talk to me about tick bites

[EmilyGF]

My daughter was bitten by a tick in mid-June. It was a teeny-tiny tick and it bit her on her face while she was visiting grandparents in the Virginia mountains. It definitely bit her by the time it was noticed.

 

Five weeks have passed. She has had no rash, no fever, no aches, nothing except the normal congestion she has (she has tonsils the size of New Jersey and has at least since a toddler). She has a well-child check up next week. 

 

Is there anything I should specifically ask the doctor to do/check related to the tick? I'll certainly ask about it, but just want to go having informed myself beforehand.

 

Thanks,

Emily

[MEmama]

I would definitely mention it so it's on record, if nothing else. Most doctors won't test for Lyme or whatever's prevalent in your area unless there are symptoms, but if you are concerned you can make a fuss and see if they'll bend. ;)

 

Idk about other tick borne diseases, but Lyme can take a long time to show symptoms, which is exactly why it can be so hard to diagnose. It took about a year to show up in my son.

 

Next time, you can save the tick in a little Baggie and send it in for testing. Our state does this for free; I'm sure others do too.

 

Most likely she's fine but yes, let the doctor know and get all the information you can. This will also give you the opportunity to feel out how up to date the doctor is, and if she does have symptoms later, whether or not he will be a good or reluctant resource.

[Carrie12345]

I agree with letting them know. If it was on her face, I'm guessing it wasn't there long. Which may not be a guaranteed pass, but it most likely is.

[EmilyGF]

I would definitely mention it so it's on record, if nothing else. Most doctors won't test for Lyme or whatever's prevalent in your area unless there are symptoms, but if you are concerned you can make a fuss and see if they'll bend. ;)

 

Idk about other tick borne diseases, but Lyme can take a long time to show symptoms, which is exactly why it can be so hard to diagnose. It took about a year to show up in my son.

 

Next time, you can save the tick in a little Baggie and send it in for testing. Our state does this for free; I'm sure others do too.

 

Most likely she's fine but yes, let the doctor know and get all the information you can. This will also give you the opportunity to feel out how up to date the doctor is, and if she does have symptoms later, whether or not he will be a good or reluctant resource.

We considered doing this but were advised against it because:

 

1) if it has Lyme, it may not have actually infected the child

2) if it doesn't have Lyme, there is still a good chance there may have been a second, unnoticed, tick bite and it would give a false sense of security

 

But we were also pretty busy at the time (had one day of down-time after the bite before leaving for a big vacation) and I don't know what we would have done if we had not been in a huge rush... Sigh.

[RegGuheert]

The type of tick you described is a deer tick, which is the kind that carries Lyme disease, babesia, and several other severe diseases.  I would request that the doctor prescribe the standard treatment for acute Lyme disease: AT LEAST three weeks of amoxicillin (or doxycycline if she is allergic to penicillin).  Why, because Lyme disease is not always symptomatic in the early stages and later stages can be unbelievably debilitating.  We live in VA and many of us have had a Lyme rash, which was easily treated.  Unfortunately, one of our sons got Lyme without us knowing.  Over time, he basically lost his ability to think clearly, developed odd fears and ultimately became suicidal.  After finding a Lyme-literate physician and 18 months of treatment, we finally got our son back.

 

If you want the full story on what Lyme disease is, what it can do to your daughter and the controversy surrounding it, then I recommend the excellent documentary on the subject: Under Our Skin.  It used to be free on Netflix, Amazon Prime and YouTube, but it looks like that is no longer true.  I cannot recommend watching this movie enough if you think someone in your family may have Lyme, babesia or other tick-borne diseases.

 

As has been mentioned, it is possible that your daughter did not get Lyme or babesia or some other serious disease, but given our bad experience I would not take any chances.

 

ETA: The standard testing used to detect Lyme disease suffers from a very high false negative rate, meaning basing ANY conclusions from the test is a bad idea.  This fact leads many doctors to think that patients do not have Lyme who actually do.

 

ETA2: I don't recommend watching Under Our Skin together with your daughter.  Instead, you should screen it first and then offer to let her see it if you think that is appropriate.

Edited July 21, 2016 by RegGuheert

[Cecropia]

Do you have a firm idea of how many hours she had the tick attached?  Did you give her a thorough full body check when the first one was noticed (including scalp)?

 

There is a very low risk of transmission over, say, the first 6 hours of a tick bite.  A helpful article can be found here (pdf):

http://www.bayarealyme.org/wp-content/uploads/2014/08/PCM-risk-poster-color-1.pdf

[Katy]

After my multiple bullseye rashes I got a few years ago from bites in my own backyard, we have a policy that any engorged tick attached to someone rates preventative antibiotics.

