Monday Medical: Kids and ticks — staying safe all summer long
Steamboat Springs — Spring arrives, the snowpack melts, hikers explore the mountain trail with their dogs, gardeners work outside in the yard for hours on end, and before we know it, ticks manage to show up again.
Ticks can be as tiny as a poppy seed or as large as an apple seed and are predominately found in eastern, western and Midwestern states. But Coloradans are not immune.
There are ticks here, too, and many people either vacation in these endemic areas, or have a visiting sister in-law from Connecticut, who would never consider placing a tick-repellant collar on her golden retriever. Regardless of the source, each year patients suffering from tick-borne diseases show up in Colorado hospitals.
Fourteen tick-borne diseases found in the U.S. are currently listed on the Centers for Disease Control and Prevention website. Most are from organisms carried by the host tick, while a few, such as Colorado Tick Fever, are caused by a virus transmitted by the Rocky Mountain Wood Tick. Lyme disease and rickettsial diseases, such as Rocky Mountain spotted fever, are both caused by bacteria transmitted by ticks.
Some of these human diseases are more familiar and notorious than others, but generally, it is a good idea to avoid all tick-borne illness.
Ticks do not fly, jump or hang glide; they attach when people and dogs brush against low trees, grass, bushes and shrubs, and the ticks jump on.
To stay protected, start by dressing for the occasion. Kids should wear long-sleeved, light-colored shirts, making it easy to spot ticks. Use hats to keep ticks off their scalp, tuck pants into socks and avoid sandals when hiking and camping, especially since tall grasses and bushes are infested with ticks.
Spraying your child’s tennis shoes, boots and pants with 30% DEET-containing insect repellant products helps. Insect repellant can be applied to the skin, but only spray once daily and be sure to avoid open areas like cuts, mouths, and eyes. Do not spray directly on a child’s face; instead, spray the insect repellant on your hand and apply carefully.
Newer permethrin products cannot be placed on skin at all but work great for clothing.
Take a few minutes to check for ticks at the end of the day. Ticks hide behind the ears and along the hairline. Most ticks do not begin to eat for 12 to 24 hours, so frequent checks during hikes and camping trips are a good idea.
The National Institutes of Health recommends that when you find a tick, grasp it with tweezers or some paper, close to the skin, and pull up slowly. Clean the bite area with alcohol or soap, and remember to wash your hands carefully.
Watch for signs of a localized, circular rash around the bite area during the next month. Some children might also develop headaches, chills, fever, fatigue, swollen glands or muscle and joint pains.
Call your physician’s office promptly if you do have a tick bite and develop these symptoms. Clinicians will evaluate symptoms and may use blood tests to confirm diagnosis of some tick-borne illnesses.
The CDC’s drug of choice, the antibiotic doxycycline, is most effective when given within the first five days of illness. New research shows that treating Rocky Mountain spotted fever in young children with a short course of doxycycline does not stain teeth or weaken enamel, a previous misconception that made some physicians wary of using the antibiotic.
Delay in treatment of rickettsial diseases may lead to severe illness or death. Children are five times more likely than adults to die from Rocky Mountain spotted fever, so it’s critical to always make sure that your family receives the most effective and safest medications against tick-borne infections.
With these precautions, it’s easier to avoid ticks, so you can get back to enjoying summer.
Visit the Academy of Pediatrics website, healthychildren.org, to learn more about ticks and children.
Steven Ross, MD, FAAP, is a pediatrician at Sleeping Bear Pediatrics in Steamboat Springs.
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