Lessons in Lyme Disease 

New Jersey schoolchildren will now study Lyme disease in their curriculum. But is it too little, too late?

New Jersey Governor Phil Murphy signed a law over the summer requiring all school districts to educate kids on Lyme disease symptoms and prevention during the new school year. Unfortunately, the ticks didn't wait until class was in session. Approximately 50 percent of all Lyme disease cases in New Jersey occur from June to July, and preliminary data from state health authorities shows that 2023 case rates have been similar to 2022's high numbers. According to the National Institutes of Health (NIH), children between the ages of five and nine account for a large proportion of the approximately 476,000 annual Lyme disease cases in the United States. With tick season expected to continue into October, Rutgers University in Camden nurse educator Rachel Derr delved into what children will learn in school this year so that parents, families, and loved ones can join in on prevention and mitigation.

Rachel Derr, director of pre-licensure programs and clinical assistant professor in the School of Nursing

Rachel Derr, director of pre-licensure programs and clinical assistant professor in the School of Nursing

Derr, director of pre-licensure programs and clinical assistant professor in the School of Nursing, emphasized that New Jersey residents face elevated risk.

“New Jersey is a high-incidence state for Lyme, so it is particularly important when a person presents with risk factors or signs of Lyme disease,” she said.

Derr said the disease can appear similar to conditions such as influenza, with symptoms occurring anywhere from three to 30 days after a tick bite. Nurses are trained to check for fever, headache, malaise, and joint and muscle pain. Derr said Lyme disease symptoms are often the same in children and adults, but children are more likely than adults to have fever, joint problems, and irritability.

Nurses will also ask about a patient’s history, including recent exposure to ticks or participation in activities that could have increased the patient’s risk of exposure. They look for “erythema migrans,” a rash that resembles a bullseye, over the tick-bite area.

“It is essential to note that sometimes we do not know that we were exposed to a tick,” Derr said. “It is very important to get any bullseye rash evaluated by a health care provider.”

Accurate screening is critical for early detection and treatment. Nurses play a critical role in each part of this process because they are often the first to see a patient.

“Teaching nursing students risk factors, signs, and symptoms of Lyme disease arms them with the knowledge needed to communicate concerns with the health care team to support diagnosis and treatment,” Derr said. 

Patients are typically treated with antibiotics in Lyme disease’s first stage, which gives the patient the best chance for a complete recovery and optimal outcome. In fact, a recent study from the NIH showed that the majority of children who present with Lyme disease recover within six months of antibiotic treatment. If left untreated, Derr said, Lyme disease can advance to Stage 2, which increases heart, joint, and neurological problems. 

Derr recommends that families plan ahead when spending time in tick-prone areas by wearing hats and light colors, which make it easier to identify ticks on clothing; apply child-safe insect repellent on skin and clothing; and teach kids to walk along paths and avoid dense shrubs or grasses, which are hospitable to ticks. 

“There is understandable fear around unknowns,” Derr said. “At Rutgers–Camden, we are committed to helping our nurses and students treat and advocate for individuals, families, and communities affected by Lyme disease.”

Creative Design: Beatris Santos

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