Ticks on babies

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 girlymonkey 03 Jun 2018

I was visiting some friends today and my friend was changing her 6 month old baby for bed when I noticed a tick on the baby's arm. (I was at the far side of the room, I think I must be a tick spotting ninja!)

I removed it for her and subsequently removed one from each of my friends too. 

Is there anything different they should be watching for other than the normal lymes symptoms that you would look for in an adult? Strikes me that the 'mild flu like symptoms' could be less clear in a baby. You could detect a fever, but not much else.

My friend is very worried. I have reassured her that I get loads of ticks every year and chances are that They will all be fine, but I understand the worry with the wee one.

They will call the GP in the morning just to check what they suggest, but in my experience some GPs are great on ticks and lymes but others know very little.

 skog 03 Jun 2018
In reply to girlymonkey:

We worried a bit about this when ours had ticks on them. Still do, in fact (though they aren't babies any more).

I'm not sure there's really any way to tell for sure - just keeping an eye on them, checking whether they become ill.

We always check them thoroughly after being places they might pick them up. I understand that if you remove the ticks quickly, there's very little risk.

 
OP girlymonkey 03 Jun 2018
In reply to skog:

They think they probably picked them up yesterday, so it would have been there for more than 24 hours. 

I know that it is highly likely that she will be fine, but I totally understand the worry. 

The baby's mother has long term health problems following mouth cancer treatment, so I think the thought of her child getting a disease like lymes which can also have serious long term effects is particularly playing on her mind.

I have suggested they get themselves a tick remover and check thoroughly after all walks.

 skog 03 Jun 2018
In reply to girlymonkey:

> I have suggested they get themselves a tick remover and check thoroughly after all walks.

 

Solid advice. We keep a tick remover in the car at all times

Ours picked up ticks from the play park at Callander by the Meadows, once when they were really wee, so it can happen when you aren't expecting it, you don't have to be up the hills or deep in the woods.

OP girlymonkey 03 Jun 2018
In reply to skog:

Interesting that you mention Callander, as they went up to Callander crags yesterday, which is where they are assuming that they picked them up.

We were at Plean country park with them today, so also a chance that it came from there, but Callander seems more likely 

 Tringa 04 Jun 2018
In reply to girlymonkey:

I don't think there are particular symptoms in babies and I don't know if babies are more susceptible than adults.

The good thing is that while ticks are fairly common, and in some areas very common, the incidence of Lyme disease is still low, though because it is not a notifiable disease the data is incomplete.

Dave

 el diablo 04 Jun 2018
In reply to girlymonkey:

I was up at the Callendar crags a couple of weeks ago and you could actually see them appear on my light coloured breeks as we walked through the very last bit of rough path to the base of the routes. Even though I removed them, I still missed two that I found at work the next day. A shame really, as I quite enjoyed the climbing and I'm now getting better at remembering to check before the itch starts. I must of removed about a dozen from my clothing at the crag.

Nothing compared to when I stopped counting at 200 one May weekend on the Ardnish peninsula some years ago!

Jim C 05 Jun 2018
In reply to skog:

>I understand that if you remove the ticks quickly, there's very little risk.

I understood that removing them properly, was possibly more important than removing them quickly, or at least as important as quickly. 

 

 Rob Parsons 05 Jun 2018
In reply to Jim C:

> I understood that removing them properly, was possibly more important than removing them quickly, or at least as important as quickly. 

 

Both are important. Probably nobody really knows for sure, but the current suggestion is that the risk of Lymes transmission is minimized if you can remove the tick within 24 hours of its first being attached.

Certainly, there seem to be more and more ticks about these days.

 LastBoyScout 05 Jun 2018
In reply to Rob Parsons:

The LifeSystems Tick Tweezers are very effective and easy to use in awkward places - used them for removing ticks from the cat, including one from her gum.

The TickCard, on the other hand, is utter rubbish.

 matthew jones 05 Jun 2018
In reply to girlymonkey:

24 hour rule is a myth, as soon as the skin is broken nasty things can pass back and forward (well, forward really!). What is worth watching is the reaction the following days, a local reaction will occur ANYWAY (ie. small midge bite), but a red ring or coloured inflammation means a trip to doctors if it is persistant. The ring can grow such that you only see a part of the circumference. We live in Norway and are surrounded by the poxy things, my son was bitten last year (not a toddler) and the doctor absoulutely caned him with antibiotics, so it is taken seriously.

It is not very gentlemanly/lady-like, but I tend to find a sheltered spot and strip off after summer cragging to check thighs, bollocks etc. (cue slew of hopeless responses…). Obviously babies need a full body inspection if they are crawling in the bracken!

 

 

OP girlymonkey 05 Jun 2018
In reply to matthew jones:

The rash is apparently only present in 40% of cases, apparently the flu-like symptoms are a more reliable indicator. 

