Are Military Family Members at Risk for Lyme Disease?
Military families may encounter Lyme disease at home and during relocation
A West Point study found a higher prevalence among family members than service members
Newer military studies show that geography, deployment, and prevention all influence exposure
Lyme disease risk for military families may depend on where they live, work, train, travel, and spend time outdoors. Military personnel may be exposed to ticks during training, while family members living near installations in Lyme-endemic areas may also face substantial exposure.
A study by Schubert and Melanson examined Lyme disease among military personnel and their families at West Point, New York. The investigators found that family members had nearly twice the period prevalence of Lyme disease reported among active-duty service members.1
More recent military surveillance provides a broader perspective. A 2024 study found that Lyme disease was the most frequently reported of four major vector-borne diseases among Military Health System beneficiaries from 2010 through 2022.2 A separate study of U.S. military personnel stationed in Honduras found evidence of Lyme seroconversion in a small percentage of personnel, illustrating how deployment and previous geographic exposures may complicate assessment of Lyme disease risk.3
Lyme Disease Cases at West Point
The original West Point study, entitled “Prevalence of Lyme Disease Attributable to Military Service at the USMA, West Point NY: FY2016–2018,” reviewed Lyme disease cases treated at Keller Army Community Hospital on the West Point Military Reservation between 2016 and 2018.1
The investigators identified 144 Lyme disease cases during the study period:
- 63 cases involved active-duty military personnel
- 81 cases involved family members
The findings were particularly interesting because military personnel might be expected to have greater tick exposure due to field training and other outdoor activities. Instead, family members had the higher measured prevalence.
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Higher Lyme Disease Prevalence Among Military Families at West Point
The period prevalence of Lyme disease among military personnel was 292 cases per 100,000 during the three-year study period.1
Among family members, the period prevalence was 581 cases per 100,000—nearly twice that reported among the service members in the study.1
The researchers concluded that their findings did not support the assumption that military personnel necessarily have greater Lyme disease risk than their family members. They called for additional research at military installations in other Lyme-endemic areas to determine whether the West Point findings could be reproduced elsewhere.
Why Might Military Personnel Have Lower Risk?
Several factors could potentially help explain why active-duty personnel at West Point had lower Lyme disease prevalence than their family members.
Although some military duties involve substantial outdoor exposure, many service members at West Point work indoors for much of the academic year. Military personnel may also benefit from organized tick-prevention programs and protective measures.
These measures may include:
- Permethrin-treated uniforms
- Education about tick exposure
- Tick checks following outdoor activities
- Other military vector-borne disease prevention programs
The West Point investigators specifically recommended further research into whether interventions such as permethrin-treated uniforms help protect service members from Lyme disease.1
What Did a 13-Year Military Surveillance Study Find?
A 2024 report broadened the picture considerably by examining vector-borne diseases reported among Military Health System service members and non-service member beneficiaries from 2010 through 2022.2
The investigators examined the four most frequently reported vector-borne diseases: Lyme disease, Rocky Mountain spotted fever, malaria, and dengue fever.
Among 5,199 reported cases of these four diseases, Lyme disease accounted for 3,400 cases, making it the most frequently reported vector-borne disease in the analysis.2
Most reported Lyme disease cases occurred within the U.S. Northern Command region. Of the 3,400 Lyme disease cases:
- 2,721 were reported in NORTHCOM
- 648 were reported in EUCOM
- 26 were reported in INDOPACOM
- 4 were reported in CENTCOM
- 1 was reported in SOUTHCOM
- None were reported in AFRICOM
The geographic concentration was striking. The authors reported that 43% of Lyme disease cases among service members and non-service beneficiaries were diagnosed at NORTHCOM Groton/New London Submarine Base in Connecticut and NORTHCOM New England.2
This reinforces an important point: military affiliation alone does not determine Lyme disease risk. Where a service member or military family lives may be particularly important.
Did Reported Military Lyme Disease Cases Change Over Time?
The 2024 surveillance report also found that confirmed Lyme disease cases peaked at 455 cases in 2012 and declined to 75 cases in 2022. Probable and suspect cases also declined over the surveillance period.2
However, these numbers should be interpreted cautiously. Surveillance data depend on case definitions, reporting practices, diagnostic availability, and other factors. The authors specifically identified challenges involving nonspecific symptoms, diagnostic availability, and accurate case classification.
Therefore, the decline in reported military cases should not automatically be interpreted as evidence that the underlying risk of Lyme disease declined by the same amount.
Can Military Personnel Be Exposed to Lyme Disease During Deployment?
A newer study examined this question using a different approach. Chen and colleagues evaluated 1,640 U.S. military personnel who had been stationed in Honduras for at least six months between 2000 and 2021.3
Rather than relying only on diagnoses recorded in medical records, the researchers compared stored blood samples collected before and after deployment.
After deployment, 22 of 1,640 personnel, or 1.3%, had IgG antibodies against Borrelia burgdorferi. When the researchers examined predeployment samples from these individuals, they found that 6 of 1,640 personnel, or 0.4%, had seroconverted during the interval.3
The remaining 16 individuals with positive postdeployment samples had already been positive before deployment, suggesting previous exposure before their assignment to Honduras.
