Dr. Glen Bartlett has had to brush up earlier than ever on his coding for tick removals, thanks to an unusually mild, not to mention brief, winter that never really got cold enough to keep the disease-carrying parasite in check.
“We had our first tick removal from the neck of a little girl last week,” said Dr. Bartlett, managing partner at Hershey Pediatric Center, in central Pennsylvania. “We also got a call from a parent who had removed a tick from his son.”
With the eight-legged arthropods already on the prowl for blood, pediatricians are reminding parents and kids, especially those families with pets, to be on the lookout for the crawling free-loaders, which can be as small as a period at the end of a typed sentence or as large as a pencil eraser.
Limited snow cover and warmer-than-average temperatures across the contiguous United States this winter have led to the early emergence of ticks in many parts of the country. And in the northeast and mid-Atlantic regions, where Lyme disease is most prevalent, many ticks never entered a dormant period; adult ticks can be active in temperatures as low as 28 degrees F.
Clinicians at Hershey Pediatric Center removed the tick from the little girl's neck during the week of March 19. Tick-related treatments at Hershey Pediatric Center, located about 1 ½ hours west of Philadelphia, generally start later in the spring, says Dr. Bartlett. “It's definitely a little early in the season, as you don't usually see any cases before early- to mid-April. A warmer winter brought things out, including pollen.”
The overall number of tick removals and associated cases at the Pennsylvania practice have also been on the upswing over the last two decades. “We see a lot more of it,” said Bartlett. “I was probably in practice 10 years before I saw a tick with Lyme disease.”
Nationally, cases of tick-borne disease have also spiked, from 10,000 reported cases in 1992 to some 30,000 in 2009, according to the Centers for Disease Control and Prevention. In 2010, 94 percent of Lyme disease cases were reported from 12 states, Pennsylvania among them.
Not surprisingly, children are most at risk for developing Lyme disease because they spend a lot of time playing in the woods and tall grass, where Lyme disease-carrying deer ticks thrive. “They're found anywhere and everywhere – on pretty much any body part,” Dr. Bartlett said. “I always say if you're out, don't invite the ticks to join you. Wear long pants and tuck them into your socks. Wear a hat. And when you get home, put your clothes in the washing machine and look yourself over.”
Parents who spot an embedded tick on their child can remove it by grabbing the head area as close to the skin as possible with a pair of tweezers and gently pull it off. Wash the bite area with soap and water and make sure the whole tick, especially the mouth, has been removed.
Dr. Bartlett says up to 95 percent of kids who contract Lyme disease through a deer tick bite develop the characteristic bullseye rash, which is easily recognized and therefore can lead to early treatment. He advises parents who have removed ticks from their children to keep an eye on the bite site and monitor for a rash. If the bullseye appears, the child should be brought in for treatment.
“Mark your calendar,” Dr. Bartlett said. “If the rash shows up in 10 to 14 days, give us a call.”
Dr. Bartlett also suggests parents take a photo of any rash that develops on their child's skin, as these skin changes may fade by the time he or she is seen by a physician.