Tick-borne illnesses – including Lyme Disease, Babesiosis, and Bartonellosis – present particular risks to children, both because of the active lifestyles that expose children to disease-carrying ticks as well as children’s vulnerability to developmental setbacks caused by illness.
Research shows that children are disproportionately vulnerable to tick-borne illnesses. Lyme Disease is most prevalent in older adults and children; children aged 5 to 14 are at the greatest risk of contracting tick borne illnesses. Children’s Lyme Network goes on to report that more children are diagnosed with Lyme each year than with pediatric cancer, type 1 diabetes, cystic fibrosis, or epilepsy combined, underscoring the particular relationship between children and tick-borne illnesses. In fact, an outbreak of arthritis in children was partly responsible for the first clinical description of Lyme disease back in 1975.
Many advocates insist that the costs of tick-borne illnesses to children’s development and futures warrant more comprehensive tick education in schools, among parents, and for pediatricians and other physicians, including the expansion of Lyme disease school accommodations to ensure equal access to quality education for children with Lyme or other tick-borne diseases that affect their wellbeing.
In the spirit of helping the public better understand the impact of tick-borne illnesses on children, we’ll explore some of the diseases that infect children at the highest rates, how these diseases can damage children’s development and health later in life, and how those who care for children can help them stay protected.
Tick-Borne Illnesses and Lyme Disease in Children
Children are at a disproportionate risk not just for Lyme Disease, the most commonly occurring vector-borne illness, but also for other tick-borne diseases:
While these diseases are mostly geographically specific, the effects of climate change on tick-borne illnesses endemicity warrant careful consideration of how these diseases present in children. Explore a brief discussion of each below.
Borreliosis (Lyme Disease)
In the United States, Lyme Disease is most often caused by the bacterium Borrelia burgdorferi. While Lyme disease in children and adults can present with inconsistent symptoms – for example, not all patients experience the circular “bull’s eye” rash – children with a sudden onset of rash, facial palsy, or arthritic pain, especially in the knee, may be at risk for Lyme disease. Many reports also acknowledge fatigue and declining school performance as possible symptoms; for many children, the effects of Lyme disease on their daily lives have driven parents to seek Lyme disease school accommodations via channels created for students with disabilities.
Borreliosis (Tick-Borne Relapsing Fever)
Tick-Borne Relapsing Fever (TBRF) is caused by bacteria that closely resemble Borrelia burgorferi. In fact, the disease often looks and acts like Lyme, but in the U.S. is usually transmitted by “soft ticks” rather than “hard ticks” (like the black-legged or deer tick) that generally transmits Lyme disease. That said, a particular strain of TBRF-causing Borrelia – B. miyamotoi – is transmitted by hard ticks in Lyme endemic areas.
The initial flu-like symptoms of TBRF can be similar to those of Lyme, before developing into a pattern of relapsing fevers that can repeat several times without antibiotic treatment. While the CDC reports that the disease is linked to sleeping in rustic, rodent-infested cabins in the mountains – and, in Texas, cave exposure – it is possible to contract TBRF in other situations, including from the same ticks that spread Lyme disease. It can be difficult to distinguish between TBRF and Lyme Disease, but IGeneX offers testing for both.
Bartonellosis (Trench Fever and Cat Scratch Disease)
There are multiple species of Bartonella that cause Bartonellosis. Cat Scratch Disease (CSD) and Trench Fever are both caused by Bartonella. Both are transmitted to humans from bites or scratches from small mammals, usually domestic or feral cats, that have themselves been infected by tick or flea bites. Like Lyme Disease, Cat Scratch Disease is most common among children ages 5 to 9, with males being hospitalized more frequently than females. Learn about Bartonellosis tests from IGeneX, including the new, much more accurate Bartonella ImmunoBlot.
Babesiosis
Babesiosis is very similar to malaria, and causes malaria-like symptoms including fever and intravascular hemolysis, as well as diaphoresis, rigors, fatigue, myalgia, headache, nausea, and abdominal pain. Reports conflict on both the prevalence of symptoms – some claim that most cases are asymptomatic whereas others claim this is rare – but it is well-known that Babesiosis can be fatal for those with compromised immune systems, such as patients with cancer, lymphoma, or AIDS, or other serious illnesses.
Rickettsiosis and Ehrlichiosis
Rickettsia rickettsii is found in the dog tick in southeastern and western states, and in the wood tick in the Rocky Mountain states. As of the early 2000s, reports warned parents to look out for fever and rash during the summer months. While some cases can be asymptomatic, children present with classic symptoms (fever and rash) at higher rates than adults.
