Can a Military Dependent Child Contract Lyme Disease Abroad?

Can a military dependent child contract Lyme disease abroad? Lyme disease is known to be endemic in parts of Japan, yet it is rarely diagnosed. Between 2006 and 2010, only 41 cases were reported nationwide, according to Soloria and colleagues.

“Forty-one cases were domestic cases with 19 suspected to have been acquired in Hokkaido, 5 cases in Nagano, and 2 cases each in Kanagawa, Niigata, Gifu, and Fukuoka,” Soloria writes in Military Medicine.

Case Report: Lyme Arthritis in an Adolescent After International Travel

Two weeks after arriving in the United States from Japan, a 17-year-old boy was evaluated for possible Lyme arthritis. He presented with a six-week history of progressive swelling of his right knee, which began while living in Japan.

The diagnosis of Lyme arthritis was confirmed through aspiration of the joint effusion and supportive laboratory testing.

“It is conceivable that he was bitten by a Lyme-infected tick in Japan, as his home there was adjacent to a wooded area,” Soloria explains.

[bctt tweet=”This case highlights the importance of obtaining a thorough travel history. A military dependent child was diagnosed with Lyme arthritis after relocating from Japan.” username=”DrDanielCameron”]

However, Soloria also notes that “it is very possible that he acquired this infection during travel to the northeastern United States the year prior to complaint of his symptoms.”

Treatment and Outcome

The adolescent was treated with a four-week course of oral doxycycline and responded well, with resolution of symptoms.

Implications for Military Families and Clinicians

This case highlights the importance of obtaining a detailed travel history in patients with Lyme disease symptoms, particularly among military families who frequently relocate.

An estimated 42,000 military dependents live on bases throughout Japan, placing a large pediatric population at potential risk for tick-borne illnesses.

“Military medical providers must be aware of travel-related infections that may have been acquired at a prior duty station,” Soloria writes.

This case underscores the need to consider Lyme disease in patients with compatible symptoms—even when exposure may have occurred outside traditionally recognized endemic regions—and to pursue appropriate testing and diagnosis.

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