variations in practice


When You Think It Might Be Lyme Disease

A classic Lyme Disease "bullseye" on my son's arm

Note: At the bottom of this post are a general guide to early Lyme Disease treatment and five pieces of official advice.

All that week, I was agitated, unquiet. I felt like the nun in “Madeline”, the children’s book: “In the middle of the night, Miss Clavell turned on her light and said, ‘Something is not right!'”

Tully, my 6-year-old son, had been bitten by a tick over Memorial Day weekend, but we didn’t find the loathsome thing until two days later, engorged and dug in on the milky-smooth skin just above his navel.

That discovery led to a quandary that many thousands of us who venture outside in Lyme-infested regions from Massachusetts to parts of the mid-Atlantic, Midwest and northern California may face: If you think it’s Lyme Disease but you’re not sure, do you err on the side of antibiotics? When is that appropriate? What if it’s not appropriate but you still want to do it?

Here’s our recent saga, and though evidence of resurgent tick populations remains no more than anecdotal at this point, it’s the kind of story likely to arise more often this year than last. The recent wet weather is just dandy for the deer ticks that carry Lyme Disease.

Lyme Disease tends to peak twice during warm weather, Massachusetts state public health veterinarian Dr. Catherine Brown said: from late May through June and possibly into July, as the tiny, hard-to-spot young “nymph” ticks sneak onto us; and from August into September, as the bigger adult ticks attack.


Dr. Jonathan Edlow: ‘It’s important for patients and parents and physicians to recognize that Lyme Disease can present with just a fever and no rash.’

Last year’s hot weather appeared to keep ticks in check, but she expects this year to be back to typical levels, which average 4,000 reports statewide of Lyme Disease and a great many other cases that go unreported.

When we found Tully’s tick, I called our pediatrician’s office, knowing that the 48 hours it had been on him was enough time to transmit Lyme Disease. But the nurse said just to wait and see if he developed any symptoms. Continue reading