Lyme disease is a bacterial infection caused by a microbe maintained by animals in nature. When certain ticks bite animals infected with the Lyme disease bacteria, they ingest the bacteria and subsequently transmit the disease. Humans and pets are 'bitten' by the infected ticks, and become infected with Lyme disease.
Charles Grose, MD, infectious disease specialist at University of Iowa Children's Hospital, talks about Lyme disease:
How widespread is Lyme disease in Iowa?
That's a very interesting question. I came to The University of Iowa about 20 years ago from Texas. There's no Lyme disease in Texas and there was no Lyme disease in Iowa at that time. The disease came to Iowa about five to seven years ago. It was carried on the deer as deer migrated from the east coast along the upper states. They came to Wisconsin and migrated from Wisconsin into Iowa.
The first location it was found in Iowa was Dubuque and the counties north of Dubuque. Over the last five years, the deer have migrated west and south so Linn and Johnson counties now have Lyme disease and have had it for the last two to three years.
It's interesting that we're talking because we had the first case of Lyme disease that I'm aware of in Johnson County, this week in our clinic.
Can insects other than ticks transmit Lyme disease?
No, the only vector for Lyme disease is the deer tick. For those who live in Iowa, they're probably aware of another tick called the wood tick or the dog tick, and it does not transmit the disease. It's only the tick that lives on the deer.
What are the symptoms of Lyme disease in a child?
The main symptoms occur within about 24 to 48 hours after the child has a tick. The symptom is a rash and called erythema migrans,. It's very characteristic, because at the site of the tick bite, the child will develop a very wide circle that is dark red. Sometimes parents will notice this rash without even seeing the tick, which may have already fallen off.
What should you do if you suspect your child might have Lyme disease?
The most important thing to do is call your local physician. In almost all cases, if they think there has been a tick bite, they will order a blood test to tell if your child actually has the disease or not.
Are there medical tests to confirm Lyme disease?
That's the interesting dilemma with this disease. This is probably one of the diseases where it's common to go the Internet for information but you might actually might become more confused. There's been an evolution in the tests for this disease. We now have very accurate tests; but we didn't a few years ago so there was a lot of confusion about whether we could diagnosis this disease. At the present time, we have very good and very accurate tests and we can diagnosis the disease accurately.
Can blood tests be negative, but the child still has Lyme disease?
Only in unusual circumstances. It's usually children in Iowa we're concerned about. If the child has just had a tick bite within one to three days and you do the test on the third day after the tick bite, it is possible that the test will be negative at that time. But the test will become positive within around seven to 10 days.
Can Lyme disease be misdiagnosed as another illness?
Again, this debate has arisen largely because we didn't have very accurate tests for diagnosing Lyme five to 10 years ago. There was a lot of confusion with people who actually did have Lyme disease but the tests were negative. That confusion should not be around anymore. In Iowa, in the summertime, there are very few other diseases that can cause this very characteristic rash, which I said is a large, circular, red area on your skin plus a low grade fever. So in Iowa right now, is certainly the most common cause.
Once diagnosed, how is Lyme disease treated in a child?
Lyme disease is actually very simple to treat. There are two common antibiotics that work on this disease. They're called doxycycline and Amoxil. Many parents will have already heard of these because they will have been used before. They antibiotics are on the list for some of the common pharmacy chains that can be purchased for somewhere around $10—so the treatment is not expensive.
Can Lyme disease be cured?
Yes, in almost all children who are treated within the first three to four weeks after they have the disease. In a few cases, when the disease is not recognized within the first month, there are children who sometimes develop arthritis. These children will sometimes need a second course of antibiotics to cure the illness.
What can parents do to help minimize the chance their child might be exposed to Lyme disease?
The main point is just to remember that Lyme disease is carried by the deer tick, so if you see deer around in your area where your children play, then there is always a risk.
The best thing I advise is, each evening when they come in from playing in the park or if you've been out hiking, to look for the deer tick. The ticks are about the size of the tip of a lead pencil, very dark grayish-black and should be visible on the child's skin. The other thing, of course, is what they frequently say on television; if you're hiking they always advise the children to wear long pants. |
