Reported Cases of Lyme Disease – United States, 2016 (CDC)

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A new study from researchers at Children’s Hospital of Pittsburgh highlights “the conversion of western Pennsylvania from a Lyme-naïve to a Lyme-epidemic area.” The study, published online in Clinical Infectious Diseases, looked at electronic medical records of pediatric Lyme disease cases from 2003 to 2013 and found a dramatic increase in the number children seeking evaluation and treatment for the vector-borne disease that is now endemic in every county of Pennsylvania. The rise in cases, Jill Daly discovered, gained “epidemic speed in 2009-11” and has recently been “exponential”:

Spread by the “black-legged” tick, Lyme disease is caused by the bacteria Borrelia burgdorferi. If not treated with an antibiotic, it can lead to problems such as muscle and joint aches, facial paralysis, arthritis and brain inflammation.


We dove deeper into the clinical “Mysteries of Lyme Disease” on The PediaBlog five years ago:

Typical symptoms are not specific:  fever, headache, muscle aches, and fatigue.  The rash that can accompany a tick bite — erythema migrans or bullseye rash — is not present in all cases. If the diagnosis is made at this early stage, treatment with antibiotics (amoxicillin or cefuroxime under eight years old and doxycycline for those who are older) for 2-4 weeks is usually curative.  If this early stage of Lyme disease is not identified and treated, the bacteria can spread to the joints (arthritis), the nervous system (meningitis, bell’s palsy), heart (arrhythmias), and cause severe symptoms of debilitating and chronic fatigue and muscle pain.  In people with these symptoms, treatment options and recovery without residual health problems are variable, less than certain, and frequently a simple  matter of opinion.  This can be frustrating for people who suffer as well as doctors who treat them.


As warmer temperatures and more precipitation bring a climate better-suited to the deer tick’s life cycle and the well-being of its mammal reservoirs (deer and white-footed mice), Lyme disease is expected to continue spreading to points west and north:

The Children’s study projected that the Lyme-affected region will continue to expand — as it has moved west of the Appalachians and across the north to Minnesota and Wisconsin since its first description in 1977.

The study results might help children’s hospitals in Cleveland, Columbus and Cincinnati, Dr. Nowalk said. “The line is moving into Ohio. That’s where I would expect the next flood of cases. There’s no real natural barriers. .. The mountains served as a barrier.”


Mary Beth Pfeiffer believes it will take the equivalent of a “Manhattan Project” to get this epidemic under control:

Pennsylvania has seen cases of Lyme disease rise sharply in the last two decades. Today it is the nation’s leader in an epidemic driven by a scourge of ticks. More than 11,000 cases were reported in 2016, which is nearly a third of the official toll in the United States.

That’s bad enough. But because of undercounting, reported cases are likely a tenth of the actual number, meaning that more than 100,000 residents were infected in 2016. This year will most certainly build on, rather than reverse, what has been a relentless upward trend…

Lyme disease has been addressed through proclamations to create awareness, token warning signs at trailheads or parks, and reports on growing case counts, including one issued recently by the U.S. Centers for Disease Control and Prevention. Far more is needed to beat back the eight-legged creatures that now are firmly in control of the size and scope of this epidemic: more public education, more research on testing and treatment, and more efforts to control the tiny, damaging vampires among us.


In the meantime, children and adults will have to follow this advice offered by Wes Venteicher and try to prevent tick bites and transmission of Lyme disease:

Ticks typically live in grassy, bushy areas. The CDC recommends treating clothing and gear with the chemical permethrin if going into those areas. People should also wear bug repellent containing DEET. After returning to the indoors, people should shower within two hours and should check clothes for ticks and tumble dry them on high heat for 10 minutes to kill any ticks.