 

So...  was the tick engorged?  If so, it was probably attached for long enough to transmit infection.  If not, I might ask for a test, but otherwise I'd forget about it.

Edited July 21, 2016 by Katy

[Carrie12345]

The type of tick you described is a deer tick, which is the kind that carries Lyme disease, babesia, and several other severe diseases. I would request that the doctor prescribe the standard treatment for acute Lyme disease: AT LEAST three weeks of amoxicillin (or doxycycline if she is allergic to penicillin). Why, because Lyme disease is not always symptomatic in the early stages and later stages can be unbelievably debilitating. We live in VA and many of us have had a Lyme rash, which was easily treated. Unfortunately, one of our sons got Lyme without us knowing. Over time, he basically lost his ability to think clearly, developed odd fears and ultimately became suicidal. After finding a Lyme-literate physician and 18 months of treatment, we finally got our son back.

 

If you want the full story on what Lyme disease is, what it can do to your daughter and the controversy surrounding it, then I recommend the excellent documentary on the subject: Under Our Skin. It used to be free on Netflix, Amazon Prime and YouTube, but it looks like that is no longer true. I cannot recommend watching this movie enough if you think someone in your family may have Lyme, babesia or other tick-borne diseases.

 

As has been mentioned, it is possible that your daughter did not get Lyme or babesia or some other serious disease, but given our bad experience I would not take any chances.

 

ETA: The standard testing used to detect Lyme disease suffers from a very high false negative rate, meaning basing ANY conclusions from the test is a bad idea. This fact leads many doctors to think that patients do not have Lyme who actually do.

 

ETA2: I don't recommend watching Under Our Skin together with your daughter. Instead, you should screen it first and then offer to let her see it if you think that is appropriate.

For someone who is unlikely to get many more bites, I might be able to reluctantly agree. And I have done preventative treatment in one case, with a questionable red mark.

 

But I'd avoid recommending blanket treatment of all bites for all people. In my house, that would involve year round antibiotics. Weighing individual pros and cons is still important.

[Spryte]

Seconding the above, and adding that you need to let the doc know that the area where your DD was bitten (VA) is endemic for Lyme, babesia and other co-infections.  A doc's perspective can change drastically if s/he lives in an endemic area, where these things are not uncommon.  

 

I've been treated for all the above (really, I think I had every co-infection except tularemia), DH has been treated, DSS (24) has bartonella, and DS (12) currently is in treatment for babesia, awaiting more test results.

 

 

[RegGuheert]

After my multiple bullseye rashes I got a few years ago from bites in my own backyard, we have a policy that any engorged tick attached to someone rates preventative antibiotics.

 

So...  was the tick engorged?  If so, it was probably attached for long enough to transmit infection.  If not, I might ask for a test, but otherwise I'd forget about it.

 

Our many experiences with deer ticks tell us that it is often difficult to tell whether or not it is even a tick.  Very often we have thought we were looking at a tiny scab only to learn that it was a tick once we got out a loupe and looked carefully at it.  If OP could see that this was a tick, then perhaps it was engorged.  But perhaps that just means it is a larger (more mature) deer tick.

 

[RegGuheert]

For someone who is unlikely to get many more bites, I might be able to reluctantly agree. And I have done preventative treatment in one case, with a questionable red mark.

 

In our experience, it was the case where there was NO acute symptom (no rash) where the consequences were most severe.  Simply put, Lyme (and babesia) are only severe diseases IF they go untreated long enough to allow for the infection to become systemic enough to be fairly untreatable.

 

BTW, Amy Tan's excellent discussion of her experience with Lyme disease is quite an eye-opener if you are not familiar with the disease.  (She DID have a bulls eye rash, but did not get treatment for it.)

[Carrie12345]

 

In our experience, it was the case where there was NO acute symptom (no rash) where the consequences were most severe. Simply put, Lyme (and babesia) are only severe diseases IF they go untreated long enough to allow for the infection to become systemic enough to be fairly untreatable.

 

BTW, Amy Tan's excellent discussion of her experience with Lyme disease is quite an eye-opener if you are not familiar with the disease. (She DID have a bulls eye rash, but did not get treatment for it.)

Oh, I get it. Truly. I sat by and waited for "Lyme or leukemia" results with my no-rash kid. That is why we treated not-exactly-bullseye kid. But someone gets bit in our house every couple of weeks. Individually, at least 2 or 3 a year, including winter. I can't abx them 21 out if 52 weeks in good conscious just in case.

