Lyme disease diagnoses have risen by 60% in rural areas and 19% in urban areas in the United States over the past 5 years and by 357% and 65%, respectively, over the past 15 years, according to data released by FAIR Health.

Lyme disease diagnoses peak nationally in June and July of each year, according to FAIR Health, a nonprofit organization that has been tracking Lyme disease diagnoses since 2007 using its database of over 36 billion privately billed health care claims. During these summer months, rural areas, on average, had a greater share of claim lines associated with Lyme disease diagnoses than urban areas. “From November to April, however, claim lines with Lyme disease diagnoses occurred more often in urban than rural areas,” FAIR Health noted. 

Geographic Distribution of Lyme Disease

Lyme disease, which was first diagnosed in the region of Lyme, Connecticut in 1975, has been moving across the country. In 2017, the states with the greatest proportion of diagnoses were New Jersey, Connecticut, North Carolina, Rhode Island, and Vermont. “Given that Lyme disease has been historically associated with the Northeast and upper Midwest, the status of North Carolina as the state with the third highest percentage of Lyme disease claim lines in 2017 suggested marked expansion to a new region,” noted FAIR Health.

Continue Reading

By 2021, however, North Carolina had dropped from the top 5 list. The top 5 states in 2021 were New Jersey, Vermont, Maine, Rhode Island, and Connecticut. “Maine, which was not previously on the list of top 5 states for Lyme disease claim lines, assumed third place in 2021, suggesting a growing presence of the tick-borne illness in the state,” FAIR Health said. Connecticut dropped from second place to fifth and Vermont emerged as the number 2 state.

Later Diagnoses

Although Lyme disease is treatable with antibiotics, some patients develop long-term additional symptoms such as fatigue, muscle and joint pain, and cognitive issues. These conditions have been linked to post-treatment Lyme disease syndrome, sometimes called chronic Lyme disease.

To identify later diagnoses associated with Lyme disease, FAIR Health examined a statistically significant cohort of individuals in its private insurance claims database from 2017 to 2021 and found a higher prevalence of malaise and fatigue as well as soft-tissue-related diagnoses among patients with Lyme disease than among patients without Lyme disease. “Across all age groups, patients with Lyme disease were generally more likely to have these apparently associated diagnoses than all patients in the cohort,” Health Affairs reported.

“Lyme disease remains a growing public health concern,” said FAIR Health President Robin Gelburd. “FAIR Health will continue to use its repository of claims data to provide actionable and relevant insights to health care stakeholders seeking to better understand the ongoing rise of Lyme disease cases.”

This is the third study FAIR Health has conducted on Lyme disease, the first appearing in an infographic released in 2017 and the second in a white paper published in 2019. 


FAIR Health. Lyme disease: a continuing concern. Infographic. Published August 2, 2022. Accessed August 2, 2022.

Lyme disease diagnoses increased 357 percent in rural areas over past 15 years, according to private insurance claims. News Release. Fair Health. August 2, 2022. Accessed August 2, 2022.

Trends and patterns in Lyme disease: an analysis of private claims data. White Paper. Fair Health. December 2019. Accessed August 2, 2022.