Larry Langdon
/ Categories: Lyme Disease

Lyme Disease in Children

The bacterium, Borrelia burgdorferi causes Lyme disease, which is spread through the bite of an infected blacklegged tick. Ticks can adhere to any region of the body and are frequently found in places that are difficult to notice, such as the groin, armpits, and scalp.

Lyme disease not only affects adults, but also children. A tick must be attached on the child's skin for 36 to 48 hours or more in order for the Lyme disease bacterium to be transmitted into their skin.

The bite of an immature tick called a nymph infects the majority of humans. Blacklegged nymph ticks are extremely little, measuring less than 2 millimetres in length and impossible to notice with the human eye. They eat more frequently in the spring and summer, when children and adults are more likely to be outside. Lyme disease can also be transmitted by adult ticks. They're a little bigger than nymphs, around the size of a sesame seed, and can be seen with the naked eye. Adult ticks are most active throughout the fall and winter months.

Lyme disease does not transmit from person to person, or from an infected mother to child while breastfeeding. It can only spread through tick bites.

Neurologic Lyme disease is more common in children, compared adults. Especially facial nerve palsy, and sometimes meningitis (brain inflammation). Lyme disease is frequently misdiagnosed in children who have just non-specific symptoms like headaches, joint pain, fatigue or weakness. Although non-specific symptoms frequently coexist with more characteristic Lyme signs and symptoms (e.g., bulls-eye rash). In children with Lyme disease, non-specific symptoms are only seen in a small percentage of cases. Studies have shown that children with Lyme disease who have been treated promptly with standard antimicrobial regimen for Lyme disease have a favourable prognosis with complete recovery, without complications and long-term effects. Early diagnosis and treatment is advised.


What Are The Signs And Symptoms of Lyme Disease In Children?

When your child is infected with the Borrelia burgdorferi bacterium, he or she may experience a variety of vague symptoms that could be mistaken for other illnesses. In addition, symptoms can alter over time, making diagnosis more difficult. If the infection is not treated, it can spread to other parts of the body, resulting in long-term medical problems and irreparable harm.

Within the first 30 days after a tick bite, common Lyme disease symptoms include:

  • Erythema migrans is a "bull's-eye" rash with a circular form. The centre can be pink or clear, while the surrounding skin can be red. It's possible that it'll last for a few weeks.
  • Rash might be extremely tiny or extremely enormous (up to 12 inches across) and an imitate hives, eczema, sunburn, poison ivy, or flea bites on the skin.
  • The rash may itch or feel hot, or it may not be felt at all. It may go away for a while, then reappearance many weeks later.
  • Symptoms of the flu may be present, such as:
  • Fever
  • Chills
  • Aches in the muscles and joints
  • Fatigue
  • Glands may be swollen

 

Your kid may develop additional symptoms if the infection spreads to other parts of the body, such as:

  • Headaches and stiffness in the neck
  • Other parts of the body have circular, "bull's-eye" rashes.
  • Severe joint pain and swelling, especially in the knees and other major joints, are symptoms of arthritis.
  • Facial Bell's palsy is characterised by a lack of muscle tone or a droop on one or both sides of the face.
  • Muscle, joint, tendon, and bone discomfort that comes and goes
  • Heart palpitations or an irregular heartbeat are two examples of heart palpitations (Lyme carditis)
  • Dizziness
  • Shortness of breath episodes
  • The brain and spinal cord are inflamed.
  • Pain in the nerves
  • Hands or feet shooting pain, numbness, or tingling
  • Short-term memory issues are a common occurrence.
  • Inflammation of parts of the eye.

 

How Is Lyme Disease Diagnosed And Tested In Children?

The Diagnosis of Lyme Disease in children is similar to that of adults. Lyme disease is usually diagnosed based on your child's symptoms, a physical examination, and a history of blacklegged tick exposure (i.e. living in or travelling to areas where the ticks are found).

Your kid's doctor may conduct blood testing to see if your child's immune system is creating specific antibodies to fight the Borrelia burgdorferi bacterium if your child has Lyme disease symptoms but no evidence of a tick bite. When the body's immune system has had time to respond to a tick bite, blood tests are most effective two to six weeks later.

Children who are tested within a few days of a tick bite may test "negative" for antibodies, but the bacterium is still present in their bodies, just not at detectable levels. As a result, early Lyme disease diagnosis is sometimes made purely on the basis of the distinctive Lyme disease "bull's-eye" rash, which appears in 70 to 80 percent of infected people.

If the Lyme disease infection has progressed beyond the skin, additional testing may be required, such as:

  • If Lyme carditis is suspected, electrocardiography (ECG or EKF) should be performed.
  • If Lyme meningitis is suspected, an MRI of the brain is recommended.
  • If there are signs of Lyme meningitis, the child may require a lumbar puncture (spinal tap).

Doctors would have to  distinguish Lyme disease and other diseases that mirror its symptoms. Making the accurate diagnosis as soon as possible allows your child to receive the best care possible.

If your child has Lyme disease, doctors make sure they get the treatment they need to get rid of the infection. If your child does not have Lyme disease, they would attempt to uncover the underlying reason of his or her condition and avoid unnecessary Lyme disease diagnosis and treatment.

 

How is Lyme Disease Treated in Children?

