Tick Bite Prevention for Kids: Why Children Get More Tick Bites
Children experience more tick bites than adults
Tick prevention for kids remains challenging
Early checks may reduce exposure risk
A study published in April 2021 examined emergency department visits related to tick bites and found that young children had the highest rates of exposure.2
The findings highlight why tick bite prevention for kids remains challenging. Young children spend more time outdoors, may not recognize tick exposure, and often depend on adults for prevention strategies.
Reducing exposure risk requires a combination of education, routine checks, and broader public health prevention efforts. Additional prevention strategies are discussed in prevention of Lyme disease.
The authors examined emergency department tick bite visits between January 2017 and December 2019 by age group, geography, sex, and seasonality. Children younger than age 9 accounted for the highest number of emergency visits related to tick bites.
During the 36-month period, investigators identified 149,364 emergency department visits for tick bites. The Northeast had the highest rates, with the largest seasonal peaks occurring in spring and early summer.
The findings support earlier studies suggesting that children experience disproportionately high exposure to ticks and tick-borne diseases.
In 2016, more than 3,500 ticks (n=3551) were submitted to the University of Massachusetts Laboratory of Medical Zoology as part of a passive surveillance study.3
Why Are Tick Bites More Common in Children?
Investigators found that children younger than age 9 accounted for the largest proportion of tick bites.
According to Xu and colleagues, 39.7% of attached ticks were nymphs while 34.6% were adult ticks.
Nearly 200 ticks were collected from children younger than age 5, while another 200 were collected from children ages 5 to 9. Fewer ticks were collected from adolescents.
Deer ticks were the most common ticks attached to children.
Of the 3,551 tick bites analyzed, 89% involved deer ticks.
Because deer ticks may transmit multiple infections, prevention efforts should extend beyond Lyme disease alone and include awareness of coinfections.
Additionally, 98% of the 1,700 adult ticks submitted were female.
The overall infection rate for Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti in human-biting ticks was 29.6%, 4.6%, and 1.8%, respectively.
Tick bites on children may lead to more than Lyme disease.
The authors reported ticks harboring multiple infectious agents:
- 1.8% were co-infected with B. burgdorferi and A. phagocytophilum
- 1.0% were co-infected with B. burgdorferi and B. microti
- 0.4% were co-infected with A. phagocytophilum and B. microti
- 0.3% showed triple co-infections
Investigators did not evaluate for other infections including Bartonella henselae or Borrelia miyamotoi.
When Do Tick Bites on Kids Occur Most Often?
Tick bites on children occurred most frequently during spring and fall when school activities and sports increase outdoor exposure.
Investigators observed two major adult tick peaks:
- April through June — reflecting overwintering tick activity
- October through December — reflecting autumn populations
Among nymphs, the clearest peak occurred during June.
How Effective Is Tick Bite Prevention for Kids?
Several studies suggest prevention methods remain underused.
One useful way to estimate prevention success is to examine how many attached ticks become engorged, since ticks generally require prolonged attachment before becoming engorged.4
Additional discussion regarding transmission timing appears in partially fed tick exposure.
Xu and colleagues found that 35.6% of ticks attached to children younger than age 9 were engorged.
This is concerning because prolonged attachment may increase infection risk.
Only 12% of children reported performing regular tick checks.
A school-based intervention involving 1,562 elementary students explored why prevention remains difficult.6
Responses included:
How often do children check for ticks?
- 56.8% = sometimes
- 25.8% = usually
- 12.0% = always
Who helps check for ticks?
- 77.8% = adult at home
- 14.6% = child alone
- 2.0% = adult at school
- 4.4% = no checks performed
These findings suggest education alone may not fully address the challenge of prevention.
Frequently Asked Questions
How can I prevent tick bites in kids?
Routine tick checks, protective clothing, repellents, and avoiding high-risk environments may help reduce exposure.
Are toddlers at higher risk for tick bites?
Young children account for a disproportionate number of tick bites and may rely on adults to identify attached ticks.
When do children get the most tick bites?
Spring and early summer represent peak periods, although fall exposure remains important.
Are deer ticks common on children?
Yes. Deer ticks represented most tick bites in the surveillance studies reviewed.
Can children get infections besides Lyme disease from ticks?
Yes. Ticks may carry organisms associated with babesiosis, anaplasmosis, and other infections.
Clinical Takeaway
Preventing tick bites in children remains difficult because exposure risk is high and prevention behaviors are inconsistently practiced.
Routine tick checks, prevention education, and awareness of multiple tick-borne infections may help reduce exposure risk in children.
Related Articles
These articles expand on prevention, tick exposure, pediatric risk, and diagnostic pathways.
Pediatric Lyme disease
Bad signs after a tick bite
Is it too late to treat a tick bite?
Delayed Lyme disease diagnosis
Babesia and tick-borne coinfections
References
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- Bacon RM, Kugeler KJ, Mead PS. Surveillance for Lyme disease—United States, 1992-2006. MMWR Surveill Summ. 2008;57(10):1-9.
- Marx GE, Spillane M, Beck A, Stein Z, Powell AK, Hinckley AF. Emergency Department Visits for Tick Bites — United States, January 2017-December 2019. MMWR Morb Mortal Wkly Rep. 2021;70(17):612-616.
- Xu G, Mather TN, Hollingsworth CS, Rich SM. Passive Surveillance of Ixodes scapularis (Say), Their Biting Activity, and Associated Pathogens in Massachusetts. Vector Borne Zoonotic Dis. 2016;16(8):520-527.
- Falco RC, Fish D, Piesman J. Duration of tick bites in a Lyme disease-endemic area. Am J Epidemiol. 1996;143(2):187-192.
- Sood SK. Lyme disease in children. Infect Dis Clin North Am. 2015;29(2):281-294.
- Shadick NA, Zibit MJ, Nardone E, DeMaria A Jr, Iannaccone CK, Cui J. A School-Based Intervention to Increase Lyme Disease Preventive Measures Among Elementary School-Aged Children. Vector Borne Zoonotic Dis. 2016;16(8):507-515.
- Beaujean D, Crutzen R, Kengen C, van Steenbergen J, Ruwaard D. Increase in Ticks and Lyme Borreliosis, Yet Research into Its Prevention on the Wane. Vector Borne Zoonotic Dis. 2016;16(5):349-351.
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
More attention should be paid to pre treatment of play areas and yards with pesticides that control tick populations. Befenthrin is most effective and easily applied by home owners.
I can’t go feedback on Bifenthrin. It has been classified as a “possible human carcinogen” based on an increased incidence of urinary bladder tumors in mice.” per fda at https://www.federalregister.gov/documents/2012/09/14/2012-22772/bifenthrin-pesticide-tolerances#:~:text=Bifenthrin%20is%20classified%20as%20a,urinary%20bladder%20tumors%20in%20mice