Lyme Disease

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Lyme disease is caused by ticks and is spread to humans through the bite of infected ticks. The ticks that carry Lyme disease are very small and hard to see - only as big as a sesame seed. Boys ages 5 to 19 are most at risk for Lyme disease but anyone can get it. 

Signs and SymptomsParent checking child's skin for ticks

  • Fever

  • Swollen lymph nodes in the neck

  • Headache

  • Stiff neck

  • Tiredness

  • Swelling of large joints

  • Red rash that often has a “bulls-eye” appearance. This rash appears in most people with Lyme disease and shows up anywhere from 3 to 30 days after the tick bite.


Lyme disease is usually treated with antibiotics that are taken for 14 to 30 days. It is very important to take all the medicine, even if you are feeling better. Most people are cured with the antibiotics, but a few will have symptoms for months or years after treatment.

If it is not treated, Lyme disease can spread to the joints, the heart and the nervous system. Often, those who are not treated until the later stages of the disease continue to have symptoms.

How to Remove a Tick

  1. Use tweezers or your fingers covered with a tissue or cloth. Grasp the tick as close to the skin as possible. Lift it in the direction from which the tick entered the skin. Pull with enough force to “tent” the skin. Keeping pressure steady, hold the tick until it lets go and you can pull it straight out.

  2. Do not twist or jerk the tick. Take care not to crush or puncture the tick during removal. Do not put anything such as mineral oil, petroleum jelly or fingernail polish remover on the tick.

  3. Do not touch the tick with a lighted match. These methods will not make the tick back out of the skin.

  4. After removing the tick, wash the area with soap and water.

  5. Make sure you pulled out the entire tick. If you do not think you got it all out, call your doctor.

  6. Wash your hands with soap and water.

  7. Using tweezers place the tick in a small jar or plastic bag and close it. This container may be sent to the State Health Department for testing if your doctor says it is necessary and if they are doing the test.

Ways to Prevent Lyme Disease

Quickly Remove Any Ticks 

  • Check all family members after being outdoors and remove any ticks with fine-tipped tweezers. Tick bites are usually painless and most people do not notice when a tick is attached to the skin. If a tick is attached to the skin for less than 24 hours, the chances of getting Lyme disease are fairly small.

Control the Ticks Around Your Home 

  • Ticks live in damp, wooded areas. Clear tall grass and leaf litter around your house. Keep playground equipment, decks and patios away from wooded areas. 

  • Ticks do not jump, fly or drop from trees, but they grasp passing hosts from leaves and grass.

  • Ticks are usually picked up on lower legs and then crawl up the body seeking a place to feed.

  • Pets can bring ticks into the home, so a person can get a tick bite without being outdoors.  Talk with your vet about ways to protect your pets.

  • Wear light-colored clothing with long pants tucked into socks.  This makes ticks easier to see and keeps them on the outside of clothes.  Wear closed-toed shoes or sandals.

Wear Insect Repellent

Use insect repellent with 10% to 30% DEET.  (Do not use DEET on children younger than 2 months.)  To use:

  1. Apply to your hands first then rub it on your child.  Do not apply over cuts or wounds.

  2. Avoid the child’s eyes and mouth.  Use lightly on the ears.

  3. Do not apply under clothing. If repellent gets on clothing, wash the clothes before they are worn again.

  4. Keep repellent out of the reach of children and pets.

  5. Do not use a product that combines repellent with sunscreen because the sunscreen needs to be applied more often than the repellent.

When to Call the Doctor

Check the bite area on your child every day for the next month. Only children who develop a rash or get sick need to have medicine. Your child may go to school or child care unless the child is not feeling well enough to take part in daily activities.

Lyme Disease (PDF)

HH-I-289 2/09  Copyright 2009, Nationwide Children’s Hospital