Tick Bite Prevention

Many infectious diseases are transmitted by ticks.  Lyme disease is the best known, but others that may not sound so familiar include Rocky Mountain spotted fever, tularemia and tick paralysis.  Not all ticks carry disease, and not all that can make your child sick, will.  Here are some precautions you can take when outdoors, especially in wooded areas and grasslands.

  • Simple avoidance:  Ticks usually climb from the ground or vegetation, so it helps to avoid tall grass or thick ground cover as well as dense woods.  Try to stay on cleared trails, away from brush and vegetation.

  • What to wear:  Ticks are most likely to bite in areas of warmth-at the beltline or neckline, at the tops of shoes or boots, on the scalp, or in the groin or armpits.  Wear long pants tucked into socks or boots.  Wear a long sleeved shirt that is snug around the wrists and tucked into the waistband.  Don't wear sandals or open toed shoes.  Wear light colored clothing to make it easier to find ticks.

  • Use repellents:  Spray a repellent containing permethrin on clothes (not skin), if product is available.  Be careful when using products with DEET in children.  Use in small amounts, and follow the label directions carefully.  Too much DEET can cause side effects.  Ask your veterinarian about tick repellents for your pets.

  • Self-inspection: After you've been outdoors, especially in wooded areas or grasslands, check your child's body carefully for ticks twice a day. Parents should check themselves and 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 the hair. Don't forget to inspect the neck and scalp.  You can use a fine tooth comb to find ticks in the hair.  Be aware that some ticks, including the one that transmits Lyme disease, are tiny-about the size of a poppy seed-before they are swollen with blood.  Be sure to check pets for ticks, too.  Bathing when you get inside can also help you find ticks and remove them. Additionally, you can tumble clothes in a dryer on high heat for an hour to kill any remaining ticks

  • Tick removal: If you find a tick on your child the best way to remove it is to grasp the tick at the point of attachment and apply slow, steady traction.  This should remove the tick intact with the cement.  Using a lighted match, heated nail or pocketknife may burn your child or cause the tick to regurgitate its contents into the host and does not stimulate the tick to detach.  Experts recommend using a blunt medium tipped pair of forceps or tweezers.  Be sure to remove all mouth parts and cement with forceps or tweezers. If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely small. But to be safe, watch for signs or symptoms of Lyme disease such as rash or fever, and see a doctor if they develop.

  • Treatment after exposure:  It is unnecessary to preserve the tick in alcohol because the predictive value of tick analysis has not been defined.  Post exposure prophylaxis with antibiotics is also not recommended, because of, first, the low risk of disease transmission after a tick bite and, second, the risk of adverse effects from the antibiotic.  Prophylaxis will be considered if a person has multiple tick bites or if a tick's attachment is known to have lasted 72 hours.

~Contemporary Pediatrics May 2006