Lyme Disease and Prevention Gateway Pediatrics’ Christine Perdue, CPNP Offers Guidance on Lyme Disease

Gateway Pediatrics

As spring turns to summer and we all get excited for spending time outdoors, there is one looming concern in the back of many of our minds: Lyme disease. Living in Maryland and Delaware comes with many benefits, but it also brings the risk of Lyme disease. More than 90% of cases in the US have been reported from just ten states, including Maryland and Delaware. This means you and your children are at an increased risk for contracting Lyme disease.

What is Lyme Disease? Lyme disease is the most common tick-borne illness in the United States. It is caused by an infection with the bacteria, Borrelia burgdorferi, which is carried by deer ticks. The bacteria are transmitted when a tick bites a person.


Lyme disease is most common in the late spring and early summer. Ticks are carried by mice, birds, and deer. Ticks are often found in shrubs and grass, often along the boundary between grass and the forest. Ticks do not survive for any length of time in sun-drenched lawns because they rapidly dry out. Ticks do not jump, hop, fly, or descend from trees but instead they latch onto anything warm as it brushes past the tick.

Risk of Lyme Disease after a Tick Bite

Although Lyme disease is something to take seriously, your risk of contracting Lyme disease even after a tick bite is quite low. Ticks take up to 24 hours from the time of first contact with the skin before they actually start to feed on the host’s blood. The tick must remain firmly attached to the skin for 48 to 72 hours to pass the bacteria that causes Lyme disease to humans. Thus, there is a long period of time between the tick’s first contact with its host and the transmission of infection. An individual who is bitten by a tick has a very low risk (about 1 in 100 chance) of acquiring Lyme disease if the tick is removed before it is engorged (filled with blood).

Prevention The best way to prevent contracting Lyme disease is a careful head-to-toe search for ticks after spending time outdoors. A tick that has not bitten cannot cause Lyme disease.


  • Erythema migrans (a bull’s-eye rash): About 80% of people with Lyme disease will develop this rash. The rash typically presents within 7-14 days. The rash may also look red without the bull’s-eye shape, but will continue to worsen instead of improving over time. Viral-like symptoms may accompany the rash.
  • Late disease symptoms: Muscle/joint pain; memory difficulty; numbness; along with other vague symptoms.


Diagnosis must be made by your or your child’s doctor. Lyme disease can be diagnosed by the presence of Erythema migrans (EM). Without EM, blood tests are ordered to confirm Lyme disease. It is important to know that immediate blood work after a tick bite will likely provide false negatives, therefore it is not appropriate to

get tested for Lyme disease after every tick bite. It is best to wait for abnormal symptoms before checking for Lyme disease.

Lyme Disease Treatment If you or your child experience a “bulls-eye” or bright red rash in the weeks after a tick bite or are experiencing joint pain and malaise, you should be evaluated by your doctor. In most people, treatment with antibiotics is very effective in eliminating symptoms, preventing progression to later manifestations of the disease, and curing the infection. Some symptoms improve rapidly with this treatment, whereas other symptoms gradually improve over weeks to months. It is important to know that “prophylactic treatment” after a tick bite is not appropriate. Without the presence of a “bulls-eye” rash or bloodwork confirming Lyme disease, treatment is not recommended.

As always, we at Gateway Pediatrics wish you and your family a happy and healthy summer!

About Christine Perdue, CPNP and Gateway Pediatrics, PA

Christine Perdue, CPNP is a board-certified Pediatric Nurse Practitioner who graduated Magna Cum Laude from Vanderbilt University in Child Development and continued there to receive her Masters of Science in Nursing. She is fluent in Spanish after working in a pediatric practice for Hispanic patients in Washington DC. She lives with her husband (Chris) and puppy (Rosie) in Salisbury.

Gateway Pediatrics is celebrating 10 years of serving newborns through 21 years of age in Salisbury, MD. Their mission is to provide quality, evidence-based pediatric care with an emphasis on individual needs. They are “The Gateway to your child’s healthy future!” Learn more at

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