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Ticks and Illness: Lyme Disease and Powassan Virus

Jun 05, 2017
Tick digging into skin

Warm weather has arrived – the sun is shining and the days are longer, but unfortunately ticks may be joining you as you spend more time outdoors.

Predictions for 2017 show the U.S. has the potential for the highest number of ticks reported in recent years, which also increases the risk of tick-borne illnesses such as Lyme disease and Powassan virus (POW). In the Northeast, mid-Atlantic and upper Midwest, the number of infected ticks continues to rise.

Tick-bite prevention is key. Although anyone can get tick-borne illnesses, people who spend a lot of time outdoors in certain regions are at particular risk.

What are Lyme disease and POW? While Lyme disease is caused by a bacterium and POW disease is caused by a virus, both are commonly found in small rodents like mice or squirrels and are transmitted to humans by the bite of an infected blacklegged tick, also known as the deer tick. POW can cause damage to the central nervous symptom, including meningitis and encephalitis. Lyme disease can cause a bullseye rash, arthritis, meningitis, or enter the tissue of the heart and cause a condition called Lyme carditis.

How do I prevent a tick bite? Prevention and detection are important if you are planning to spend time outdoors this season. Try to avoid areas with high grass and leaf clutter, wear light colored clothing with long sleeves, use a repellant, and thoroughly check your child’s body and hair for ticks. It’s also important to bathe as soon as possible after coming indoors.

Are tick repellants harmful to my child? Parents should not hesitate using repellents to prevent tick-borne diseases. Repellents are available to apply to clothing (permethrin) and to skin (DEET – N,N-diethyl-meta-toluamide). The American Academy of Pediatrics recommends that products with no more than 30% DEET be used on children two months of age and older.

Do all ticks carry illness? Ticks are common but most do not carry infectious agents. Furthermore, a tick typically needs to be attached for 24-48 hours to transmit the bacterium that causes Lyme disease. From animal models, POW may be transmitted within a very short period (15 minutes) after attachment, unlike the case for Lyme disease. The chances that your child has been infected from a tick bite are low, but it is important to remove an engorged tick promptly to decrease the potential risk of infection.

Tick identification and analysis may be helpful in determining risk of types of disease but not the actual risk of transmission.

What are the early signs and symptoms of a tick-borne illness? If a person has flu-like symptoms 1-30 days after possible tick exposure, then Lyme disease or Powassan virus should be considered. Symptoms can include any of the following:

  • Fever
  • Headache
  • Fatigue
  • Muscle and joint aches or swollen joints
  • Chills
  • Vomiting
  • Weakness
  • Confusion
  • Difficulty speaking
  • Seizures
  • Loss of balance or coordination
  • Rash

A bullseye/target-shaped rash may appear in about 70-80 percent of cases of Lyme disease. The rash may feel warm to the touch, but it is rarely itchy or painful.


Do I need to get my child tested? If you have found a tick on your child or live in (or traveled to) an area where ticks are prevalent, you should consult your health care provider to ask about testing of a child with any of the above signs or symptoms. Patients who test positive for Lyme disease are typically treated with antibiotics for 14 days and usually recover quickly. There are no medications for POW except those that may be able to help reduce symptoms of brain swelling. Symptoms may also be treated with respiratory support or intravenous fluids.

If an engorged, embedded tick is found and believed to have been attached for at least 36 hours, you may consult with your doctor or an infectious disease specialist regarding consideration of a single preventive dose of antibiotic for Lyme disease. For more information on Lyme disease, download our Helping Hand.

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W Garrett Hunt
W. Garrett Hunt, MD
Infectious Diseases

W. Garrett Hunt, MD, is a member of the Section of Infectious Diseases at Nationwide Children’s Hospital and an Associate Professor of Clinical Pediatrics at The Ohio State University College of Medicine.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.