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Communication

Seasonality of Acute Lyme Disease in Children

by
Kathryn M. Sundheim
1,*,
Michael N. Levas
2,
Fran Balamuth
3,
Amy D. Thompson
4,
Desiree N. Neville
5,
Aris C. Garro
6,
Anupam B. Kharbanda
7,
Michael C. Monuteaux
8 and
Lise E. Nigrovic
8,*,† on behalf of the Pedi Lyme Net
1
Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA
2
Division of Pediatric Emergency Medicine, Medical College of Wisconsin, Wauwatosa, WI 53226, USA
3
Division of Emergency Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
4
Departments of Pediatrics and Emergency Medicine, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA
5
Division of Emergency Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
6
Departments of Pediatrics and Emergency Medicine, Rhode Island Hospital and Brown University, Providence, RI 02903, USA
7
Division of Emergency Medicine, Children’s Minnesota, Minneapolis, MN 55404, USA
8
Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
*
Authors to whom correspondence should be addressed.
†
Collaborators of Pedi Lyme Net are indicated in the Acknowledgment section.
Trop. Med. Infect. Dis. 2021, 6(4), 196; https://doi.org/10.3390/tropicalmed6040196
Submission received: 28 September 2021 / Revised: 29 October 2021 / Accepted: 4 November 2021 / Published: 9 November 2021
(This article belongs to the Section Vector-Borne Diseases)
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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.
Keywords: Lyme disease; seasonality; pediatric; arthritis Lyme disease; seasonality; pediatric; arthritis

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MDPI and ACS Style

Sundheim, K.M.; Levas, M.N.; Balamuth, F.; Thompson, A.D.; Neville, D.N.; Garro, A.C.; Kharbanda, A.B.; Monuteaux, M.C.; Nigrovic, L.E., on behalf of the Pedi Lyme Net. Seasonality of Acute Lyme Disease in Children. Trop. Med. Infect. Dis. 2021, 6, 196. https://doi.org/10.3390/tropicalmed6040196

AMA Style

Sundheim KM, Levas MN, Balamuth F, Thompson AD, Neville DN, Garro AC, Kharbanda AB, Monuteaux MC, Nigrovic LE on behalf of the Pedi Lyme Net. Seasonality of Acute Lyme Disease in Children. Tropical Medicine and Infectious Disease. 2021; 6(4):196. https://doi.org/10.3390/tropicalmed6040196

Chicago/Turabian Style

Sundheim, Kathryn M., Michael N. Levas, Fran Balamuth, Amy D. Thompson, Desiree N. Neville, Aris C. Garro, Anupam B. Kharbanda, Michael C. Monuteaux, and Lise E. Nigrovic on behalf of the Pedi Lyme Net. 2021. "Seasonality of Acute Lyme Disease in Children" Tropical Medicine and Infectious Disease 6, no. 4: 196. https://doi.org/10.3390/tropicalmed6040196

APA Style

Sundheim, K. M., Levas, M. N., Balamuth, F., Thompson, A. D., Neville, D. N., Garro, A. C., Kharbanda, A. B., Monuteaux, M. C., & Nigrovic, L. E., on behalf of the Pedi Lyme Net. (2021). Seasonality of Acute Lyme Disease in Children. Tropical Medicine and Infectious Disease, 6(4), 196. https://doi.org/10.3390/tropicalmed6040196

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