Tick bite on 9 year old child with tendency to get all kinds of infections. Worried. (Boston: living, professionals)

[rp1234]

This was a nymph and probably has been there for a day or two. However she showered and we lost it in the shower. We are looking for a doctor in the Cape Code area who will treat this properly. I understand the prophylactic singe dose of antibiotic only reduces the rash and not the occurence of lyme disease.

We biked in falmouth today and I took all kinds of precautions, yet it happened. We are not from around here and so the seriousness of this may not have been apparent to my child.

Please help. I am searching desperately for doctors and information, but the information seems mainly about prevention and not what to do or who to contact once there IS a BITE.

Thanks for any and all advice.

[timberline742]

Wait, what are you panicking about? Bite from what type of tick? Sure it was a deer tick and not a wood tick? I generally get 4-6 wood ticks attached each day I'm in the field this year, its no big deal. And I've had a few deer ticks, but that doesn't mean I need treatment. Not all deer ticks have lyme (or one of the others) and its not a 1x1 bite to infection.


Calm down, this is probably nothing. You're going to get ticks being outside.

[NewfieMama]

We went down this road earlier this year when our 3-year-old was bitten by a tick that tested positive for Lyme. Our regular doctor would not treat her prophylactically with antibiotics because the tick was not attached for more than 48 hours. We called maybe 10 local doctors/hospitals/urgent care centers to find a doctor who WOULD, but came up empty handed. Boston Children's used to treat prophylactically, but now they have a service where one of their doctors will call your child's doctor and talk with them about whether treatment is needed.

After talking with several doctors, they said the best bet is to go to the emergency room--those doctors will be slightly more aggressive because there is no guarantee that the parent will bring the child back. So if you go to your regular doctor, they will say "keep an eye out for a rash, a fever, etc." and if you notice something, you bring the child back. ER docs are more likely to operate under the assumption that they will only see the child once. Two urgent care centers I called also offered doxy to adults, but not children. But it might be worth calling a couple of urgent care centers near you.

We ended up talking for an hour with our doctor about ALL of our concerns and our options. He didn't want to treat our child with doxy because she's so young and there are adverse side effects of treating a young child with a high dose of doxy, but he did offer to do a titer for lyme around 6 weeks after the bite just to make sure her antibody levels weren't elevated. Our daughter only had the tick for a few hours at most and never developed any symptoms at all, so we opted not to do the titer, but I think it's a good option if you're concerned. Since your child is older, some doctors might be more willing to give the doxy. Just wanted to share our experience.

[massnative71]

Originally Posted by timberline742

Wait, what are you panicking about? Bite from what type of tick? Sure it was a deer tick and not a wood tick? I generally get 4-6 wood ticks attached each day I'm in the field this year, its no big deal. And I've had a few deer ticks, but that doesn't mean I need treatment. Not all deer ticks have lyme (or one of the others) and its not a 1x1 bite to infection.


Calm down, this is probably nothing. You're going to get ticks being outside.

Considering that > than 50% of deer ticks in the area are infected, that is pretty bad advice. Much better off playing it safe than simply waiting to see if one gets sick, where treatment then becomes far more complicated.


Remember, not everybody develops a rash.

Originally Posted by NewfieMama

We went down this road earlier this year when our 3-year-old was bitten by a tick that tested positive for Lyme. Our regular doctor would not treat her prophylactically with antibiotics because the tick was not attached for more than 48 hours. We called maybe 10 local doctors/hospitals/urgent care centers to find a doctor who WOULD, but came up empty handed. Boston Children's used to treat prophylactically, but now they have a service where one of their doctors will call your child's doctor and talk with them about whether treatment is needed.

After talking with several doctors, they said the best bet is to go to the emergency room--those doctors will be slightly more aggressive because there is no guarantee that the parent will bring the child back. So if you go to your regular doctor, they will say "keep an eye out for a rash, a fever, etc." and if you notice something, you bring the child back. ER docs are more likely to operate under the assumption that they will only see the child once. Two urgent care centers I called also offered doxy to adults, but not children. But it might be worth calling a couple of urgent care centers near you.

We ended up talking for an hour with our doctor about ALL of our concerns and our options. He didn't want to treat our child with doxy because she's so young and there are adverse side effects of treating a young child with a high dose of doxy, but he did offer to do a titer for lyme around 6 weeks after the bite just to make sure her antibody levels weren't elevated. Our daughter only had the tick for a few hours at most and never developed any symptoms at all, so we opted not to do the titer, but I think it's a good option if you're concerned. Since your child is older, some doctors might be more willing to give the doxy. Just wanted to share our experience.

