Lyme disease in kids is rising—and it’s not just a seasonal spike or a testing artifact. Pediatric cases are becoming more frequent, more complex, and often harder to diagnose. In some children, symptoms appear younger and progress faster. Others never get a classic rash.
Environmental changes, diagnostic delays, and atypical presentations create significant challenges. Understanding what’s driving this trend can help families recognize symptoms earlier and push for appropriate evaluation.
For a broader discussion of how Lyme disease can be overlooked in children, see Pediatric Lyme Disease: Why Children Are Often Misdiagnosed.
What’s Driving the Increase in Pediatric Lyme Disease
The uptick in pediatric Lyme is likely multifactorial. Expanding tick habitats, warming climates, and suburban sprawl have brought children into closer contact with ticks carrying Borrelia burgdorferi, the Lyme bacterium.
But environmental exposure isn’t the only factor. Some children seem more susceptible to severe or persistent forms of the disease, suggesting immune or genetic vulnerability may also play a role.
At the same time, children are more likely to miss the classic bullseye rash—or never develop one at all. Their symptoms may emerge instead as fatigue, mood swings, sleep disturbances, headaches, or even cognitive changes, which are often misattributed to behavioral issues, puberty, or school stress.
Why Children with Lyme Often Go Undiagnosed for Too Long
Children with Lyme often cycle through multiple providers before receiving a proper diagnosis. Pediatricians may not immediately connect vague symptoms like leg pain, irritability, or school refusal with Lyme—especially in areas once considered “low risk.”
This diagnostic delay can allow infection to spread, leading to more complex or chronic presentations. Neurologic symptoms that may develop include brain fog, light and sound sensitivity, poor memory or concentration, and new anxiety, OCD-like behavior, or tics.
When Lyme Looks Like Something Else: PANS and PANDAS
In some cases, tick-borne infections may trigger immune dysfunction, leading to pediatric acute-onset neuropsychiatric syndrome (PANS). These children may have sudden changes in personality, intrusive thoughts, rages, or severe food restriction.
Lyme disease and co-infections like Bartonella or Babesia have been implicated in triggering or exacerbating these syndromes. Awareness is key: If neuropsychiatric symptoms appear suddenly after a tick bite, patients should be evaluated for post-infectious autoimmune phenomena.
Why Early Action Matters
Children’s brains and bodies are still developing. Untreated or undertreated Lyme disease can interfere with learning, emotional regulation, growth, and social development. The longer symptoms persist, the more entrenched and debilitating they can become.
Treatment decisions must balance the need for effective care with the importance of preserving function and minimizing long-term consequences. In many cases, early antibiotic treatment can be curative. But for children with complex or persistent symptoms, a multidisciplinary approach is often needed.
A Wake-Up Call for Prevention, Awareness, and Research
The rise in pediatric Lyme cases underscores the need for earlier detection and more inclusive diagnostic criteria, better tick prevention strategies tailored to kids, greater provider education on atypical pediatric presentations, and more research on the intersection of Lyme, autoimmunity, and neurodevelopment.
Clinical Takeaway
Lyme disease in kids is rising, and the presentations are becoming more complex. Environmental factors, delayed diagnosis, and atypical symptoms—especially neuropsychiatric manifestations—create significant challenges for families and providers. Early recognition matters profoundly for children’s developing brains and bodies.
If your child’s symptoms don’t fit the usual explanations, trust your instincts and push for answers. The right diagnosis can restore what Lyme tries to take: energy, confidence, and the ability to simply be a child again.
Frequently Asked Questions
Why is Lyme disease in kids rising?
Multiple factors contribute: expanding tick habitats due to warming climates, suburban development bringing children closer to tick populations, and increased awareness leading to more diagnoses. Some children may also have genetic or immune vulnerabilities that make them more susceptible to infection.
What age children are most affected by Lyme disease?
Children ages 5–14 have among the highest reported rates of Lyme disease in the U.S., with boys under 10 particularly affected. However, Lyme can occur at any age, including infancy.
Can Lyme disease cause behavioral changes in children?
Yes. Lyme disease and co-infections can trigger neuropsychiatric symptoms including anxiety, OCD-like behaviors, rage episodes, personality changes, and cognitive difficulties. In some cases, this may overlap with PANS (Pediatric Acute-onset Neuropsychiatric Syndrome).
Do all children with Lyme disease get a rash?
No. Many children never develop the classic bullseye rash, or the rash appears in a hidden location like the scalp or behind the knee. Some children present with behavioral or cognitive symptoms before any physical complaints emerge.
What should I do if I suspect my child has Lyme disease?
Document symptoms carefully, trust your instincts, and seek evaluation from a clinician experienced with pediatric tick-borne illness. Don’t accept dismissal if something feels wrong. Early diagnosis and treatment offer the best chance for full recovery.
Related Reading
References
- National Institute of Mental Health. PANS and PANDAS: Questions and Answers. NIMH Publications.
- Rhee H, Cameron DJ. Lyme disease and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): an overview. Int J Gen Med. 2012;5:163-174.
- Centers for Disease Control and Prevention. Lyme Disease Data and Surveillance. CDC.
