Ticks: When to Worry About Lyme Disease

Ixodes Tick

Have you found a tick attached to you or your child? As the weather warms up, kids spend more time outside—running through grass, hiking trails, camping, playing sports, and

exploring nature. Along with all that outdoor fun comes something many parents worry about: Ticks and Lyme disease.

The good news? Most tick bites do not lead to Lyme disease. However, knowing what to watch for can help you stay calm, know when to monitor, and understand when your child should be evaluated.

First: Not Every Tick Carries Lyme Disease

Lyme disease is caused by bacteria spread by certain ticks, primarily the Ixodes, black-legged tick (deer tick). Not all ticks carry Lyme disease, and even deer ticks are not always infected. In the Midwest, however,—including Wisconsin—Lyme disease is more common than in many other parts of the country, so awareness is very important.

The Biggest Factor: How Long Was the Tick Attached?

In general, Lyme disease transmission usually requires:

1. A deer tick (black legged Ixodes tick)

2. Attached for approximately 36 hours or longer

   
   

If you find a tick crawling on your child or attached only briefly, the risk of Lyme disease is

very, very low. Ticks that are swollen or engorged have usually been feeding longer and

deserve closer attention.

What Should You Do If You Find a Tick?

Remove it promptly!

Use fine-tipped tweezers and:

1.Grab the tick as close to the skin as possible

2. Pull upward steadily

3. Clean the area with soap and water

Avoid:

• Burning the tick

• Smothering it with petroleum jelly

• Twisting aggressively

When to Consider Prophylactic Treatment?

Generally, the following criteria must be met for prophylaxis to be indicated:

1. Tick species: Identified as Ixodes (blacklegged) deer tick

2. Endemic area: Bite occurred in a Lyme disease endemic region - Wisconsin is included

3. Attachment duration: Tick was attached ≥36 hours (engorged, not flat)

4. Timing: Tick removed within the last 72 hours

5. Safety: Doxycycline is safe for the patient (no allergy, not pregnant or lactating)

   
   

If the tick cannot be identified or attachment duration is unknown, watchful waiting is

recommended instead of prophylaxis.

Best Ways to Prevent Tick Bites:

Prevention matters the most. So what can you do?

• Wear long sleeves and pants in wooded areas

• Using EPA-approved insect repellents

• Performing tick checks after outdoor play

• Showering after hiking or camping

• After being outside do a body check of hidden areas:

  • Scalp

  • Behind ears

  • Groin

  • Armpits

  • Behind knees

  • Ticks in children are often found on the scalp and neck.

Kids Hiking

Key Takeaways:

Most tick bites are manageable and low risk. The key things parents should remember are:

1. Prompt tick removal matters

2. Longer attachment increases Lyme risk, especially if engorged

3. Watch for rash, fever, fatigue, or joint symptoms within 3-30 days after a tick bite

4. Not every bite needs antibiotics or testing

When in doubt, take a picture of the tick or rash and contact your pediatrician. If the tick is engorged and it meets the criteria above, reach out to your Pediatrician sooner rather than later to consider prophylaxis. Sometimes reassurance is all that’s needed—but sometimes early prophylactic treatment can make all the difference!