Yes, we do a full body check after any day out, but these friends didn't know to. They do now! Yes, we checked under kids nappies etc. Both kids were being carried in child carriers. The toddler didn't have any, but baby did. 

 skog 05 Jun 2018
In reply to matthew jones:

> 24 hour rule is a myth

Hmm.

http://www.hps.scot.nhs.uk/resourcedocument.aspx?id=6140

https://www.cdc.gov/features/lymedisease/index.html

https://members.scouts.org.uk/supportresources/4709/ticks-advice-on-prevent...

 

> as soon as the skin is broken nasty things can pass back and forward (well, forward really!).

Sure. But everything I've read and heard on this, including several sources I consider trustworthy, has said that Lyme disease (specifically - not necessarily other infections) is a lot less likely to be contracted during the first 24 hours.

Jim C makes a good point about the method of removal - you want the tick out cleanly, and don't want it to regurgitate while embedded.

> What is worth watching is the reaction the following days, a local reaction will occur ANYWAY (ie. small midge bite), but a red ring or coloured inflammation means a trip to doctors if it is persistant. The ring can grow such that you only see a part of the circumference. We live in Norway and are surrounded by the poxy things, my son was bitten last year (not a toddler) and the doctor absoulutely caned him with antibiotics, so it is taken seriously.

It's taken more seriously in Scandinavia, probably partly because people are more often in areas where they can pick up ticks, and also because there's also tick-borne encephalitis to worry about. And while the rash is a clear sign of Lyme, the rash does not actually occur in many or even most cases of Lyme, so its absence isn't particularly reassuring.

> It is not very gentlemanly/lady-like, but I tend to find a sheltered spot and strip off after summer cragging to check thighs, bollocks etc. (cue slew of hopeless responses…). Obviously babies need a full body inspection if they are crawling in the bracken!

Yep, thorough checking is a good idea.

 Dave Williams 05 Jun 2018
In reply to matthew jones:

> 24 hour rule is a myth, as soon as the skin is broken nasty things can pass back and forward (well, forward really!). 

Agree totally as this was my (very well informed) GP's view too. Despite taking all reasonable precautions, I found and then removed a tick within 24 hours a couple of years ago. Within days I had a red ring- like inflammation which quickly grew in size. After a visit to the GP, I too was absolutely caned with doxycycline, so it is taken seriously here in Mid Wales too. The side effects from the strong antibiotic made me very ill but I finished the course. Since then a blood test has tested positive for Lyme and due to flare ups I've had 2 subsequent courses of antibiotics. The GP's fairly certain that the bacterium is hiding away somewhere out of reach of the antibiotics, eg in the gut lining. His view was that antibiotics will get it eventually, but it could take a good while.

Over the weekend I walked for 15 mins up to a new Ceredigion crag, over rough grassland and occasionally brushing through very small patches of bracken, to see if peregrines were nesting on it. I was wearing light coloured trousers and both legs probably had  about 5 visible ticks on each when I got to the crag. On the return journey, I picked up even more. Cue a full body inspection by my (horrified) wife when I got back to the car, plus yet another when we got home. I found 3 ticks on the dog the following morning, plus another 2 today. Poor thing. Thankfully I was clear. 

A SNP Warden told me recently that a limited area sample in the Rhinogydd found that just under 30% of the ticks collected were carrying Lyme disease. During recent good weather I've come across many walkers and climbers happily wearing shorts in waist high bracken and heather, seemingly oblivious to the increased risk they may be running. <Shudder

 

 Red Rover 05 Jun 2018
In reply to Dave Williams:

I've started using permithrin spray on my clothes, apparently it kills ticks (but it kills cats as well in very small doses, i.e. brushing up against your trousers). I walked through 500 m of bracken which also contained sheep in cumbria last weekend and didn't find any ticks (although that's nowhere near statistical). 

 matthew jones 05 Jun 2018
In reply to skog:

Was referring to information from our GP, who I assume is well-informed given our location. Obviously risk of infection increases with time but is not impossible when skin is first punctured. Visual symptoms are obviously not conclusive, but certainly a pointer, which is what I assume(d) girlymonkey was looking for, albeit at the risk of meeting a thousand armchair experts. 

 matthew jones 05 Jun 2018
In reply to Dave Williams:

And to you sir, get well soon. Wife has a friend who had a solid fight with this and has recovered 100%, thankfully, if that is encouraging. Unfortunately her diagnosis was very late slowing the whole process. Tried pushing our GP for a stat on bites/infections but he said it is impossible to tell or even guess, which is a bit defensive, but not an unreasonable answer! 

 skog 05 Jun 2018
In reply to matthew jones:

I'm reasonably sure girlymonkey already knew about the bullseye rash!

It's the worry that a baby or toddler might be infected without giving such obvious warning signs that's the real concern, I think. Certainly, I've worried about that.

I'm also not sure there's really anything to argue about here - your GP probably knows what they're talking about, and unless I've misunderstood hasn't actually said it isn't less likely to get infected if the tick is removed promptly; one would hope that those writing the NHS and CDC advice would be specialist, and so know what they're talking about rather well. Yes, you can probably get infected straight away; it's also the case that it's a lot less likely initially (for Lyme).