In the early stages of Lyme disease, treatment with suitable antibiotics results in a rapid and complete remission of symptoms with no long-term consequences. Doxycycline, amoxicillin, and cefuroxime are common oral antibiotics used to treat Lyme disease. They are usually administered as a two- to four-week course, depending on the stage of the infection. Doxycycline as an initial treatment is usually avoided in children under 8 years of age

Lyme disease usually responds well to medication, but if symptoms persist after the first course of treatment, a second course of antibiotics may be required.

Children who have been diagnosed with neurologic or cardiac disease may require IV antibiotics. Children with Lyme disease-related heart, joint, or brain problems may require extensive follow-up with paediatric specialists.

 

What Is The Prognosis Of Lyme Disease in Children?

Children with Lyme disease who take the full course of antibiotics as prescribed are unlikely to experience long-term effects from their sickness. Alternative diagnosis must be considered if symptoms persist despite antibiotic treatment. Long-term (months-long) IV antibiotics have not been proven to be beneficial.

If your child has had a Lyme disease infection, his or her body will manufacture antibodies to the infection long after the disease has been treated. This does not mean that your child is still infected; rather, it means that his or her body is still aggressively fighting any potential re-infection by the Lyme disease-causing bacterium.

Re-infection is possible after therapy for children who acquired "bull's eye" rashes and were treated early in the course of a Lyme disease infection. Because the medications removed the infection before your child's body could create protective immunity against future Lyme disease infections, your child's body was unable to generate protective immunity.

 

How Can Lyme Disease Be Prevented?

There is no vaccine available to prevent Lyme disease at present.To prevent Lyme disease, tick bites should be avoided. The following guidelines can help - these apply to parents as well, as parents can also carry unattached ticks into the house which can attach to the child during close contact:

  • Avoid tick-infested places:
    Remind your children not to stroll through or play in wooded areas and fields on cleared trails and roads whenever possible. Parents should also avoid tick infested areas. Unattached ticks on parents can attach to the child during close contact
  • Protecting the skin and hair:
    When walking in shady, wooded areas, wear a hat, long pants, and long sleeves. Even in the heat, it's critical to protect any exposed skin. Your child's hair should be pulled back into a ponytail or tucked into a cap. Ticks can't fly or jump from trees, but they can make their way up your child's hair.
  • Using insect repellents but with caution:
    Tick repellents containing DEET are useful, although they aren't 100 percent effective. Use a child's bug repellent with a concentration of 10 to 30 percent DEET. It can be used on exposed skin as well as shirt collars, sleeves, and pant cuffs. Infants under the age of one year should not be exposed to repellent. Apply to the area around your child's nose, mouth, and eyes only if necessary. Apply to any cuts or open sores with caution.
     

Things to keep in mind while using insect repellents:

  • Allowing children under the age of 10 to apply repellant on their own is not recommended.
  • Apply to young children's hands, as well as the area around their eyes and lips.
  • Ensure the child does not inhale, swallow, or get their hands in their eyes (DEET is toxic if swallowed).
  • Repellent should not be used to wounds or broken skin.
     
  • Maintaining hygiene:
    Encourage your child to shower as soon as he or she enters the house with soap/ body wash or bathe them thoroughly with soap/ body wash. The child’s hair must be washed as well. Unattached ticks can be removed by showering.
  • Keep Ticks off of Animals at home:

To keep ticks out of the house, limit your family pets' access to tick-infested areas and put veterinarian-prescribed tick prevention products on them.

  • Keeping the yard free of ticks:

In your landscaping, create "Tick-Safe Zones." It's a simple procedure. Patios, play spaces, and playground equipment should be free of shrubs, bushes, and other vegetation. Regularly remove leaves, clear tall grasses and shrubs around your home, and place wood chips or gravel between lawns and forested areas to keep ticks away from recreational areas (and away from you).

  • Using chemical pesticides:

Use acaricides (chemical tick pesticides)to reduce the number of ticks in treated areas of your yard. Spraying, on the other hand, has no effect on your chances of becoming infected. Deer is the principal food source for adult ticks. Remove plants that attract deer and create impediments (such as a fence) to keep them out of your yard so they don't carry ticks with them.

  • Look for ticks:
    If you reside in or plan to visit a region where Lyme disease illnesses have been documented, it's critical to check your entire family, including your pets, for ticks on a regular basis.


Check the following places for ticks in the body:

 

  • The belly button, in and behind the ears, on the neck, near the hairline, armpits, groyne, and the scalp are all common tick hideouts.
  • Bending parts of the body like behind the knees, between fingers and toes, underarms, and crotch.
  • Areas where clothing presses against the flesh, such as where elastic waistbands meet the skin.
  • Check your child's hair for ticks every day with a fine-toothed comb.
  • Visually inspect the rest of your body and hair, then softly run your fingertips over the skin as ticks can transmit from the parents to the child

 

What To Do If You Come Across A Tick On Your Child’s Body?

If you find a tick on your child's body (or even yours), try to remove it. It may help prevent illness if the tick was on the body for less than 36 hours.

To securely remove a tick, follow these steps:

  • Grasp the tick at its head or mouth, near to the skin, with fine-tipped tweezers.
  • Pull hard on the tick until it pops out of the skin. Any pieces that get lodged in the skin should be eased out as much as possible.
  • Apply an antiseptic lotion or cream to the bite area after cleaning it with rubbing alcohol or soap and water.

 

References

https://pubmed.ncbi.nlm.nih.gov/9166958/

https://pubmed.ncbi.nlm.nih.gov/25999224/

https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-018-1163-2

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