Master's Project Title:

Pediatric Lyme disease in Minnesota

MCH Student:

Grace McCauley

Date of Defense:

August 31, 2016


Introduction. Incidence of Lyme disease is common in children, but demographic and clinical symptoms by age group have yet to be described using Minnesota data.

Objective. The goals of this study were to describe demographic characteristics of children with Lyme disease from 2010-2014 in Minnesota, identify age trends in manifestations of symptoms, and describe differences by age as well as metropolitan and non-metropolitan residency, between date of onset of symptoms and lab test date.

Methods. A five-year data set (2010-2014) was extracted and reviewed from the Minnesota Electronic Surveillance System (MEDSS) for children with Lyme disease who were ≤17 years old at the time of reporting. The Council of State and Territorial Epidemiologists (CSTE) surveillance case definitions for probable and confirmed cases of Lyme were used by the Minnesota Department of Health for classification of cases prior to extraction. The study used chi-square tests to test for independence of late manifestation Lyme symptoms between age groups and acquire a p-value as well as a Kruskal-Wallis chi-squared test to compare the independent length of time (days) between age groups and children living in metro verses non-metro counties.

Results. The study included 3,222 children with probable and confirmed cases of Lyme. The highest number of confirmed cases (44.8%) were seen in children whose permanent residence were in counties in the Metropolitan region and who were between the ages of 6 and 11 years (43.5%). The distribution of presence of a late manifestation differed by age groups (p-value<0.001). The average time between when symptoms started and when a lab test was done was between 8 and 12 days for all age groups, with the longest average time period of 12.3 days for children age 12-17 years and the shortest at 8.1 days for children 0-5 years (p-value<0.001).

Conclusions. Slight age-related differences were found among the symptoms examined, children between the ages of 12 and 17 should be looked at more closely for late manifestation symptoms, specifically AV heart block, there was no conclusive evidence to warrant changing parent or provider recommendations based on the results of this study.