Lyme disease in kids is rising—and it’s not just a seasonal spike or a testing fluke. 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. What’s driving this shift?

What’s Driving the Increase in Pediatric Lyme?

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, including neurologic symptoms like:

1. Brain fog

2. Light and sound sensitivity

3. Poor memory or concentration

4. 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:

1. Earlier detection and more inclusive diagnostic criteria

2. Better tick prevention strategies tailored to kids

3. Greater provider education on atypical pediatric presentations

4. More research on the intersection of Lyme, autoimmunity, and neurodevelopment

Did You Know?
Children ages 5–14 have among the highest reported rates of Lyme disease in the U.S., especially boys under 10.

Have you seen signs of Lyme in your child — or lived through pediatric Lyme yourself? Drop your questions or story below.

Additional Resources:

1. PANS and PANDAS: Questions and Answers
2. Lyme disease and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): an overview
3. PANS and PANDAS Overview