Q: My child has been sick, and he plays outside a lot. Could he have Lyme Disease?

Ask Our Expert About Lyme Disease

About Our Expert

Luther Rhodes, M.D.
Chief, Division of Infectious Diseases
Lehigh Valley Hospital and Health Network

• My child has been sick, and he plays outside a lot. Could he have Lyme Disease?
• I’ve heard Lyme Disease is hard to diagnose.
• How is Lyme diagnosed?
• How is Lyme treated?
• Can I get Lyme if I live in the city?
• I’ve heard that Lyme cannot be successfully diagnosed or treated.
• Is there anything I can do to prevent Lyme?
• How long should I be on tick alert?
• There’s a lot of conflicting information on the Internet. How do I know what’s reliable?

Q: My child has been sick, and he plays outside a lot. Could he have Lyme Disease?

A: In the early stages, Lyme Disease mimics many other flu-like illnesses. Fatigue, fever and aching joints could be Lyme or many other conditions. If you have these symptoms plus a rash, joint swelling, headache, stiff neck, facial paralysis, dizziness or irregular pulse, you should see your doctor.

Q: I’ve heard Lyme Disease is hard to diagnose.

A: Diagnosing Lyme has become much easier in recent years as testing has become standardized and we’ve learned more about how the disease operates. Your primary care physician (family physician, internist or pediatrician) is best able to diagnose and treat you.

Q: How is Lyme diagnosed?

A: Lyme is diagnosed with lab tests and a physical exam. The blood test alone is not enough, since you may not have developed antibodies in the first few weeks, or may have antibodies from a previous Lyme infection. If you’ve had Lyme, you may test positive for many months. If you have a new infection and it is not treated, the test will get stronger over time.

A particular rash is one indication of Lyme, although not everyone develops a rash. It usually begins at the site of the tick bite. If untreated, it will grow and change day-to-day. It can look like the classic bulls-eye, or it may appear as multiple rings. If the rash is the size of a dime or smaller, it’s not usually Lyme. A person with Lyme will generally feel bad all over, not just at the site of the bite or rash. The Lyme rash will eventually go away, even if untreated.

If an initial screening blood test is positive for Lyme, it will be followed by a confirmation test called the western blot test. A urine test is not a reliable test for Lyme, and therefore not recommended.

Q: How is Lyme treated?

A: Most cases of Lyme are treated with a few weeks of oral antibiotics – generally doxycycline for adults and amoxicillin for children. Fortunately, very few cases require intravenous antibiotics. It is almost always completely curable. Symptoms in Lyme infection, like other infections, may take a few days or weeks to completely clear. It is very good advice to approach Lyme infection as a condition which can be diagnosed and cured, and to avoid a mindset that it is a lifelong affliction.

Q: Can I get Lyme if I live in the city?

A: Anyone in the Lehigh Valley can get Lyme, regardless of where you live. The ticks that carry Lyme live on mice and other small rodents. Pet dogs can get Lyme infection from accidental exposure to deer ticks, but the commonly seen dog tick does not cause Lyme infection. They are most often found on grass that’s at least ankle-high. The tick attaches to you when you brush against the grass, so it usually starts around your ankles and travels upward. Children are especially susceptible to ticks when they roll around in the grass. Keeping your lawn mowed will help keep Lyme ticks at bay. Tiny deer ticks are the only kind that carry Lyme.

Q: I’ve heard that Lyme cannot be successfully diagnosed or treated.

A: This is one of the many misconceptions about Lyme. Lyme is a bacterial infection. As with any illness, you may be tired and not yourself for a few weeks or more, depending on when it’s diagnosed, but you will get past that if you allow yourself time to recover and gradually increase your activity. Studies show that children do not suffer any long-term athletic, academic or developmental effects when diagnosed and treated successfully.

Rumors that Lyme can lead to multiple sclerosis, sexually transmitted diseases, pulmonary hypertension or other problems are false.

Q: Is there anything I can do to prevent Lyme?

A: You can prevent Lyme by preventing ticks from biting. Use an insect repellent which contains DEET, which is perfectly safe for adults and children when used as directed. This will also protect you from mosquitoes. You don’t need to saturate yourself – just enough to make you “smell bad” to ticks and mosquitoes. DEET wipes are now available if you don’t like the spray, or you can make your own repellent wipes by spraying a towelette. Dab it on key spots like arms, back of legs, neck and feet if you wear sandals.

A tick needs to be in place for 48 hours in order to infect you, so the next best way to prevent Lyme is to do daily tick inspections. Check in obscure locations like behind knees, around ankles, on the buttocks and at the nape of the neck and hairline.

If you find a tick, carefully remove it with tweezers. Do not use petroleum jelly or try to burn it off. Then watch the area carefully for the next week to ten days.

Q: How long should I be on tick alert?

A: The ticks themselves are generally around through September and into October, but Lyme symptoms can show up at any time. People may develop symptoms in the fall from a bite they got in the spring or early summer.

Q: There’s a lot of conflicting information on the Internet. How do I know what’s reliable?

A: A study published in The Pediatric Infectious Disease Journal in December, 2004, confirmed that many Internet web sites indeed contain inaccurate information about Lyme disease. But you can find accurate information at these sites: www.cdc.gov, www.fda.gov, www.healingwell.com, www.hopkins-arthritis.com, www.intelihealth.com, www.kidshealth.org, www.webmd.com, www.aldf.com, www.acponline.org.

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