Signs of Lyme disease in children are similar to those in adults. Children can also develop systemic symptoms, including fever, chills, and muscle and joint aches.

Lyme disease in children and adults results from the bacteria group Borrelia burgdorferi.

These bacteria transmit to humans through the bite of infected black-legged ticks, known as deer ticks in the northeastern and north-central United States, and the western black-legged tick in the Pacific Coast.

This article looks at what to know about Lyme disease in children.

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Symptoms often appear 3 to 30 days after the bite.

The hallmark sign of Lyme disease is the erythema migrans rash, which appears in about 70% to 80% of cases.

It often begins as a small spot at the site of the tick bite and expands over days or weeks, forming a circular or oval-shaped rash. Sometimes, it resembles a bull’s eye target. The rash is usually not itchy or painful.

Children may also experience fever, chills, fatigue, muscle and joint aches, headache, and swollen lymph nodes. A person may mistake these symptoms for other viral illnesses.

Later signs and symptoms

Without prompt diagnosis and treatment, Lyme disease can progress to more serious symptoms months or even years after the tick bite, such as:

  • Neurological problems: Lyme disease can affect the nervous system, causing symptoms such as:
    • facial palsy, which refers to the loss of muscle tone or droop on one or both sides of the face
    • headaches
    • neck stiffness, which can suggest meningitis
    • difficulties with concentration or memory
  • Joint pain and swelling: Lyme arthritis, a late-stage symptom, can cause intermittent or persistent joint swelling, pain, and sometimes joint warmth, most commonly in the knees.
  • Heart problems: Although rare in children, Lyme disease may affect the heart, leading to Lyme carditis, which can cause a slow heart rate, palpitations, or fainting.

If someone lives in or has visited an area where Lyme disease is common, and a child in their care develops symptoms — especially after a known tick bite — they should seek medical attention.

In areas where Lyme disease is common, a parent or caregiver may wish to contact a doctor if they find a tick on the child that has been attached for more than 24 hours.

The risk of Lyme disease increases the longer the tick remains attached, but transmission is unlikely before 36 to 48 hours of attachment.

What will the doctors want to know?

When contacting a healthcare professional, parents and caregivers should be prepared to discuss the following:

  • the child’s symptoms and their onset
  • any known tick bites, including when and where the tick bite occurred
  • the duration the tick was attached, if known
  • any travel history to areas where Lyme disease is prevalent

People should also make sure they know:

  • what medicines a doctor prescribes, and why
  • why a doctor recommends a certain test and what the results may mean
  • how to contact their healthcare professional in case symptoms worsen

Diagnosing Lyme disease in children can be challenging due to the nonspecific nature of early symptoms.

A doctor may order an antibody test to diagnose Lyme disease.

However, testing may not be necessary if certain criteria are met, such as:

  • potential tick exposure
  • a rash consistent with erythema migrans
  • being in an area where Lyme disease is common

This is because guidelines suggest that a healthcare professional begins treatment on the basis of clinical findings, as people are likely to test negative during the early stages of Lyme disease.

The antibody test’s accuracy depends on how long a person has had the infection. After 4 to 6 weeks, it is fairly accurate.

A doctor will prescribe antibiotics to treat Lyme disease. The choice of antibiotic can differ depending on symptoms, allergies, and other considerations.

In most cases for children older than 8 years of age, the doctor will prescribe doxycycline for 10 days. For those under 8 years of age, a doctor will prescribe amoxicillin or cefuroxime for 14 days.

Pain-relieving medications can help treat other symptoms, such as joint pain and swelling.

Learn more about the cure for Lyme disease and its complications.

Children who have received treatment in the early stages of Lyme disease generally recover completely and quickly. If the disease has progressed to more serious symptoms before diagnosis, treatment can still be effective, although recovery may take longer.

Most children with Lyme disease recover fully with appropriate antibiotic treatment. Parents and caregivers need to ensure the full course of treatment is completed, even if the child starts feeling better before the medication is finished.

Preventing tick bites is key to preventing Lyme disease. Some preventive measures include:

  • Using insect repellent: Parents and caregivers can apply insect repellent to any exposed skin and clothing.
  • Wearing protective clothing: When in areas where ticks are common, dress children in long sleeves and pants. Tucking pants into socks can help prevent ticks from getting onto the skin.
  • Performing regular tick checks: Check children’s bodies for ticks after they have been in areas where ticks are common. Pay special attention to the scalp, behind the ears, underarms, and groin area.
  • Showering after being outdoors: Showering and washing clothes after outdoor activities can help remove unattached ticks.
  • Landscape management: Keeping grass short and creating tick-safe zones in the yard can reduce the tick population in play areas.

The signs of Lyme disease in children are similar to those in adults. The most common sign is a rash, which can appear similar to a bull’s eye target. Other symptoms include fever, chills, headache, muscle and joint aches, and swollen lymph nodes.

Prevention, early recognition, and timely treatment are key to a positive outcome for children with Lyme disease. Regular tick checks and protective measures against tick bites are essential, especially in areas where Lyme disease is common.