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Ticks and kids ... not a friendly mix.

The summer months bring to children promises of longer days, no school and endless opportunities for fun outdoor activities. Unfortunately, the increased outdoor activities during the warmest months of the year give parents yet another concern as to the well being of their children. In addition to guarding against sun exposure, and poison ivy, children who spend time outdoors may be at risk for bites and subsequent disease caused by ticks. Such diseases are called Tick-borne Rickettsial Diseases (TBRD) and include such diseases as Rocky Mountain Spotted Fever (RMSF) and Lymes Disease.

Ticks are members of the insect world and share the same taxonomic classification as spiders and scorpions (i.e. Arachnida); they are divided into three families. Of these families two are deemed to be harmful to humans and animals. The first, Argasidae, is commonly known as "soft ticks" while the second family, Ixodidae, represents the "hard ticks."

A well-known disease, Rocky Mountain Spotted Fever is caused by a bacteria that is carried by the tick Dermacentor andersoni (found in the Western US) and Dermacentor variabilis (found in East, Central, and Pacific parts of the U.S.). They are commonly referred to as the Rocky Mountain Spotted Fever and American Dog Tick, respectively. This disease is characterized by early onset of symptoms commonly associated with the flu, such as nausea, vomiting, head and muscle aches, and lack of appetite (due to nausea). As the disease progresses, a rash may appear, which is comprised of non-itchy pink spots that appear raised and generally are noticed around six days after the tick bite occurs. Children may also complain of abdominal pain or joint pain.

Diagnosis is often difficult during onset due to nonspecific common complaints and alternative diagnoses. Diagnosis is confirmed by three observations: fever, rash and tick presence/bite. However, parents and pediatricians should not wait for confirmation by lab results to begin treatment as this disease is aggressive and may prove fatal, especially in the young and immuno-suppressed. Rather, symptomatic treatment should be started immediately. It is generally accepted that the drug therapy of choice for this disease is Doxycycline given over the course of five to ten days. Prognosis is generally excellent if diagnosis and treatment are started early.

Lymes Disease is another tick-borne disease that is transmitted by the tick Ixodes dammini. Although signs may include flu-like symptoms similar to RMSF (fever, head and muscle aches, fatigue), there is a major difference in the appearance of a rash, which resembles a raised bull's eye and may be seen between three and thirty days after the initial tick bite, increasing in size over time. If left untreated, this disease can cause bouts of arthritis as well as chronic neurological problems.

Diagnosis is made on the basis of the bull's eye rash and the presence (finding) of tick. Confirmation may be made either by ELISA or Western Blot testing of blood serum. As with RMSF, due to the serious nature of Lymes Disease, it is advisable to begin supportive treatment and drug therapy while awaiting test results.

Treatment for children who are suspected of having contracted Lymes Disease is by antibiotic therapy using Doxycycline, Amoxicillin, or Cefuroxime axetil. According to CDC sources, those who begin treatment early generally recover quickly, while patients who are diagnosed in late stages of the disease may require two courses of therapy at four weeks each. As with Rocky Mountain Spotted Fever, early diagnosis and intervention lead to a faster recovery time.

So, what can parents do to protect children from tick-borne diseases such as RMSF and Lymes Disease? Initially, take stock of the surroundings children live in. In outdoor areas, keep grass mowed in yards and restrict areas of access to children that may harbor ticks such as forest and woodland areas. Before allowing children to go outside, apply child-friendly insecticides that will discourage biting insects such as mosquitoes and ticks. But keep in mind that children are not miniature adults and commercial insecticides can be harmful to children if using a product not specifically designed for them due to inappropriate concentrations. To avoid such toxic effects, use only child-approved products in accordance with manufacturer's instructions.

If your family includes man's best friend or a friendly feline, use topical flea and tick preventatives such as Advantage or Frontline products to ensure that Fido or Fluffy doesn't bring home unwanted guests. In addition to treating your animal, maintain sanitary conditions in your pet's living area such as bedding and toys that may harbor ticks or fleas.

If after all of these precautions you discover a tick attached to your child, don't panic. Using tweezers, grasp the tick as close to the child's body as possible and pull the tick straight out, checking to make sure you remove the whole insect. Then clean and disinfect the area as you would any minor wound. For future reference, preserve the tick in a discarded medicine bottle in rubbing alcohol in case of the need for later identification. Carefully monitor your child for any future symptoms indicating the need for further medical care.

If child displays symptoms or you feel uneasy, never hesitate to seek the help of your pediatrician. After all, ticks and kids are not a friendly mix.

Oreta has recently received her masters in public health and is now pursuing a PhD in health sciences. In addition to freelance writing, she is a full-time veterinary technician at Fort Valley State University in Ft. Valley, Ga. Her work has appeared in Veterinary Technician Journal and I Love Cats.

By Oreta Marie Samples, MPH, VT
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Author:Samples, Oreta Marie
Publication:Pediatrics for Parents
Geographic Code:1USA
Date:Jun 1, 2008
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