[RegGuheert]

Here is a video by a Lyme patient which details what one might expect from an untreated case of Lyme disease:

 

 

[J-rap]

But I'd avoid recommending blanket treatment of all bites for all people. In my house, that would involve year round antibiotics. Weighing individual pros and cons is still important.

 

I'd agree with this.  We have multiple tick bites every year;  most people do around here.  There is no way that doctors would just put our entire community on antibiotics all spring and summer every year.  You somehow have to weigh things.  For example, if someone's health was already fragile, then that's one thing to consider.  If multiple Lyme's cases have been found in your exact area, that's something else to consider.

 

Three people in my family actually have had tick-borne illnesses.  (None from our area though.)  They did all have symptoms and were all on antibiotics within weeks.  None have had any long-term problems, thankfully.  

 

But, I still would not consider getting preventative treatment for a tick bite.  I would clean it well and watch it.  

 

I do understand why other people approach this differently though.

Edited July 21, 2016 by J-rap

[mommyoffive]

argh 

 

this is freaking me out

 

Dh and one kid had ticks on them this weekend.  

[EmilyGF]

I'm very aware of how extreme Lyme disease can be. Thanks.

[RegGuheert]

I'm very aware of how extreme Lyme disease can be. Thanks.

 

Good.  That's part of the equation.

 

The other significant part is that it is VIRTUALLY IMPOSSIBLE to get a positive diagnosis of Lyme disease from a doctor without a rash.  This is more true in parts of the country where Lyme is not at epidemic levels.  The reason is that the CDC ONLY acknowledges the existence of Acute Lyme disease.  According to them, Chronic Lyme disease does not exist.

 

It's relatively easy to get a doctor to prescribe three or four weeks of amoxicillin following the tick bite.  If that is not done, your options later are extremely limited and your insurance will not pay a dime.

[Spryte]

My life is a cautionary tale about undiagnosed, untreated Lyme Disease and co-infections.  20+ years before a proper diagnosis, and I am very cautious with our kids, and DH.  I will never be the same.  My body will never be the same.  I am missing organs as a result, and have several other organs that do not and will never function properly again - all as a result.  I am lucky to be alive.  I can't watch the video linked, it just rips me apart.   :(

 

I get it, if people don't want to treat every tick bite.  We don't, either.  When a healthy member of the family gets a bite, we examine the tick.   Depending on the type and age - we make a decision.  If it is an adult, male deer tick - attached to DH - we don't worry as much.  Adult male deer ticks are less likely to transmit disease.  If it's on me - we treat.  If it's on DS, with a compromised immune system - we treat.  We haven't had to make a decision for healthy DD yet.  We make all decisions with the help of my nationally known LLMD, so I'm comfortable with our choices.

 

All ticks are saved in baggies with moist cotton balls, labeled and kept.  All bites are photographed and documented.

 

We live in an endemic area, and my life will never, never be the same.  But - we still do outdoors things.  We are outdoorsy people.  We take precautions.  If my kids suddenly started picking up more ticks (20 weeks out of 52, yikes), I'd increase our precautionary measures.  Permethrin spray on shoes and clothes, DEET, removal of leaf litter, treating animals, Damminix Tick Tubes, nightly tick checks.  All of these things will reduce one's exposure to ticks.  For me, weighing the risk of, say, DEET against the risk of undiagnosed TBDs - that's a no brainer.  For someone else, maybe it's not.  

 

Even with all of these precautions, and our awareness:  my son has been violently, dangerously ill for a month.  It started mid-June, with meningitis.  He's been hospitalized 4 times, and to a national children's hospital once.  We could have lost him. He's seen a pediatrician or other doc every 3 days for the last month.  And... We missed it.   They didn't catch it.  I even asked the Infectious Disease Specialist at Children's point blank.  She asked if we remember a bite or he had a rash.  My DH was the one to figure it out, last Fri, and call the LLMD's private number.  She worked DS in immediately, and he's already showing improvement.  But we don't recall the bite, there was no rash.  We do tick checks!  But ticks can be tiny, and there's not always a rash.  

 

If you don't live in an endemic area, it doesn't have the same urgency.  I'd just be aware that the risk is there.  And for the OP, I'd probably not be too concerned, but would want it documented that a bite happened in an endemic area.  OP, you'll want to know what's endemic in that area, where the bite happened.

