Lyme disease in children hard to diagnose

Last summer, 3-year-old Colin McMahon started acting strange. He couldn't focus, he swiped his hands over his face nonstop and he became anxious -- to the point where he wouldn't go into a room by himself.

Colin's parents finally figured out what was wrong: Colin had Lyme disease.

Lyme is the most common of all the diseases in the United States transmitted by mosquitoes, ticks and fleas, with about 20,000 cases reported each year nationally.

New York has the second-highest rate of Lyme in the United States, with nearly 6,000 cases reported in 2009.

Public health officials say the number of undiagnosed cases is probably higher.

Most illness occurs in June, July and August, when the infected ticks are most active.

Experts say this year's cool, wet spring is the perfect climate for ticks, and he is seeing many of the critters in his practice.

The incidence of Lyme among people is highest in two age groups: adults between 55 and 69 and children between 5 and 14, particularly boys.

"He was so young, and I thought he was going through a phase," said Darlene McMahon, Colin's mother, who lives near Plattsburgh upstate.

Lyme symptoms come in many forms and are hard to pin down in children, said Dr. Kari Bovenzi, an Albany pediatrician who treats many kids with the ailment.

Children have trouble explaining their symptoms and don't have a reference point for what is normal, Bovenzi said.

The tick itself is rarely seen and the bull's-eye rash associated with Lyme only appears in 7 percent of cases, she said. On top of that, tests for Lyme are unreliable.

"It's tricky to prove what is going on," Bovenzi said.

Lyme can attack any organ in the body, including the brain, leading to a spectrum of symptoms in children that might include poor concentration, short-term memory problems, irritability, fatigue, fever, body pain, speech problems, facial paralysis and seizures.

Consequently, Lyme has been misdiagnosed as attention deficit disorder, behavioral problems and even autism, Bovenzi said.

She said pediatricians need to be educated about the disease, especially in New York where Lyme is widespread. And if they have a patient with inexplicable symptoms, "You better think about Lyme."

The International Lyme and Associated Diseases Society recommends longer courses of antibiotics that end when the patient feels better.

Colin is on antibiotics and 90 percent of his symptoms are gone, his mother said.

McMahon has started a national group to connect families of children infected by Lyme and educate people about the variety of symptoms that accompany the disease.

The group is called the Children's Lyme Disease Network and can be reached at info@childrenslymenetwork.org.

"Our hope is to really promote awareness, specifically for children," McMahon said.

Staying healthy

Tips for preventing Lyme disease in children:

At the end of the day, remove clothing outside the bedroom to prevent a tick on the clothing from finding its way to the child.

Check the skin for ticks, particularly the underarms, belly button, groin, back of the head, and in and around the ears.

Avoid leaf piles and stacks of wood.

When outdoors, wear long sleeves and tuck pants into socks. Ticks can be spotted more easily on light colored clothing.

Walk on cleared paths and pavement through wooded areas and fields when possible.

Use insect repellent safely. The American Academy of Pediatrics says repellant with DEET should not be used on infants under 2 months old.

Shower after all outdoor activities. It may take up to four to six hours for ticks to attach firmly to skin. Showering will help remove unattached ticks.

Symptoms of Lyme in children:

Bull's-eye rash, any rash, flu-like symptoms, headache, stiff neck, muscle aches, joint pain, fatigue, poor appetite, sore throat, swollen glands, joint selling, neurological problems, skin disorders, eye problems, weakness, problems with coordination, poor concentration, anxiety, and obsessive-compulsive behaviors.

Source: Centers for Disease Control and Prevention, Children's Hospital Boston and Dr. Kari Bovenzi