Several tick-borne infectious diseases that can affect children are prevalent in different geographic areas within the United States. Examples of these include: babesiosis, a protozoal infection transmitted by the deer tick(Ixodes scapularis); Colorado tick fever, which is an arboviral infection; and tularemia, a Gram-negative bacterial infection. Several rickettsial diseases also are spread by tick bites, including ehrlichiosis,which is spread by the tick vector Amblyomma americanum and possibly Ixodes scapularis, and Rocky Mountain spotted fever (RMSF). RMSF is transmitted in the South Atlantic/Southeastern states primarily by the dog tick Dermacentor variabilis, in the Western United States by the wood tick Dermacentor andersoni, and in the South Central region by the Lone Star tick, Amblyomma americanum.Perhaps the most notorious tick-borne disease in the United States today is Lyme disease, caused by the spirochete Borrelia burgdorferi. The disease is transmitted by the deer ticks Ixodes scapularis(previously Ixodes dammini) in the East/ Midwest and Ixodes pacificus in the West.Control measures for these and other tick-borne pediatric infectious diseases are aimed at preventing infected ticks from biting children. These measures include avoiding tick-infested areas; wearing protective clothing that covers exposed parts of the body; using tick/insect repellant; and carefully examining the child’s head, neck, and body following possible tick exposure.Any ticks that are discovered should be removed promptly either by using the fingers or fine tweezers. Whatever method is used, the tick should be grasped as close to the skin as possible and removed by pulling straight out. Twisting motions should be avoided. In addition, care should be taken not to squeeze the body of the tick. Fingers always should be protected by tissue paper and thoroughly washed with soap and water after tick removal.Adherence to the measures described can diminish the transmission of tick-borne diseases by reducing contact with ticks and preventing infected ticks from biting and engorging on children.Worldwide, only mosquitoes surpass ticks as arthropod vectors of human infections, and the range of infectious agents transmitted by ticks to people is an unfortunate reflection of nature’s almost infinite variety: virus, bacterium,protozoa, rickettsia, and spirochete,not to mention the noninfectious neurotoxin that causes tick paralysis. Children are particularly susceptible to tick-borne disease because they love to play in the kinds of places where ticks live, as do their pets,another common source of exposure.An article published in Pediatrics(Needham GR. Evaluation of five popular methods for tick removal. 1985;75:997) serves as the scientific basis for the recommendations outlined by Dr Ozuah. Despite what our grandmothers may have told us,neither petroleum jelly, fingernail polish, alcohol, nor a hot match works as well in extracting a tick intact as totally straight traction. Dr Ozuah points out that if fingers are used instead of tweezers, they should be protected by tissue or rubber gloves to keep infectious agents in the tick’s saliva from invading through breaks in the skin—an argument for not allowing children to “de-tick” their pets.Because of the risk of contamination with infectious agents from the tick’s saliva, the site of a bite should be disinfected carefully after the tick has been removed. Removed ticks should be put into a bottle of alcohol or flushed down the toilet.