Lyme disease — it’s not child’s play

Lyme disease is a year-round problem. Transmitted by a tick bite, this unwanted souvenir can be picked up just about anywhere – a walk in the woods, day at the farm, or weekend camping trip.

Left untreated, Lyme disease can cause short-term symptoms, and may cause long-term health problems — so it is important to know the signs and symptoms.

Lyme disease is a multi-stage, multi-system infection caused by a bacterium that is most commonly the result of a bite from an infected tick. The disease takes its name from Lyme, Connecticut, where the illness was first identified in the United States in 1975.

Ticks live in wooded areas, low-lying grasslands and yards. Children and adults are more at risk outdoors in these areas. Adults know to check themselves for ticks after being outside, children usually don’t. That is why it is so important for parents to know what symptoms to watch for in their children.

Symptoms of Lyme disease

Pediatrician Robert Spewak, MD, Washington University Clinical Associate at Southwest Pediatrics explains, “Symptoms of Lyme disease typically appear one to three weeks following a tick bite. One of the primary symptoms is usually a rash at the site. The rash is circular and often described as looking like a “bull’s eye. Some kids can have a fever and fatigue, as well.”

The rash can:

  •  Appear several days after infection, or not at all
  •  Last up to several weeks
  •  Mimic skin problems such as hives, eczema, sunburn, poison ivy, and flea bites
  •  Itch, feel hot, or may not be felt at all
  •  Disappear and return several days later

Several days or weeks after a bite from an infected tick, flu-like symptoms can appear, including the following:

  •  Headache
  •  Stiff neck
  •  Aches and pains in muscles and joints
  •  Low-grade fever and chills
  •  Fatigue
  •  Poor appetite
  •  Swollen glands
  •  Painful and swollen joints may occur after several months

Dr. Spewak cautions, “Because the symptoms of Lyme disease may resemble other conditions or medical problems, it can often be misdiagnosed.”

 Other symptoms include:

  •  Neurological problems
  •  Heart problems
  •  Skin disorders
  •  Eye problems
  •  Hepatitis
  •  Severe fatigue
  •  Weakness
  •  Problems with coordination


Dr. Spewak explains, “If diagnosed early – when the rash first appears, 14-21 days of antibiotics would be the prescribed course of treatment. Blood and laboratory tests cannot accurately diagnose Lyme disease in its early stages, but can be helpful in making the diagnosis in the later stages of the disease if there are no obvious symptoms. If the diagnosis comes later, a longer course of antibiotics would be necessary.

To help keep your child more comfortable, we encourage plenty of liquids, as well as Tylenol ® or ibuprofen. Your pediatrician should recommend the right dosage.”


Ticks can’t bite through clothing, so prevention begins with how you and your family dress. When outdoor activities take you into grassy or wooded areas, everyone should wear:

  • Long-sleeved shirts tucked into pants
  • Socks with closed-toe shoes
  • Long pants tucked into socks
  • Light-colored clothing (so ticks can easily be seen)

Check your child often for ticks during and after your time outside. Places where ticks are commonly found include behind the knees, between fingers and toes, underarms, groin, belly button, in and behind the ears, neck, hairline and top of head.

If possible, always walk on cleared paths and pavement through wooded areas. Showering helps remove unattached ticks, so be sure to shower after all outdoor activities. Re-check your child after he or she has showered.  It may take up to four to six hours for ticks to attach firmly to the skin.

Insect repellents that contain DEET help, but are not 100% effective. Treat clothing with a product that contains permethrin, which is known to kill ticks on contact. DO NOT use permethrin directly on the skin.

Dr. Spewak and the pediatricians of Southwest Pediatrics are accepting new patients. For an appointment, please call 314-353-8777.

Southwest Pediatrics (WUCA)
6526 Landsdowne Ave.
St. Louis, MO 63109