August 2011 Greater Harrisburg's Community Newspaper - theBurg

Family Health
When That Tick Bites
A primer on avoiding, detecting Lyme disease.
Dr. Deepa Sekhar
walk into my next patient room, and
I a worried mother hands me a plastic
bag with a small black insect inside.
“I pulled this off my daughter’s
head an hour ago. Does she have
Lyme disease”
Warm weather in central
Pennsylvania brings plenty of these
visits, and, usually, parents and I
together are able to sort out the best
course of action.
Lyme disease was first identified
in the 1970s in Lyme, Conn. It is caused
by the bacteria, Borrelia burgdorferi,
which is transmitted to people when
a deer tick bites. Deer ticks are tiny,
about the size of a poppy seed.
People may be exposed to them when
engaged in outdoor summer and fall
activities. In the United States, the
highest incidence of Lyme disease is
among children 5 to 9 years old and
adults 45 to 54 years old.
To transmit the Borrelia
burgdorferi bacteria, a tick must
successfully attach to and bite
a human. The risk of infection is
extremely low the first day or two after
attachment, but higher after the tick is
engorged with blood—and especially
if the tick has been “on” for at
least 72 hours. Questions I ask
parents include: “Was the tick
engorged” and “How long do
you think it was attached”
In a child infected with
Lyme, the first symptoms
usually appear within one
to two weeks, though some
children do not develop
symptoms until two months
after exposure. These
symptoms include a circular red
rash, sometimes described as
a bulls-eye. The rash may itch
slightly or be warm to touch,
but many children are not
bothered by it. The rash may
not even be noticed. Additional
symptoms may include fever,
fatigue, headaches, mild neck
stiffness and muscle aches.
Rarely, and usually much later,
children may present with
more widespread involvement
of their joints, heart and
nervous systems.
It’s tempting to want
to test for Lyme disease or treat for
Lyme immediately after locating a
deer tick on your child, but this is
not recommended. Testing for Lyme
involves a blood test to examine
the body’s response to the Borrelia
burgdorferi bacteria. It takes the
average individual at least two weeks
to mount this response, so testing
immediately after tick exposure is
not helpful. Even in highly endemic
areas, risk of infection is low enough
that routine treatment of children
exposed to a deer tick is not usually
recommended.
Families are asked to watch their
children for development of early
Lyme disease symptoms over the
next couple of months and return as
needed. By discussing the symptoms
and examining your child, your
physician can determine the need for
treatment. However, parents can take
several steps to reduce the chance
their child is exposed.
First, if you find a tick on your
child’s skin, remove it promptly. Use
a cotton ball to gently clean the
area around the tick. Grasp the tick
firmly with a pair of tweezers and pull
straight out. Do not twist and don’t
attempt to crush the tick’s body. Clean
the area on your child’s skin where the
tick was removed.
Secondly, if you are going to be in
a situation with a high risk of exposure
(woods or high grass) to deer ticks,
use an insect repellent with “DEET”
(diethyltolumide). DEET should be
applied every one to two hours and
may be used sparingly on the face as
well. Also, children should wear long
shirts and pants with the legs tucked
into socks. Light-colored clothing is
preferred to make ticks easier to spot.
After returning home, inspect clothing
and skin for ticks. Children should be
washed in soap and water to remove
DEET.
Lastly, pets may also bring ticks
indoors. Inspect your pets for ticks
after they have been outside and
speak with your veterinarian about
methods to reduce ticks on animals.
Dr. Deepa Sekhar is
a pediatrician at the
Milton S. Hershey
Medical Center.
Health Students Get
Scholarship Funds
Seventy-eight local students majoring
in healthcare-related fields were
recipients of the 2011 PinnacleHealth
Auxiliary Ernest R. McDowell Health
Career Scholarship Fund.
The fund, underwritten by
PinnacleHealth Auxiliary, awarded
$64,500 this year.
The fund offers yearly monetary
educational support for permanent
residents of the greater Harrisburg
area interested in pursuing a career in
healthcare.
For this year’s awards, 45 college
students received $500 to $1,500 each
and 33 high school students received
$500 each.
Twenty-seven of the recipients
are nursing students; 17 have a family
member working for PinnacleHealth;
eight are current employees of
PinnacleHealth; and seven have
volunteered for PinnacleHealth.
PinnacleHealth can be found
online at www.pinnaclehealth.org.
TheBurg 29