 

And, then, OP, I'd keep this in the back of your mind always.  Because the danger in it is that symptoms will crop up much, much later.  You won't remember the tick bite, if something comes up years later.  You'll do all the right things, and your DD will go to specialist after specialist and not get clear answers.  Or they'll be vague answers, without a clear root cause - like fibromyalgia, chronic fatigue syndrome, myofascial pain syndrome, IBS, even MS - and then you'll chase those bunny trails.  And someday, if you're very lucky, someone might look at the whole big picture and say, "hey, there must be a reason for all of this!"

Edited July 21, 2016 by Spryte

[Spryte]

 

 

It's relatively easy to get a doctor to prescribe three or four weeks of amoxicillin following the tick bite.  If that is not done, your options later are extremely limited and your insurance will not pay a dime.

 

So true.  The cost of treatment early is negligible.

 

The cost later - huge.  We had to use the equity in our house.  It was worth it, but has set us back financially, for years.

[RegGuheert]

We take precautions.  If my kids suddenly started picking up more ticks (20 weeks out of 52, yikes), I'd increase our precautionary measures.  Permethrin spray on shoes and clothes, DEET, removal of leaf litter, treating animals, Damminix Tick Tubes, nightly tick checks.  All of these things will reduce one's exposure to ticks.

 

Thanks for the tips!  Since our issue with DS16 got very severe, MomsintheGarden now puts Tea Tree Oil (inexpensively available at Wal-Mart) in every load of laundry.  She also purchases shampoo with Tea Tree Oil in it and some of the people in the family use this.  I have to think these precautions are working since I cannot recall a latched-on tick on anyone in the family in the past few years.

[mommyoffive]

I didn't save the ticks from this weekend.  

 

Should I call the doc and get meds?

[mommyoffive]

Thanks for the tips!  Since our issue with DS16 got very severe, MomsintheGarden now puts Tea Tree Oil (inexpensively available at Wal-Mart) in every load of laundry.  She also purchases shampoo with Tea Tree Oil in it and some of the people in the family use this.  I have to think these precautions are working since I cannot recall a latched-on tick on anyone in the family in the past few years.

 

tea tree oil is a preventive? 

 

I hadn't heard that.

[RegGuheert]

I didn't save the ticks from this weekend.  

 

Should I call the doc and get meds?

 

It depends:

 

- Were the ticks latched on?  If not, I wouldn't worry.

- If so, what type of ticks were they?  If you could easily see them, then they might have been wood ticks, which CAN carry Rocky Mountain Spotted fever, but that is quite rare.  I've been around wood ticks all my life and basically have very little concern for them.  (I certainly understand others have had a much worse experience with these ticks.)

- If it was a very small tick that was latched on, then I would recommend getting treatment immediately (even if Lyme is not known to be common in the area).  Amoxicillin is preferred if they aren't allergic to penicillin.  Otherwise, treat with doxycycline (drawback is extreme sun sensitivity).  Three weeks minimum, four weeks preferred.

 

tea tree oil is a preventive? 

 

I hadn't heard that.

 

If you are asking if tea tree oil prevents Lyme disease, I don't think it does.  MomsintheGarden uses it because she believes ticks might not like the smell of it and might stay away from us.  Anecdotally, we do seem to have fewer ticks since she started washing with us.

[mommyoffive]

I didn't see the one on Dh so I don't know how big it was.

 

The one on dc was big.  Around the size of an eraser on a pencil. 

 

Came off easy so I don't know that it was latched on.  Didn't see any blood when we removed it.

 

This dc was on meds for a tick bite years ago.  I think tested positive for lyme?  And had an allergic reaction to the meds.  Maybe a penicillin allergy. 

[MEmama]

Spryte:

 

((HUGS!!!!!!!!!!!!))

 

Sending positive thoughts your family's way!

[Carrie12345]

I didn't see the one on Dh so I don't know how big it was.

 

The one on dc was big.  Around the size of an eraser on a pencil. 

 

Came off easy so I don't know that it was latched on.  Didn't see any blood when we removed it.

 

This dc was on meds for a tick bite years ago.  I think tested positive for lyme?  And had an allergic reaction to the meds.  Maybe a penicillin allergy. 

 

A tick that large is almost definitely not a deer tick.

 

If he's tested positive before, he's likely to test positive again, regardless.

[RegGuheert]

The one on dc was big.  Around the size of an eraser on a pencil. 

 

Came off easy so I don't know that it was latched on.  Didn't see any blood when we removed it.

 

That was NOT a deer tick and almost certainly was a wood tick (some call them dog ticks).  And it doesn't sound like it was latched on.  If it were me, I would ignore it.  You'll have to do what makes the most sense to you.