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Published on: February 4, 2018
Seasonality of Acute Lyme Disease in Children
Kathryn M Sundheim1, Michael N Levas2, Fran Balamuth3
1Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.
Insights
Pediatric Lyme disease shows seasonal patterns, with most early cases occurring in summer. However, Lyme arthritis in children can appear year-round, requiring ongoing clinical vigilance.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Vector-borne Illnesses
Background:
- Lyme disease exhibits seasonal variations linked to its vector's life cycle.
- Limited research exists on the seasonality of Lyme disease specifically in pediatric populations.
- Understanding pediatric Lyme disease seasonality is crucial for timely diagnosis and management.
Purpose of the Study:
- To investigate the seasonal patterns of pediatric Lyme disease across three U.S. endemic regions.
- To analyze the timing of presentation for different stages of Lyme disease in children.
- To inform clinical practice regarding the year-round suspicion of Lyme disease in pediatric patients.
Main Methods:
- Children presenting to Pedi Lyme Net emergency departments were enrolled.
- Cases were categorized into early, early-disseminated, and late (arthritis) Lyme disease.
- Fourier regression models were used to assess cyclical patterns in disease incidence.
Main Results:
- Early and early-disseminated pediatric Lyme disease cases predominantly presented during summer months.
- A significant proportion of pediatric Lyme arthritis cases were observed throughout the entire year.
- Seasonal trends varied by disease stage in the pediatric population.
Conclusions:
- While early Lyme disease in children is seasonal, Lyme arthritis requires year-round consideration.
- Clinicians should maintain a high index of suspicion for Lyme disease in children presenting with acute arthritis at any time of year.
- This study highlights the need for continuous Lyme disease surveillance and awareness in pediatric care.
Abstract:
Due to the life cycle of its vector, Lyme disease has known seasonal variation. However, investigations focused on children have been limited. Our objective was to evaluate the seasonality of pediatric Lyme disease in three endemic regions in the United States. We enrolled children presenting to one of eight Pedi Lyme Net participating emergency departments. Cases were classified based on presenting symptoms: early (single erythema migrans (EM) lesion), early-disseminated (multiple EM lesions, headache, cranial neuropathy, or carditis), or late (arthritis). We defined a case of Lyme disease by the presence of an EM lesion or a positive two-tier Lyme disease serology. To measure seasonal variability, we estimated Fourier regression models to capture cyclical patterns in Lyme disease incidence. While most children with early or early-disseminated Lyme disease presented during the summer months, children with Lyme arthritis presented throughout the year. Clinicians should consider Lyme disease when evaluating children with acute arthritis throughout the year.
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