Lyme Disease in Children: 4 Cases at Southern Camp

4 Children Infected with Lyme Disease in the South from One Camp

The number of tick-borne diseases, including Lyme disease, has been steadily rising in the South as tick populations expand into new territories. One study reports that “the trends in these data paint a clear picture of southward expansion of Lyme disease.” As a result, communities once considered non-endemic for Lyme disease are now at risk, including those in the southern United States.

The CDC recently reported several children infected with Lyme disease at a single wilderness camp in North Carolina. The children, who were between the ages of 6 and 8, attended the wilderness day camp at least 1 day a week in the Fall and Spring. Three of the four children were homeschooled but attended the camp. Three children had ticks removed.

“Further investigation identified an earlier camp participant who had received a diagnosis of Lyme disease in 2017,” the authors explain.

Tick Investigation Results

Using a “flagging and dragging” method across 0.27 acres of the camp, investigators collected 37 Ixodes scapularis ticks, commonly called deer ticks.

Out of 35 ticks tested, 6 were positive for Borrelia burgdorferi sensu stricto, the causative agent of Lyme disease. Results indicated that nymphal ticks collected at the campsite had a B. burgdorferi infection prevalence of 17%.

Additionally, 1 of the 6 ticks tested positive for Borrelia miyamotoi. None of the ticks tested positive for the pathogens responsible for Anaplasmosis or Babesia microti.

Clinical Presentations and Diagnosis

In 3 of the 4 children, blood tests confirmed a Lyme disease diagnosis. Two of the children had an erythema migrans (bull’s eye) rash. One was considered probable because the test was positive by ELISA and IgM Western blot but not IgG Western blot.

The clinical presentations included brief, recurrent attacks of joint swelling, arthralgia, fever, headaches, loss of appetite, and fatigue. One child developed radiculoneuropathy and Bell’s palsy.

Treatment

All four children were treated with doxycycline. The authors did not indicate how long they treated the young children or the outcome of treatment.

Implications for Southern Communities

“Clinicians should be aware of the risk for transmission of Lyme disease in North Carolina and consider recommended diagnostic testing and treatment,” the authors conclude.

Other studies have also identified ticks infected with the causative agent of Lyme disease in the south. As tick populations continue expanding southward, communities once considered non-endemic for Lyme disease—including the southeastern United States—now face increasing risk.

Frequently Asked Questions

Is Lyme disease spreading to the southern United States?

Yes. Multiple studies document southward expansion of Lyme disease as tick populations move into new territories. Areas once considered non-endemic, including North Carolina and other southeastern states, now have established populations of infected ticks and confirmed human cases.

How many children got Lyme disease at the North Carolina camp?

Four children between the ages of 6 and 8 were diagnosed with Lyme disease after attending the same wilderness day camp in North Carolina. An earlier camp participant had also been diagnosed with Lyme disease in 2017, indicating ongoing tick exposure at the site.

What percentage of ticks at the camp were infected with Lyme disease?

Testing revealed that 17% of nymphal deer ticks collected at the campsite were infected with Borrelia burgdorferi, the bacterium that causes Lyme disease. This infection rate is comparable to rates seen in traditional endemic regions.

Can children in the South get Lyme disease from outdoor activities?

Yes. As this camp cluster demonstrates, children participating in outdoor activities in southern states face genuine risk of Lyme disease. Parents and camp administrators should implement tick prevention strategies even in areas historically considered low-risk.

Should southern doctors test for Lyme disease in children?

Yes. Clinicians in southern states should maintain awareness of Lyme disease risk and consider appropriate diagnostic testing and treatment when children present with compatible symptoms, especially if they have outdoor exposure in wooded or grassy areas.

Clinical Takeaway

This cluster of four pediatric Lyme disease cases at a single North Carolina camp confirms the ongoing southward expansion of Lyme disease into historically non-endemic regions. With a 17% tick infection rate documented at the site, southern communities can no longer assume Lyme disease is a northern problem.

Clinicians in southern states should maintain appropriate clinical suspicion for Lyme disease in children with compatible presentations, particularly those with outdoor exposure. Parents and camp administrators in the South should implement tick prevention measures comparable to those used in traditional endemic regions.