Pay Attention, It Might be Lyme

By Jordan Wilkinson

While most of us adults marvel at the “don’t stop till you drop” energy of children, we’re often more impressed with their ability to bounce back from illness. While we sometimes even invite the sniffles as an excuse for a break, the stagnation that accompanies sickness is endlessly frustrating for most children.

One of the sicknesses that seems to stop children in their tracks, though, is one that is all too often diagnosed. This sickness is Lyme disease and gives children a host of problems that extend far beyond missed school days and play dates.

About a quarter of all Lyme disease diagnoses are given to children every year. Among these children, boys aged 5 years to 19 years are particularly burdened by the disease, suffering three times more Lyme disease than any other group, according to a article titled “Children.”

But children diagnosed with Lyme disease suffer not only physical discomfort. The disease can also have long-lasting impacts on their emotional and psychological well-being.

In 2004, the Centers for Disease Control (CDC) conducted a study on the effects of Lyme disease on school attendance rates among 64 school children in New Jersey.

They found that the median duration of illness was 363 days, 103 of which resulted in school absences, on average. Of those absences, the average home instructional days amounted to 98.

“Schooling and extracurricular learning activities were seriously interrupted for most children,” the CDC reported. “Often, children spent large blocks of time as semi-invalids, isolated from social groups and missing out on cultural, sports and social activities. School performance of nearly all children fell, sometimes drastically, and in several instances was said to interfere with selection by colleges and universities.”

When long school absences hinder social development and interaction, children are left depressed and at a loss, according to experts involved with the study. In a related article published by The Journal of Neuropsychiatry and Clinical Neurosciences in 2001, parents reported that 41 percent of children diagnosed with Lyme disease had suicidal thoughts and 11 percent of them made a “suicidal gesture.”

From the Eyes of Children

Given the heavy burden that Lyme exacts on children, it’s especially critical that they absorb public health messages about how to avoid being infected.

Before the pressures of wearing just the right amount of indifferent “coolness” kicks in, children are often the first to adamantly tell you that smoking is bad for you and that you should add a side of broccoli to your dinner routine. In their eyes, brushed teeth, fresh air and a hat in the winter are the keys to finely tuned immunity. But are children really aware of the threat that Lyme poses, or are they simply too young to grasp that a pair of high socks can make all the difference?

In a 1980 study conducted by Susan Phillips, a resident in the Department of Family and Community Medicine at Toronto Western Hospital, 32 eight- and nine-year olds were given a medical questionnaire and taken on a visit to a hospital.

“Though there was certainty about health,” Phillips says, the study revealed a “lack of clarity about identifying sickness and treating it.”

The problem is that children “can’t always explain what is wrong,” a article points out. “Because the symptoms of Lyme disease can be non-specific, vague, and changeable, parents and teachers may suspect them of malingering or making things up to gain attention. It is also difficult for parents to discern when their child’s symptoms are worse or better, given the difficulties children have making that determination themselves.”

While the idea of children faking or exaggerating symptoms is nothing new, it becomes increasingly difficult to diagnose Lyme disease in children because the early symptoms are less obvious than a bad case of sniffles.

As a result, children with Lyme disease may go undiagnosed or be misdiagnosed.

“Often children exhibit problems associated with Lyme, especially behavioral and mood changes that go unrecognized by districts,” writes the International Lyme and Associated Disease Society (ILADS) in a letter released by the New Jersey School Board Association.

“At times, children may be improperly classified, labeled neurologically impaired or emotionally disturbed when perhaps a classification including ‘other health impaired’ might be more appropriate to address the medical problems triggering the neurologic and/or psychiatric problems that stem from Lyme,” it states.

A common misdiagnosis may be Attention Deficit Disorder (ADD). Children with Lyme who are misdiagnosed as ADD are then prescribed stimulant drugs like Ritalin and Adderall instead of prompt antibiotic treatment.

Not only does this misdiagnosis delay effective treatment, these stimulant drugs can make Lyme symptoms even worse, especially behavioral ones. Stimulant drugs can increase the potential for auditory hallucinations, paranoia, and psychotic behavior, as well as aggression, as the New York Times reports.

Rather than keep children from the romp and play they are so apt to enjoy, the solutions to lowering Lyme incidence in children may lie in teaching them about their health more effectively. Is it time for a reform in the curriculum of our children’s health and science classes?