A recent article (Sept 2nd 2015) has been published by the Canadian Pediatric Society that gives a useful insight into this the most notorious tick-borne disease in Canada. Whilst the incidence of Lyme Disease is uncommon (Approx. 500 case reported in 2013) it remains a source of great concern for patients following a tick bite, especially parents of children with a tick bite..

This article re-iterates that the best way to avoid Lyme Disease is to prevent tick bites by using insect repellent. However once bitten, the child is often brought up to the Emergency Department for tick removal and advice.

Once removed, the tick is placed in a container and sent for to the National Laboratory for analysis .

The most common question that we get asked after removing the tick is: “Is there a risk of developing Lyme Disease? and can you prescribe something to prevent it?”

The guidance on postexposure prophylaxis from the Canadian Pediatric Society is:

Consensus on postexposure prophylaxis for LD is lacking at this time. Some experts recommend giving doxycycline as a single dose of 200 mg for children and youth ≥8 years of age after a tick bite (for individuals weighing <45 kg, 4 mg/kg to a maximum of 200 mg). Prophylaxis can be started within 72 h of removing a tick, even if it has been attached for ≥36 h. Data are insufficient to recommend amoxicillin prophylaxis in younger children.

In Canada, such prophylaxis should be considered in ‘known endemic areas’ (see Table 1 and Figure 1 in reference 1). Physicians should bear in mind that the true prevalence of B burgdorferi is often unknown and that the geographical range of infected ticks is expanding in some areas.The Public Health Agency of Canada continues to monitor the distribution and prevalence of infected ticks as well as cases of LD.

A vaccine to prevent LD in humans is not available at the present time.

The full article can be accessed here