It's important to remember that those titer tests are not the most reliable and miss at least 50% of cases. They do not test for all strains of Lyme or other TBDs. 9 years old sounds old enough to put on doxy, but at the very least they should be putting them on amoxicillin. ERs can be hit or miss in their willingness to treat, another problem with them is they typically won't give a full dosage beyond the "initial" 2 or 3 days.

[timberline742]

Originally Posted by massnative71

Considering that > than 50% of deer ticks in the area are infected, that is pretty bad advice. Much better off playing it safe than simply waiting to see if one gets sick, where treatment then becomes far more complicated.
.

No, it isn't, because the VAST majority of ticks people get are wood ticks, which don't have lyme, and not deer ticks. The OP didn't even identify this as a deer tick.


And there is a reason why med professionals just don't go ahead and treat without any systems, it often does more harm than good.


Living scared is no way to live, and yes, I've had lyme. Occupational hazard.


Listen to the professionals and keep calm. Ticks are part of being outside, most aren't harmful at all. If I got treated for every embedded tick I found I'd be at the hospital a dozen times a summer, at least. Ridiculous.

[massnative71]

Originally Posted by timberline742

And there is a reason why med professionals just don't go ahead and treat without any systems, it often does more harm than good.

Yes, and that reason is most of them follow the severely outdated and flawed IDSA/CDC guidelines. If somebody came in contact with HIV or Tuberculosis (and no test to prove it negative), I suppose you would advise them to "wait for symptoms"?


Because you have been lucky, does not mean others should be told to chance it given the high risk in the region.






But yes, if it is a wood tick there is LESS reason to worry. We still don't know what the bite was from.

[gentlearts]

Originally Posted by rp1234

This was a nymph and probably has been there for a day or two. However she showered and we lost it in the shower. We are looking for a doctor in the Cape Code area who will treat this properly. I understand the prophylactic singe dose of antibiotic only reduces the rash and not the occurence of lyme disease.

We biked in falmouth today and I took all kinds of precautions, yet it happened. We are not from around here and so the seriousness of this may not have been apparent to my child.

Please help. I am searching desperately for doctors and information, but the information seems mainly about prevention and not what to do or who to contact once there IS a BITE.

Thanks for any and all advice.

Really? Ticks are everywhere in MA. It's probably nothing to worry about. Just watch her for symptoms. New England kids play outside and get ticks on them. It very rarely causes any long term problem.

[timberline742]

Originally Posted by massnative71

Yes, and that reason is most of them follow the severely outdated and flawed IDSA/CDC guidelines. If somebody came in contact with HIV or Tuberculosis (and no test to prove it negative), I suppose you would advise them to "wait for symptoms"?

Because you have been lucky, does not mean others should be told to chance it given the high risk in the region.

But yes, if it is a wood tick there is LESS reason to worry. We still don't know what the bite was from.

I would advise people to follow a medical professional's advice. And good thing there are tests for HIV and TB that can be taken without there being symptoms.


Chances are it was a wood tick though, and that means there is NO reason to worry.


But if you're going to demand antibiotics every time you have a tick, don't go outside, ever. You're going to help foster anti biotic resistant strains of other bugs and harm yourself in the long run.


And no, I haven't been "lucky". I'm just not prone to paranoia.

[massnative71]

The problem with waiting for symptoms is that by that point treatment can become much more difficult. The Cape is an epidemical area so if it was in fact a deer tick then I wouldn't mess around. The danger is very REAL.


I don't understand these people with constantly having ticks on them. Doesn't anybody take precautions, or heard of DEET? Tuck your pants inside your socks while in the woods. You should be fine.

[timberline742]

Originally Posted by massnative71

The problem with waiting for symptoms is that by that point treatment can become much more difficult. The Cape is an epidemical area so if it was in fact a deer tick then I wouldn't mess around. The danger is very REAL.


I don't understand these people with constantly having ticks on them. Doesn't anybody take precautions, or heard of DEET? Tuck your pants inside your socks while in the woods. You should be fine.

You can put deet on, but that doesn't keep ticks off you to any real degree, despite their claims. And wood ticks don't just crawl up from the leg.


Also, if you're working in the field all day in the summer, wearing long pants and long sleeves is a real burden. Try pulling oriental bittersweet and cutting glossy buckthorn for 8 hrs in 90 degree weather like that.


You live scared. That's fine. That's your choice. Almost everyone I know working in the field has had lyme at least once, often multiple times (a friend in Stow MA at a land trust has had it 5 times). It's part of life in the northeast. No reason to live afraid.