The organism that causes ehrlichiosis resembles Rickettsia rickettsii, and can present with such similar symptoms that the two diseases can seem “indistinguishable,” especially if rash is present.
The Impact of Tick-Borne Illnesses on Child Development
Because Lyme is a multi-system disease, its attacks on a child’s body can have severe and complex impacts on the child’s well-being. This includes both impacts stemming directly from the disease and indirect consequences either from treatment, or from the compensation techniques children develop to deal with their condition.
Psychotherapist and author Sarah Berenbaum has collected years of invaluable insight through her work with children with tick-borne illnesses and their families. She’s documented the way Lyme disease in children leads to physical and psychological consequences that compound over time, making school, socialization, and emotional growth difficult, to the detriment of children’s health, educational and career opportunities, and overall well-being even into adulthood. Now she advocates not only for better Lyme awareness and education in schools, but also for better support through Lyme disease school accommodations to level the playing field for children with Lyme and other tick-borne illnesses.
Common Complications from Lyme Disease and other Tick-Borne Illnesses in Children
Children spend most of their days at school, learning about the world and completing assignments and tests, learning social skills by creating and maintaining friendships, and expanding their personal growth through extracurricular activities. The following physically and mentally debilitating symptoms of Lyme disease and other tick-borne illnesses make all of this more difficult:
- Physical suffering in the form of long-lasting headaches, joint pain, and fevers interrupts education by causing absence and tardiness. Even when children are able to go to school, these physical symptoms impact their concentration and moods.
- Insomnia and other sleep disturbances damage children’s focus, cognitive abilities, ability to retain new information, and moods.
- Cognitive issues such as problems with concentration and attention, brain fog, and difficulty with spatial-visual reasoning, abstract reasoning, and language impact both children’s day-to-day cognitive development as well as their educational and career opportunities later in life.
- Depression and anxiety, and in some cases paranoia and even hallucinations, compound problems with school performance, peer relationships, and ultimately self-esteem.
- Time spent on diagnosis and treatment – such as long car rides to far-away specialists – interrupts children’s day-to-day lives and contributes to fatigue, compounding educational and emotional challenges.
- The accumulation of symptoms and complications contribute to feelings of isolation, as children withdraw from school activities and peer groups to cope with their conditions. Children’s Lyme Network found in one study that 79% of children with Lyme had reported a loss in number of friends.
Such difficulties don’t simply stop once treatment starts. Berenbaum notes that for many Lyme patients, once antibiotic treatment begins, symptoms temporarily get worse before they get better as the spirochetes in the body die off. What’s more, antibiotic treatment is known to cause or exacerbate digestive issues in some children, which can lead to physical suffering as well as disordered eating well after the disease has been treated.
And that’s if children get timely treatment at all. For those who were unable to detect or get diagnosed for their disease(s) promptly, tick-borne illnesses can become chronic, impacting the nervous system, causing grave neurological symptoms, and compounding all of the above developmental challenges.
The Challenge of Diagnosing Tick-Borne Diseases in Children
One of the biggest barriers to timely diagnosis and treatment in children is that they – especially very young children – have no baseline by which to analyze their symptoms. Whereas an adult experiencing a sudden onset of symptoms at one period in time may be able to compare their current condition to a time when their bodies and brains felt healthy (even if they don’t remember a tick bite or tick exposure), children have less life experience and may have a harder time distinguishing between what is normal and what is not.
This means not only are children at a higher risk of exposure to tick-borne illnesses as they spend summers outdoors, on vacation or at camp, but they’re also less equipped to detect changes in their health in time to get adequate treatment. This increases the risk that diseases will have time to spread throughout the body and have long-term impacts on the child’s learning, socialization and self-esteem, and health in adult life.
What Parents Can Do
Education and Prevention
Parents can do as much as possible to educate their families about how tick-borne illnesses spread and help them protect themselves against tick bites. Particularly in areas where tick-borne illnesses are endemic, parents should help children:
- Avoid tick hot spots.
- Deter ticks with protective clothing and tick repellant if possible.
- Prevent disease by checking for and removing ticks after outdoor activities.
Supporting Children at Risk
If you think your child has been bitten by a tick, it’s imperative that you monitor for symptoms of Lyme disease or other tick-borne illnesses. If you notice anything out of the ordinary, your child will need to be tested at a reputable center with the latest technology in testing for tick-borne diseases. It may be a difficult journey, but with timely diagnosis, your child can get support from the right specialists.
To learn more about the latest testing technology for Lyme disease and other tick-borne illnesses, read about the IGeneX Advantage today.