Lyme Disease


Jayne Laurin Kinney DNP, PNP-BC



Lyme disease is a bacterial infection transmitted to humans through a bite of infected blacklegged ticks, or deer ticks.  Ticks live in forests, wooded areas, and marshy areas near water.  Symptoms of early Lyme disease include fever, headache, fatigue, swollen glands, aches and pains in the muscles or joints, or a rash.  The rash of Lyme is sometimes called a bull’s eye rash.  It begins as a pink or red circle that expands over time and may become several inches or larger. The rash can appear anywhere on your body and anytime from 3 to 30 days after a tick bite. Some people only have one circle, while others may have many.  Most people do not feel the rash, but for a few, the rash can be itchy, burn, or feel warm to the touch.  If a tick has attached, it takes at least 36 to 48 hours of feeding for it to transmit Lyme disease. If your child develops symptoms of Lyme disease, call your healthcare provider.


In addition to symptoms of early Lyme disease, Lyme disease in its later stages can cause arthritis (swelling of one of more joints) or an infection of the nervous system.  Symptomatic Lyme disease is treated with antibiotics. Most people who are treated appropriately recover quickly and completely.   A small percentage of people can have symptoms that last for several months. These prolonged cases are sometimes called “chronic Lyme disease”.  The proper term for chronic symptoms following treatment of Lyme disease is known as Post-treatment Lyme Disease Syndrome (PTLDS). The National Institutes (NIH) has funded several studies on the treatment of Lyme disease that show most people recover when treated with a few weeks of antibiotics taken by mouth.  For more information on the treatment of Lyme disease, visit the NIH website:


Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. Ticks can be found right in your own backyard, depending on where you live. Keeping your yard clear of leaves, brush, and tall grass may reduce the number of ticks. Ask a licensed professional pest control expert about other steps you can take to reduce ticks in your yard.

  • Avoid places where ticks live. Whenever possible, avoid shaded, moist areas likely to be infested with ticks.
  • Cover arms and legs. Wear a long-sleeved shirt and tuck pants into socks.
  • Wear a hat to help keep ticks away from the scalp. Keep long hair pulled back.
  • Wear light-colored clothing to make it easier to spot ticks.
  • Wear enclosed shoes or boots. Avoid wearing sandals in an area where ticks may live.
  • Use insect repellent. Products with DEET are effective against ticks and can be used on the skin. However, large amounts of DEET can be harmful to your child if it is absorbed through the skin. Look for products that contain no more than 30% DEET. Wash the DEET off with soap and water when your child returns indoors. Products with permethrin can be used on clothing, but cannot be applied to the skin.
  • Stay on cleared trails whenever possible. Avoid wandering from a trail or brushing against overhanging branches or shrubs.
  • After coming indoors, check for ticks. This will only take a couple minutes. Ticks often hide behind the ears or along the hairline. It usually takes more than 48 hours for a person to become infected with the bacteria, so removing any ticks soon after they have attached themselves is very effective for reducing the chances of becoming infected.
  • Bathe or shower as soon as possible after coming indoors (preferably within 2 hours) to wash off and more easily find ticks that are crawling on you.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs.
  • Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.
    • If the clothes are damp, additional time may be needed.
    • If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks effectively. If the clothes cannot be washed in hot water, tumble dry on low heat for 90 minutes or high heat for 60 minutes. The clothes should be warm and completely dry.


Ticks do not fly, jump, or drop from trees. They hide in long grass and small trees, bushes, or shrubs waiting for an animal or person to brush by. Then they attach themselves to the animal or person’s skin. When a tick is found on a person or pet, try to remove as much of it as possible using the following steps:

  1. Grasp the tick as close to the skin as possible with fine-tipped tweezers. Be careful not to squeeze the tick’s body.
  2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal. Attempts to remove these mouth-parts may result in significant skin trauma.
  3. After the tick is out, clean the bitten area with rubbing alcohol or other first aid ointment.
  4. Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.



Many people have incorrect information about Lyme disease. Some people are concerned that Lyme disease cannot be treated if antibiotics are not given early. This is not true. Even later symptoms of Lyme disease can be treated effectively with proper antibiotics. Many local Lyme disease networks and national organizations distribute unproven information and should not be the only source of information about Lyme disease.

The following organizations provide reliable health information.

  • National Library of Medicine


  • National Institute of Allergy and Infectious Diseases


  • National Center for Infectious Diseases

Division of Vector-Borne Infectious Diseases

  • American Lyme Disease Foundation, Inc.


We are  here to help by following the guidelines of the American Academy of Pediatrics, The Centers for Disease Control, and the Infections Disease Society of America.  If you call with concerns about a specific tick bite or symptoms, we will most likely invite you in for an appointment for more in-depth discussion.

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