Tick Bites in Children: Why Risk Is Higher Than You Think

Young children account for the most tick bites
Many ticks carry multiple infections
Prevention strategies are often not enough

A study published in April 2021 examined emergency department visits for tick bites across the United States. Investigators analyzed 149,364 visits over a 3-year period, finding that children under age 9 accounted for the highest number of cases. :contentReference[oaicite:0]{index=0}

The incidence was highest in the Northeast, with peak activity in the spring and early summer.

Young Children Face the Highest Risk

Additional surveillance studies confirm that younger children are disproportionately affected by tick bites.

In one analysis of 3,551 ticks submitted for testing, nearly 400 were collected from children under age 9, with the highest numbers in those under age 5.

Most of these ticks were Ixodes scapularis (blacklegged or deer ticks), the primary vector responsible for Lyme disease.

Ticks Often Carry More Than Lyme Disease

Tick testing revealed that many ticks carried infectious organisms:

• 29.6% carried Borrelia burgdorferi (Lyme disease)
• 4.6% carried Anaplasma phagocytophilum
• 1.8% carried Babesia microti

Some ticks were co-infected with multiple pathogens, increasing the risk of tick-borne coinfections following a single bite.

• 1.8%: Lyme + Anaplasma
• 1.0%: Lyme + Babesia
• 0.4%: Anaplasma + Babesia
• 0.3%: triple co-infections

When Do Tick Bites Occur?

Tick exposure in children peaks during periods of outdoor activity:

• Spring to early summer: peak nymph activity
• Fall: adult tick activity

These patterns align with school sports, outdoor play, and recreational activities.

Why Prevention Often Falls Short

Despite awareness campaigns, prevention remains inconsistent.

One key measure is whether ticks are removed before becoming engorged. Ticks typically require prolonged attachment to become engorged, increasing infection risk.

However, studies found that:

• 35.6% of ticks on children under age 9 were already engorged
• Only 12% of children reported performing regular tick checks

These findings highlight gaps in prevention and early detection, as discussed in our Lyme disease prevention guide.

Education Gaps in Tick Prevention

A school-based study of 1,562 children revealed inconsistent prevention habits:

• 56.8% checked for ticks only “sometimes”
• 12% reported “always” checking
• 77.8% relied on a caregiver to perform tick checks

These results suggest that education alone may not be enough to prevent tick exposure.

Why This Matters

Tick bites in children are common—and often underestimated.

Because ticks may carry multiple pathogens and symptoms can vary widely, early recognition is critical.

Children with tick exposure should be monitored carefully for evolving symptoms, even when the bite initially appears minor.

Start here: Lyme disease symptoms guide

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention