When most parents think about Lyme disease, we think of a bright red rash that resembles a bull’s-eye. It’s the most infamous symptom of the infection and the absolute easiest way to get a diagnosis, but you might be surprised to learn that many kids get sick without ever developing this tell-tale sign.
Lyme disease is the most common tick-borne illness in North America, with the Centers for Disease Control (CDC) estimating about 300,000 diagnoses a year. Anyone who spends time near grassy or wooded areas is at risk of contracting the disease, but kids are particularly susceptible. After all, what do children love more than rolling around in the dirt, climbing trees and spending long summer days traipsing through the great outdoors?
For years, parents have been told to look for a rash that looks like a bull’s-eye, so when a kid gets a tick bite, parents usually rule out Lyme disease when one doesn’t appear. But it turns out that could actually be a big mistake.
The CDC reports at least 30 percent of kids who contract Lyme disease never develop any rash at all. Instead, they present with other symptoms — headaches, muscle aches, fever, chills and joint pain — that are easily misdiagnosed or leave doctors stumped as to what could possibly be wrong.
Mom Cassandra Egan of upstate New York says that’s exactly what happened when her 2-year-old daughter contracted Lyme disease. The toddler visited her pediatrician at least three times for pain and what Egan calls a “general sense of misery,” but she had no rash or outward signs of illness, so the doctor kept assuring them everything was fine. Eventually the girl began complaining about aching joints, particularly in her knees, and that’s when the doctor decided to run some tests. Says Cassandra, “They brought us in and said they wanted to do blood work since she was having joint pain. A few days later, they called to tell me she tested positive for early Lyme [disease] and prescribed an antibiotic.”
Egan’s daughter was cured completely by a 10-day course of antibiotics, but treatment is much more difficult when the diagnosis comes late. As the illness progresses, symptoms can grow severe and start to affect more parts of the body. Late stages of Lyme disease can damage the nervous system and the heart, and in rare cases can even cause encephalitis.
Pediatrician Carrie Rubin says identifying the illness without the infamous bull’s-eye rash is tricky for a number of reasons. Not only can your symptoms vary depending on what stage of the illness you’re in, your age and personal health history, but there’s also some dispute among physicians as to which symptoms even qualify.
“Some argue that symptoms of chronic fatigue, joint pain, muscle aches, headaches, etc. aren’t really from Lyme disease at all, but from something else,” Rubin explains. “In children, the chance of Lyme disease in the absence of typical symptoms is low, so it’s felt they [kids with no rash] wouldn’t need to be tested.”
Despite some doctors’ reluctance to test, it’s still important to see a health care provider as soon as you suspect Lyme disease. Even if your child doesn’t have that bull’s-eye rash, Rubin advises to look out for joint pain that’s focused mainly in larger joints like the knees, recurring headaches and high fevers, as these are the most common symptoms that appear one to four weeks after infection. Rubin also notes that a child’s odds of getting Lyme disease are less than three percent if the tick is removed within 48 hours of the initial bite.
Lyme disease is detected through a simple two-part blood test. The first part detects foreign antibodies in your bloodstream and the second confirms the specific types of antibodies. Doctors will usually ask you about your child’s medical history, including whether they’ve spent time in areas where ticks are common, to determine if they need to run tests. You can always request a test or seek a second opinion if you’re unsatisfied with your doctor’s response.
Obviously prevention is the best medicine, but knowing what to look for and being an advocate for your child can also help keep them safe. With rapid detection, most kids are able to make a quick recovery from Lyme disease and get back to their usual outdoor adventures.