Tick Bites

Dear Lisa

I found 3 ticks on my 10 year old son after he was playing in the woods. I am worried about Lymes Disease. What signs do I look for?

“Tick bites in N.J.”

Dear “Tick bites”,

Borrelia burgdorferi is the organism that causes Lymes disease. The transmission of the disease usually occurs because of a tick bite, in which the tick remains attached for a period of time. Typically the rash appears 1 to 2 weeks after exposure, but has been known to occur as early as 3 days or as late as 31 days after exposure. Signs of early localized disease include erythema migrans rash, headache, fever, malaise, mild neck stiffness and joint pain. The typical erythema migrans rash appears as a red mark at the site of the tick bite and expands to a round, red, flat rash which is 5cm or more in size. The rash may also have partial central clearing, giving it a bull’s eye appearance.

If the signs of early localized disease are not detected then early disseminated disease followed by late disease may occur. Signs of early disseminated disease include multiple erythema migrans (which are usually smaller than the primary lesion and may occur in any location), cranial nerve palsies, meningitis, arthralgias and conjunctivitis. I recommend that you check your child for a rash and/or "flu" like symptoms over the next few weeks. If either of these develop, contact you Doctor or Nurse Practitioner for an evaluation.

Lisa Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

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