Military Lyme

Welcome to another selection from my book “An Expert’s Guide on Navigating Lyme disease.” The book highlights the findings of my first 600 Lyme disease Science blogs.  In this episode, I will discuss Lyme disease and its impact on members of the military.

Few papers address the issues of Lyme disease for members of the military and their family. This is an area that merits greater exploration.

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.