Only a minority of children with Lyme disease recall a tick bite

With at least 300,000 new cases of Lyme disease each year in the U.S., an estimated 25% of those involve children. Unfortunately, the prevailing message has been that the majority of people, including children and adolescents, who develop Lyme disease will see either a tick bite or a bull’s eye rash. This just isn’t the case, as a new study by Nigrovic and colleagues demonstrates.

The study looked at 325 children with Lyme disease who were evaluated at six different emergency medicine departments located in Lyme endemic regions. The patients all had an available tick bite history.

“Our goal was to report the frequency of a known tick bite in children with Lyme disease overall and by stage,” the authors explain.

[bctt tweet=”Study finds, only 18.5% of children with Lyme disease recall a tick bite. ” username=”DrDanielCameron”]

The children were diagnosed with Lyme disease based upon the presence of an erythema migrans (bull’s-eye) rash or a positive or equivocal C6 EIA followed by a positive immunoblot.

The authors found that only a minority (18.5%) of the children recalled a tick bite preceding their illness. “We demonstrate that lack of tick bite history does not reliably exclude the possibility of Lyme disease for children from endemic areas,” the authors write.

The takeaway message of this study? Don’t count on seeing a tick bite in children with Lyme disease.