Lyme disease in children surges in Western Pennsylvania
Lyme disease infections increased at an exponential rate from 2003 to 2013 in Western Pennsylvania, reaching more children in cities and towns, according to a new study from Children's Hospital of Pittsburgh of UPMC.
The Lawrenceville hospital and its regional community practices treated 285 children for the disease in 2013, up from just five cases in the years 2003 through 2005, according to study results published in Clinical Infectious Diseases. The disease spreads through deer tick bites.
“We thought that we would see that there was an increase in the number of children with Lyme disease, but we were surprised to see that it was this number and that it rose this rapidly,” said Dr. Brian Campfield, an assistant professor of pediatrics at Children's who co-authored the study.
Of the 773 cases of Lyme disease the authors found, 270 came from rural zip codes, while 503 came from urban and suburban areas, with the non-rural cases increasing over time, according to the study. The disease, which originated in Connecticut, has spread southwest.
Campfield said disease-carrying ticks may be spreading in urban areas through two of their most common hosts.
“Anywhere there's deer and mice, it's plausible they could be transporting ticks,” he said.
Campfield said the study didn't identify a reason for the spread, but he refuted a common myth that ticks are surviving winters that no longer get cold enough to kill them. He said ticks go into a dormant state during winter and aren't killed by subzero temperatures. They can wake up on warm days in January or February, but 62 percent of the cases found in the study came between May and August.
The disease was most common in white males between five and nine years old. Campfield said children start spending more time outdoors at those ages and their parents might not be as likely to spot ticks on them as on younger children who they would bathe.
The disease usually appears first as a rash, usually within a week of a bite, according to the Centers for Disease Control and Prevention. Rashes can spread to about a foot in diameter and may feel warm to the touch but rarely are itchy or painful.
If it isn't treated, serious symptoms can develop, including meningitis, neck stiffness, arthritis, brain inflammation, nerve pain, facial palsy, pain and short-term memory loss. Antibiotics are an effective treatment for the disease, and usually cures the associated symptoms, however serious, Campfield said.
The study authors found that children diagnosed in rural settings tended to visit doctors at later stages of the disease, when symptoms such as arthritis had developed. In urban settings, children tended to receive treatment in an emergency room or urgent care center for earlier symptoms.
“We're not sure why that is; if it's simply better access to medical care or if it's a reliance in certain communities on seeing your pediatrician,” Campfield said.
He said children who have meningitis, severe arthritis or heart rhthym irregularities should be treated immediately, while children with rashes, joint pains or flu-like symptoms don't necessarily require emergency care.
Ticks typically live in grassy, bushy areas. The CDC recommends treating clothing and gear with the chemical permethrin if going into those areas. People should also wear bug repellent containing DEET. After returning to the indoors, people should shower within two hours and should check clothes for ticks and tumble dry them on high heat for 10 minutes to kill any ticks.
Lyme disease isn't necessarily any more common in children than adults, Campfield said. The study authors studied children because they happen to specialize in treating children and noticed an increase in cases.