Lyme disease incidence in the United States, 2016-2023

Traditional surveillance underestimates Lyme disease (LD) incidence in the United States (US). We aimed to estimate national LD incidence using validated algorithms to identify LD cases in administrative claims data. We identified potential LD cases in commercial and Medicare claims, classified cases by disease stage, adjusted case counts using algorithm-specific positive predictive values, and standardized the adjusted counts to the US population.

The study population included >66 million individuals per year. After adjustment and standardization, we estimated 191.7, 26.8, and 16.6 new cases per 100,000 population in high-incidence, neighboring, and low-incidence states, respectively, with 24% of cases diagnosed with disseminated disease. The relative burden of disseminated LD was highest in low-incidence states (28.6%) and increased with age.

This study corroborates published estimates of national LD incidence and elucidates patterns of disease stage at diagnosis. The substantial burden of disseminated LD underscores the need for earlier detection and treatment of LD.