After 37 years treating Lyme disease, I’ve seen few papers address the issues of military Lyme disease for members of the military and their families. This is an area that merits greater exploration and has serious implications for Lyme disease recovery among those who serve. The following selection from my book “An Expert’s Guide on Navigating Lyme disease” highlights findings from my first 600 Lyme disease Science blogs on how Lyme disease impacts military personnel.

Lyme Ends Army Officer’s Career

We often consider Lyme disease as a public threat to those who enjoy outdoor activities like hiking and gardening. But Lyme disease and other tick-borne illnesses are a constant risk to military personnel who spend considerable time working in heavily forested or mountainous terrain. A 24-year-old army officer failed Lyme disease treatment, which ended his career. “Eventually, a medical retention decision point was reached, and he was deemed unfit for duty” (Weiss et al., 2019). “This case highlights the need for increased surveillance for Borrelia burgdorferi in military training areas and for the early and aggressive diagnosis and treatment of military personnel who present with the symptoms of acute Lyme disease” (Weiss et al., 2019). Read more.

Soldier Dismissed from Active Duty After Failing Treatment

In another case, a 21-year-old man remained ill and “was unable to perform moderate or strenuous physical exercise or cognitive activity due to cognitive impairment affecting short-term memory and ability to focus, severe fatigue, post-exertion malaise, asthma, and increasing allergic-type reactions with chemical and food sensitivities, histamine intolerance, and progression to heat/ultraviolet-induced urticaria” (Melanson et al., 2022). The young man was considered unfit for duty by the Army Medical Evaluation Board for the following reasons: “Lyme disease, mycotoxicosis, chronic fatigue syndrome, allergic rhinitis, and vasomotor rhinitis.” Read more.

Risk of Tick Bites Among German Military Personnel

“One out of 17.5 recruits suffered a tick bite during basic training.” However, “It turns out that there is a rather low but relevant risk of being exposed to tick bites for military personnel during their field training” (Sammito et al., 2019). However, the actual number may have been higher, as the figures were based solely on a review of the medical records. “It cannot be ruled out that tick bites went unnoticed or that attached ticks were removed by the affected soldiers themselves” (Sammito et al., 2019). In contrast, earlier studies have shown a higher incidence of tick bites in the military. However, these studies were conducted in Germany’s other regions and climate zones (Fauld et al. 2014). Read more.

US Veterans Suffer from Tick-Borne Illnesses

The electronic records of veterans treated between January 1, 2000, and December 31, 2016, at the New York Northport Veterans Affairs Medical Center were studied. Out of 181 patients, 32 presented with an erythema migrans rash. The veterans also exhibited: joint pain (n = 58), myalgias and fatigue (n = 34), headache/neck pain (n = 27), peripheral neuropathy (n = 14), seventh nerve palsy (n = 5), and palpitations (n = 2). Coinfections were also common. “Seven patients had babesiosis with positive smear and parasitemia ranging from 0.1% to 3%. Another patient with babesiosis had a history of splenectomy and required exchange transfusion” (Psevdos et al., 2019). Two additional tick-borne pathogens were observed. “Two [Lyme disease] patients had Anaplasma IgM antibody positive and one with positive A. phagocytophilum PCR” (Psevdos et al., 2019). Read more.

Military Families at Risk for Lyme Disease

Schubert and Melanson described the exposure of military personnel and their families to the Ixodes scapularis (or black-legged) tick, the vector of Lyme disease attributable to service at the West Point Medical Academy (Schubert et al., 2019). The authors examined cases of Lyme disease treated at a hospital on the West Point Military Reservation, in New York between 2016 and 2018. Out of 144 cases identified, 63 involved military personnel, but family members accounted for 81 cases. The authors concluded that family members were at higher risk of contracting Lyme disease than service members. Read more.

Military-Dependent Child Contracts Lyme Abroad

Two weeks after arriving in the U.S. from Japan, a 17-year-old boy was evaluated for possible Lyme arthritis. He had a 6-week history of progressive swelling of his right knee, which started in Japan. The diagnosis of Lyme arthritis was confirmed by aspiration of the joint effusion and laboratory testing. However, the clinicians were unsure whether he contracted Lyme disease from Japan, or the U.S. (Solaria and Adams 2019). An estimated 42,000 military-dependent children are living on military bases outside the U.S. “This case highlights the importance of obtaining a travel history from military members and their families who frequently relocate due to military orders” (Soloria and Adams, 2019). Read more.

Clinical Takeaway

After 37 years treating Lyme disease, I’ve learned that military Lyme disease represents a significant but underexplored health threat to service members and their families. Military personnel face constant exposure to tick-borne illnesses during field training in heavily forested or mountainous terrain, with documented cases of treatment failure ending military careers and leaving young soldiers deemed unfit for duty. Studies show tick exposure during basic training, high rates of Lyme disease among veterans (including coinfections like Babesia and Anaplasma), and notably, military family members at West Point faced higher Lyme disease risk than service members themselves. This area merits greater surveillance, early aggressive diagnosis and treatment, and recognition that frequent relocations can complicate diagnosis when military families contract tick-borne diseases abroad.

Frequently Asked Questions

Are military personnel at risk for Lyme disease?
Yes. Military personnel face constant exposure to tick-borne illnesses during field training in heavily forested or mountainous terrain, with documented tick bites during basic training and high rates of Lyme disease among veterans.

Can Lyme disease end a military career?
Yes. Documented cases show young service members deemed unfit for duty after failed Lyme disease treatment, unable to perform physical exercise or cognitive activity due to persistent symptoms.

Are military families at risk for Lyme disease?
Yes. At West Point Military Reservation, family members accounted for 81 out of 144 Lyme disease cases, while military personnel accounted for only 63 cases, showing higher risk for families.

Related Reading

Lyme Disease Recovery: What Patients Need to Know
Lyme Disease Forces Officer Out of Military
Soldier Dismissed After Failing Lyme Disease Treatment
Are Military Family Members at Risk for Lyme Disease?
USA Veterans Suffer from Tick-Borne Illnesses

References

1. Weiss KE, Boggs SR. Acute Lyme disease followed by Lyme arthritis in an active duty soldier. Mil Med. 2019.
2. Melanson SE, et al. Persistent symptoms in a soldier after standard treatment for Lyme disease. Mil Med. 2022.
3. Sammito S, et al. Risk of tick bites during basic military training in Northern Germany. Int J Environ Res Public Health. 2019.
4. Psevdos G, et al. Lyme disease and associated coinfections in veterans at a medical center in New York. Int J Infect Dis. 2019.
5. Schubert C, Melanson SE. Lyme disease exposure in military personnel and dependents at West Point. Mil Med. 2019.
6. Soloria JD, Adams WV. Lyme arthritis in a military dependent with international travel history. Mil Med. 2019.