And as far as I can tell, we're both "armchair experts" in the same situation - having both taken advice from qualified professionals in Scandinavia and in the UK, and having had reason to consider the safety of our children in this regard.

 
 ChrisJD 05 Jun 2018
In reply to girlymonkey:

Was in Scotland (southern uplands then west coast Highlands) over half term, the tick count was:

Wife: 2

Son-1: 2

Son-2: none

Me: none (never knowingly had one)

Small dog (white fur): >12

 

Carefully checked everyone, keeping eye out for symptoms/rash.  Thankfully dog very compliant. Wife and Sons, less so....

 

Also, from NHS web-site:

'The rash can appear up to 3 months after being bitten by a tick and usually lasts for several weeks. Most rashes appear within the first 4 weeks.'

Post edited at 20:55
 George Allan 06 Jun 2018
In reply to girlymonkey:

On the basis that prevention is better than cure, have started a defensive regime:

  • gaitors, even on hot days
  • spray clothes with permethrin clothes spray
  • Saltadine spray (I prefer it to deet) on entry points (waist, wrists, legs etc)

Not scientific but so far so good. This level of insecticides might not be advised for young kids.

Rock boots also add to exposure, of course.

 oldie 06 Jun 2018
In reply to Dave Williams:

>Re:  24 hour rule is a myth.

Agree totally as this was my (very well informed) GP's view too. Despite taking all reasonable precautions, I found and then removed a tick within 24 hours a couple of years ago. Within days I had a red ring- like inflammation... < 

I may be wrong but I don't think the advice was ever intended to indicate certain  preventation by removing within 24 hours  but just that removing ASAP reduced the risk. 

> A SNP Warden told me recently that a limited area sample in the Rhinogydd found that just under 30% of the ticks collected were carrying Lyme disease. <

Worrying. So that means that it is highly likely that if someone finds three ticks on them at least one will be a carrier. On the plus side judging by the number of ticks people often report without subsequent development of the disease it would seem that the Lyme bacterium is either often not rapidly transmitted, fails to infect or any symptoms are minor. But no reason for complacency! Hope your treatment proves successful, after having to twist his GP's arm for a test our neighbour tested positive, received treatment and has been fine.

 

In reply to Dave Williams:

What symptoms did you have?

I'm currently awaiting a blood test result, but I think I should have insisted on a course of Doxycycline. I've been bitten before, with no symptoms, but this time, I started feeling spaced out after two weeks. Not convinced the quack understands how potentially serious it is.

No target rash, but those only occur with 30-40% of infections.

 Dave Williams 07 Jun 2018
In reply to captain paranoia:

When first bitten by a tick in the eastern Rhinogydd in June 2016, other than the concentric, so-called bullseye rash, I had no symptoms at all. Bloods were taken but the GP said that that an early blood test may not pick it up and so wasn't 100% reliable. He also prescribed a 3 week course of doxycycline 'as a precaution'. The cure was tough due to many side-effects. Bloods came back negative. GP was non-plussed and said it was not unexpected.

Last year I had flu-like symptoms but no fever. I had joint pain, elbows and knees especially, as well as generally feeling unwell, off my food and being uncommonly tired, all of which got progressively worse over a couple of weeks. Back to the GP, who took more bloods and prescribed another dose of doxy in the meantime. I gradually got better, despite suffering the side-effects yet again. This time the bloods tested positive for Lyme disease antibodies. To my knowledge, I hadn't been bitten by another tick in the meantime as I've become totally obsessive about taking preventative action.

In Jan-Feb of this year, I began suffering with the same symptoms again, plus this time not being able to sleep soundly, so would wake up totally knackered every morning. Again, no fever. As there was a lot of flu around I left it for over 2 weeks before seeing the GP. Bloods were taken and I was assured that it was 'probably just the flu'. This time two separate blood tests tested positive for Lyme antibodies. Cue a call back to the surgery and yet another 3 week dose of doxy. Since then I've been fine. 

GP opinioned that, despite very quick initial treatment by antibiotics (within 3 weeks of being bitten), I'm probably suffering from 'post-treatment Lyme disease syndrome'. He said that very little or no research was being carried out on this in the UK, so its cause and treatment were basically an unknown. He speculated that the Borrelia was hiding somewhere out of reach of the antibiotic (he mentioned the gut lining) and said that if it flared up again, he'd prescribe a different antibiotic. 

Under the circumstances I can't fault my GP. He's taken it seriously since the very beginning and he's clearly hoping that continued antibiotic therapy will eventually do the trick. However, I've now read that there's much evidence, particularly from studies in the States, that long-term antibiotic therapy doesn't in fact improve the chances of a complete recovery. Anyway, there's nothing I can do about it; I'm remaining positive, so we'll see. 

This is probably not what you really want to hear. Hopefully though, the balance of probability means that you weren't even bitten by an infected tick in the first place.

Dave

 


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