Hi. I’m sorry you found a tick on your child!¬†Please put Neosporin on the cut.

Of course, now you are worried about Lyme. There are a number of choices:

The CDC recommendation for a child over 8 is to give a single dose of Doxycycline and then watch for any signs of Lyme disease, such as fever or the bullseye rash. THIS MUST BE GIVEN WITHIN 72 HOURS OF REMOVING THE TICK.

The CDC recommendation for a child under 8 is to just watch for signs of Lyme. They can appear up to 3 months later.

Why no single dose of Doxy for the child under 8? Theoretically, it could stain the teeth, leaving a brown stain on the adult teeth. Would just one dose do that? No one knows. If you would like the single dose, I will prescribe it, provided you accept the uncertainty regarding the teeth.

What about testing the tick? This is not recommended but can be done. Why is not recommended? If it is negative, I think it is helpful, since you can then stop worrying. If it is positive, it is not helpful, since not every tick with Lyme gives it to the person on whom it is found. A tick needs to be on your skin for 24 hours and to be feed blood to transmit Lyme. That said, if you want the tick tested, place it in rubbing alcohol and bring it to the office.

What about testing the child? It can take several months for the Lyme blood test to come up positive. Since the tick that gives you Lyme is usually NOT the one you found, but rather the one that fed on you and then crawled away, anyone in our area could be infected with Lyme at any time. It would not be clinically reasonable to test everyone, so why test the person who found a tick? That said, I can send a blood test to look for Lyme, about 2 months after the tick was found, (at least 3 weeks later) if you would like.

What about treating for Lyme disease without knowing the child has Lyme? This is not recommended by the CDC. Most of the time, even when people are extremely worried about Lyme disease, the child does NOT end up having Lyme disease if they are checked several months later. Three weeks of antibiotics are not to be embarked upon lightly. There is the possibility of allergic reaction to the antibiotic or creating antibiotic resistance in the child. If you think you want treatment for Lyme, the best course of action is to do a blood test at least 3 weeks after finding the tick but preferably a month or two after.

What about prevention? That is best. Wear long sleeves and tuck pants into socks when hiking in the woods. Use a DEET insect repellant — but remember to wash it off after about 2 hours. It can be neurotoxic, so please do not sleep with DEET on the skin.

With this information, please let me know how you would like to proceed.