Typically the Lyme rash -- called erythema migrans -- expands at a rate of 1 cm per day. Official definitions require the rash to be at least 5 cm diameter in order to qualify as a case of erythema migrans.
A small fraction of cases of Lyme Disease do not have the erthema migrans rash. In these cases, other early signs to watch for include fever, fatigue, body aches, headache, and red eyes. If you see any signs that concern you for Lyme, contact our office. It's important to treat Lyme but generally not an emergency. If your child develops symptoms after hours, in almost all cases, it will be safe to wait to see us in the office the following day. If you are unsure about your particular situation, please don't hesitate to call us.
Lyme Disease is entirely treatable, with an easy and complete recovery expected in virtually all cases after a several week course of oral antibiotics. Children, in particular, seem to do very well with Lyme Disease, with long-term sequelae being very rare. So, you should not worry that Lyme will be a long-term problem for your child.
To read more information about Lyme Disease, please click here to see the Massachusetts Department of Public Health fact sheet.