Co-Morbidity of Lyme Disease, Bartonella, and Autism Spectrum Disorder in Children

Rates of Lyme and other tick-borne diseases have been steadily rising with estimates, with the most recent estimates saying 14% of the world’s population. At the same time, the prevalence of Autism spectrum disorder is currently at 3.49% among children and adolescents in the United States. 


These growing health crises are more intertwined than we originally knew. This is why Project Lyme hosted an expert panel to raise awareness about the co-morbidity of Lyme, Bartonella, and Autism Spectrum disorder (ASD) and to educate the public as to how it happens and what to do if it does.

Introducing Co-Morbidity

Patients with Lyme disease and/or Bartonella can share some of the same physical manifestations as those diagnosed with ASD. The central theme in comorbidity is neural inflammation, but there are many other symptoms that are identified in both diagnoses. These include:

  • Delayed development in baby/toddler/child (language, motor, cognitive/learning)*
  • Diminished or low muscle tone
  • Unusual eating and sleeping habits*
  • Unusual mood or emotional reactions (i.e. anxiety, panic attacks, mood swings, irritability, depression, excessive worry)*
  • Obsessive-compulsive disorder, including restrictive or ritualistic behavior*
  • GI issues such as nausea, vomiting, constipation, diarrhea, and abdominal pain*
  • Sensory sensitivity – light, sound, touch
  • Dizziness, poor balance, increased motion sickness
  • Hyperactive, impulsive, and/or inattentive behavior*
  • Epilepsy or seizure disorder*
  • Lack of fear or more fear than expected*
  • Increased pain sensitivity and pain-related anxiety
  • No or delayed speech
  • “Stimming” as a type of tic
  • Self-harm
    * Listed on CDC website for ASD. Children do not typically have all of these symptoms, but rather, clusters of symptoms, particularly involving the neurological system.

It is important to note that transmission of Lyme or Bartonella can occur in multiple ways. For example, your child may get a tick bite. Alternatively, if the mother has a tick-borne infection it is possible to pass it to the child congenitally through the placenta. Either of these ways can ultimately cause developmental issues and your child may end up with a dual diagnosis of a tick-borne infection and ASD.

Identifying in Your Child

It can be hard to identify if your child may have Lyme, Bartonella, or ASD. Your first step is to review the symptom list above. If you are still unsure if your child is experiencing co-morbidity and they are having behavioral and developmental problems, then review the other red flags listed below:

  • If the child’s onset of symptoms occurred older than the typical age for Autism diagnosis (i.e. > age 4) or if they have a cluster of overlapping symptoms, it could suggest that co-morbidity has occurred.
  • If the child’s mother has health issues such as (i.e. chronic pain, fatigue, psychiatric symptoms, autoimmune conditions, food allergies/sensitivities, MS, sleep disorders, migraines, etc.) then it could suggest congenital Lyme which can lead to co-morbidity.

With co-morbidity assumed, it is now critical to begin working with a doctor. The practitioner you see should begin by looking at the case clinically. They will ask many questions to be prepared to discuss the type of symptoms you are witnessing in your child, as well as outline what type of behavior or developmental issues are occurring.

From there, the doctor may begin testing for a range of underlying diseases, such as tick-borne infections, or biomarkers of comorbidity such as inflammation in the brain. Remember, you can always request a test if your doctor hasn’t done one.

Urine PCR tests tend to deliver the best results as they are the most specific, but there are still some issues with testing guidelines and accuracy so clinical suspicion will be the main driving factor behind a diagnosis.

Sharable Facts on Co-Morbidity

  • According to a hypothesis published in Elsevier, chronic infectious diseases, including tick-borne infections such as Borrelia burgdorferi may have direct effects, promote other infections and create a weakened, sensitized, and immunologically vulnerable state during fetal development and infancy leading to increased vulnerability for developing autism spectrum disorders.
  • A 2014 study proposes that some children with an autism spectrum disorder (ASD) in the United States have undiagnosed Lyme disease and that different testing criteria used by commercial laboratories may produce false-negative results. The study evaluated the two-tiered Enzyme Immunoassay (EIA) followed by an IgM and/or IgG Western Blot test. Of the 48 parents surveyed, 94% indicated their child initially tested negative using the two-tiered CDC/IDSA approved test. The parents sought a second physician who diagnosed their child with Lyme disease using the wider range of Western Blot bands.

Other Resources on Lyme, Bartonella, and Autism