"It's been a stressful few days," says Christine. Once they had removed the tick (using tick tweezers from MEC,) they headed over to the Children's Hospital of Eastern Ontario (CHEO) emergency department to inquire about potential treatment and testing.
According to Dr. Manisha Kulkarni, 1 in 3 ticks in the west end of Ottawa is carrying the Lyme disease bacteria. There has been a 145% increase in the tick population in this city between 2016 and 2017 and this number is expected to rise. In the Odessa area where Christine's son got the tick bite, there is a 40-45% chance that the bug is carrying Lyme.
By now, most folks have learned about ways to protect themselves against tick bites, but it's always helpful to review the proper methods for removal (tick keys or tick tweezers are best, but in a pinch you can use flat-edged tweezers.) It's important not to stress the tick, so no dousing it in oils or other substances, and no squeezing or twisting the body. Grip firmly at the base and pull.
Once the tick was removed, Christine's journey into the murky world of ticks and Lyme disease began. Upon arrival at CHEO, Christine learned that not only would her son not be a good candidate for preventative antibiotics, but that the tick itself could not be sent away for testing.
"There is a role for preventative antibiotics (which is different from treatment,) if the tick was engorged (attached for > 36 hours) and the child is more than 8 years old," says Dr. Gina Neto, head of Emergency Medicine at CHEO. In kids under eight years of age, it’s still controversial** as to whether or not there’s a benefit in doing preventative antibiotics, mainly because it's not been well studied and carries potential risks.
Preventative antibiotics need to be administered within 72 hours to be effective. This means that many tick bites could be treated by a primary care physician, as long as the patient has access to timely care.
However, CHEO knows that sometimes seeing your family doctor is not practical. "We understand if families come to the emergency department," says Dr. Neto. "We accept that and we know that they’re worried." (Another alternative would be a visit to your local urgent care clinic as opposed to emerg.)
When antibiotics within 72 hours are not advisable (as in Christine's case) or when the window has been missed, then the next step is to watch for symptoms of Lyme disease. These typically include flu-like symptoms, such as body aches, fever and lack of energy. Symptoms generally present between 7 - 14 days, but parents should be vigilant up to 30 days after the bite. Also, the typical "bulls eye" rash that is a possible sign/symptom doesn't show up in all cases - when it does, it usually pops up several days after the bite.
The treatment for Lyme disease** is similar to the treatment a child would receive for an ear infection - a course of amoxicillin, as well as rest and recovery. "[Early stage] Lyme disease isn’t something that makes you really, really sick," says Dr. Neto.
With prompt treatment, patients can avoid more severe symptoms that may arise with second or third-stage Lyme disease. Dr. Neto is quick to point out how rare it is to struggle with long-term Lyme disease symptoms. "It gets portrayed a lot in the media and that’s where people get scared," she says.