What Does the Honduras Study Tell Us About Deployment Risk?
The researchers characterized the 0.4% seroconversion rate as a low-risk threat and recommended additional investigation of potential Borrelia vectors in the region.3
The study is also important for another reason: some personnel who tested positive after deployment had already been seropositive beforehand.
For military personnel and their families, exposure history may therefore extend far beyond the current duty station. People may move repeatedly between states and countries, making a detailed geographic and travel history particularly useful when evaluating a possible tick-borne illness.
Why Geography Matters for Military Families
Together, these studies show why Lyme disease risk among military populations cannot be reduced to a simple question of whether someone serves in the military.
Risk can be influenced by:
- Where the service member is stationed
- Where the family lives
- Previous duty stations and residences
- Training and deployment locations
- Outdoor recreational activities
- Local tick populations
- Use of protective clothing and repellents
- Tick-prevention education
This geographic history can be especially important for military families who relocate frequently. A Lyme disease exposure may have occurred at a previous residence or duty station rather than where symptoms are eventually evaluated.
Need for Additional Research
The military studies answer different questions and should not be directly equated.
The West Point study examined diagnosed Lyme disease among service members and family members at a single installation in an endemic region.1 The 2024 surveillance study examined reported vector-borne diseases throughout the Military Health System across multiple geographic commands over 13 years.2 The Honduras study used stored pre- and postdeployment blood samples to look for serologic evidence of exposure among deployed personnel.3
Taken together, they suggest that military personnel and their families can encounter Lyme disease through multiple pathways, including residence in endemic areas, outdoor activity, previous geographic exposure, and potentially deployment.
Additional research is needed to determine which military populations are at greatest risk and how effectively preventive measures reduce that risk.
Clinical Takeaway
Military families may move frequently between regions with very different Lyme disease risks. Clinicians evaluating unexplained symptoms should consider not only a patient’s current residence but also previous duty stations, deployments, travel, and outdoor exposures.
The available research also challenges the assumption that active-duty personnel necessarily have the greatest risk. At West Point, family members had nearly twice the measured prevalence of Lyme disease. Broader military surveillance confirms that Lyme disease remains an important vector-borne disease within the Military Health System, while deployment studies demonstrate the value of considering both recent and previous exposures.
Frequently Asked Questions
Are military personnel at higher risk for Lyme disease?
Not necessarily. Risk depends on geography, outdoor exposure, training activities, preventive measures, and other factors. At West Point, family members had a higher period prevalence of Lyme disease than active-duty service members.
Are military family members at risk for Lyme disease?
Yes. Family members living near military installations in Lyme-endemic regions may encounter infected ticks during everyday outdoor activities. Frequent relocation may also result in exposure at previous residences or duty stations.
Is Lyme disease common in the Military Health System?
In a 2024 surveillance report covering 2010 through 2022, Lyme disease was the most frequently reported of the four leading vector-borne diseases evaluated among Military Health System beneficiaries.
Can military personnel be exposed to Lyme disease overseas?
Potentially. A study of U.S. military personnel stationed in Honduras identified seroconversion in 0.4% of 1,640 personnel studied. The investigators characterized the finding as representing a low-risk threat and called for additional surveillance.
Why is travel history important when evaluating Lyme disease in military families?
Military families may live in several states or countries over relatively short periods. A person’s relevant tick exposure may therefore have occurred months or years earlier or at a previous duty station rather than near the location where symptoms are evaluated.
Related Articles
- Lyme Arthritis in a Military Dependent Child After Travel From Japan
- Can Lyme Disease End a Military Career? Army Officer Case
- Can You Join the Military With Lyme Disease?
- Lyme Disease and Military Service: Fitness for Duty and Discharge
References
1. Schubert, S. L., & Melanson, V. R. (2020). Prevalence of Lyme disease attributable to military service at the USMA, West Point NY: FY2016–2018. Military Medicine, 185(1–2), e28–e34. https://doi.org/10.1093/milmed/usz156
2. Stidham, R. A., Cole, R., & Mabila, S. L. (2024). Brief report: The four most frequently diagnosed vector-borne diseases among service member and non-service member beneficiaries in the Geographic Combatant Commands, 2010–2022. Medical Surveillance Monthly Report, 31(1), 14–16. https://pubmed.ncbi.nlm.nih.gov/38359365/
3. Chen, H. W., Sugiharto, V. A., Gatrell, S. K., Blazek, G. R., Cherry, A. M., Simons, M. P., Jenkins, S. A., & Schilling, M. A. (2026). Assessment of Lyme seroconversion among US military personnel in Honduras. Military Medicine, 191(3–4), e470–e473. https://doi.org/10.1093/milmed/usaf216
This article is for educational purposes and is not intended as medical advice. Individuals concerned about possible Lyme disease or other tick-borne infections should discuss their symptoms, exposure history, and appropriate evaluation with a qualified healthcare professional.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
