Pediatric Lyme Disease in Pennsylvania: Rising Cases and Changing Patterns
Cases are increasing rapidly
Urban areas are now affected
Children are at significant risk
Symptoms can vary widely
Pediatric Lyme disease in Pennsylvania is rising—and spreading beyond rural areas. New research shows an exponential increase in cases among children, with shifting patterns that affect both urban and suburban populations.
According to the CDC, nearly 38% of all reported Lyme disease cases in 2016 occurred in Pennsylvania, highlighting the region as a major hotspot.
Study Overview
Researchers reviewed 773 children diagnosed with Lyme disease over a 10-year period at Children’s Hospital of Pittsburgh.
Eddens and colleagues analyzed:
- Clinical presentation
- Healthcare utilization
- Geographic distribution
Cases increased exponentially over the study period.
Lyme Disease Is Expanding Beyond Rural Areas
One of the most important findings:
- The highest burden shifted from rural to non-rural areas
- 503 children lived in non-rural zip codes
- 169 cases occurred within the city of Pittsburgh
Lyme disease is no longer limited to rural environments.
For broader trends, see how Lyme disease spreads.
Who Is Affected?
- Average age: 8.1 years
- 22% were ages 0–4
- 45% were ages 5–9
- 59% were male
Young children represent a significant portion of cases.
Seasonal Patterns
- 62% of cases occurred between May and August
This reflects peak tick activity during warmer months.
Common Symptoms in Children
- 56% had an erythema migrans (EM) rash
- 47% had joint pain
- 45% had fever
- 31% had joint swelling
- 30% had headache and fatigue
- 22% had difficulty walking
For a full overview, see Lyme disease symptoms guide.
Neurologic Symptoms
Neurologic findings were less common but still important:
- 12% had cranial nerve palsy
- 11% reported neck stiffness
For more, see neurologic Lyme disease.
Tick Bite History Often Absent
- Only 29% of children recalled a tick bite
Absence of a known tick bite does not rule out Lyme disease.
Treatment Patterns
- 47% received doxycycline
- 44% received amoxicillin
More severe cases required:
- Intravenous antibiotics for Lyme meningitis and arthritis
Children were treated by multiple specialties, including:
- Rheumatology
- Infectious Disease
- Neurology
- Cardiology
Over time, more cases were diagnosed in emergency departments and primary care settings.
Rapid Growth in Cases
The increase in pediatric Lyme disease was significant:
- Cases doubled approximately every 1.6 years
This rapid growth suggests expanding risk across regions.
Similar trends are now being seen in other states, including Ohio, Illinois, North Dakota, and Iowa.
Clinical Takeaway
Pediatric Lyme disease in Pennsylvania is increasing—and spreading into urban areas.
Children may present without a known tick bite and with a wide range of symptoms.
Early recognition and treatment remain critical to preventing complications.
Reference
- Eddens T et al. Clin Infect Dis. 2018.
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
My six-year-old son is a “statistic” in this study. Here in a suburb of Pittsburgh the general population is largely unaware of how high-risk our region has become. There is very little public awareness effort being generated from anywhere including the major health institution the doctors who authored the study are employed by (UPMC). No public awareness media campaigns, no awareness and prevention education at schools, very little coming from county government, just information on their website. The local news coverage of this study was minimal. It should have been headline news in this region. It is getting more attention in the Lyme community but we’re the ones who already know Lyme is a huge, growing problem. Thank you Dr. Cameron for highlighting this important information and including more detail than I could find anywhere else.