Lyme Disease Risk for International Travelers to the United States
Lyme disease remains a significant risk for international travelers visiting the United States, particularly in endemic regions.
“Despite being a top international tourist destination, few sources describe the spectrum of infectious diseases acquired among travellers to the USA,” writes Stoney in the Journal of Travel Medicine.
Researchers analyzed data from GeoSentinel clinics, a global surveillance network established by the CDC and the International Society of Travel Medicine, reviewing cases from 1997 to 2016.
Who Is Affected?
Among 1,222 non–U.S.-resident travelers who became ill:
- 52% were female
- The median age was 40 (range 0–86)
- Most travelers came from Canada (31%), Germany (14%), France (9%), and Japan (7%)
Lyme Disease Leads Among Vector-Borne Infections
While mosquito-borne infections such as West Nile, dengue, and Zika were uncommon, Lyme disease stood out.
Lyme disease was the most frequently reported arthropod-borne illness among travelers, accounting for 4% of cases.
This finding reinforces that tick exposure—not just mosquito exposure—should be considered when evaluating travel-related illness in the United States.
Broader Spectrum of Illness
Travelers were also diagnosed with a wide range of infections, including:
- Respiratory illnesses
- Gastrointestinal infections
- Dermatologic conditions
- Systemic febrile illnesses
However, Lyme disease remains the leading vector-borne concern among these cases.
Clinical Implications
This study highlights the importance of educating international travelers about tick-borne disease risks in the United States.
Clinicians should consider Lyme disease when evaluating travelers with compatible symptoms, particularly those who visited endemic regions.
Prevention strategies—including tick avoidance and early recognition—are essential for travelers unfamiliar with Lyme disease risk.
Clinical Takeaway
Lyme disease should be considered a key travel-related risk for visitors to the United States, not just a domestic concern.
Related Articles
- Lyme disease in returning travelers
- American traveler with Lyme disease
- Borrelia miyamotoi and travel risk
References
- Stoney RJ, Esposito DH, Kozarsky P, et al. Infectious diseases acquired by international travellers visiting the USA. J Travel Med. 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
If the great minds of economics and medicine could cross reference then damage to these vector-borne diseases. There would likely be more of a movement effort toward better testing and treatment protocols.