Pop singer Justin Timberlake announced that he has been struggling with Lyme disease, bringing attention to a growing public health threat.
Timberlake, 44, said in an Instagram post Thursday that he was “shocked for sure” by his diagnosis after he had been “battling some health issues” and feeling unwell during his Forget Tomorrow World Tour.
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The singer said confirming the diagnosis at least helped him “understand why I would be onstage and in a massive amount of nerve pain or, just feeling crazy fatigue or sickness.”
Lyme disease, spread by the bacteria Borrelia burgdorferi, is the most common type of tick-borne illness worldwide. U.S. cases have rapidly increased in recent years, mostly in the New England and mid-Atlantic states.
Symptoms usually start within 3 to 30 days of a tick bite, with a rash developing in about 80% of patients. Other early symptoms include fever, headache, tiredness, joint pain, and swollen lymph nodes, making it difficult to distinguish from other illnesses.
However, without rapid antibiotic treatment, symptoms can rapidly progress to muscle weakness and paralysis, irregular heartbeats, arthritis and joint pain, and in rare cases, brain swelling or encephalitis.
Cases on the rise and areas most at risk
Awareness of the rising prevalence of Lyme disease has been growing over the past several years, but the number of cases has been steadily increasing in the United States since the 1990s.
In 1996, the Centers for Disease Control and Prevention recorded just shy of 16,500 cases of Lyme disease in the U.S. By 2023, cases had shot up to nearly 89,500 nationwide.
The CDC classifies states along the Eastern Seaboard, from Maine to Virginia, as high-incidence areas. Michigan, Wisconsin, and Minnesota are also higher-risk states.
In 2023, more than 22,000 individual cases of Lyme disease were identified in New York, followed by more than 16,600 in Pennsylvania and nearly 10,000 in Massachusetts.
Seniors over age 60 are at the highest risk of contracting Lyme disease, followed by children between the ages of 5 and 14.
But it’s not just a U.S. problem; cases are rising across Europe as well. A 2019 study estimated that over 1,000,000 people worldwide are affected by Lyme disease each year, with roughly a quarter of cases occurring in Europe.
Climate change and other factors
While greater awareness of the disease among doctors and the general public has contributed somewhat to the rising number of Lyme disease cases, climate change also plays a significant role because it has created conducive conditions for a rising tick population.
A 2024 report from the Environmental Protection Agency found that rising temperatures in the Northern Hemisphere have given ticks more habitats and improved breeding conditions.
“Warming temperatures associated with climate change are projected to increase the range of suitable tick habitats and are, therefore, one of the multiple factors driving the observed spread of Lyme disease,” the EPA said.
Richard Marconi, a tick-borne disease researcher at Virginia Commonwealth University School of Medicine, told the Washington Examiner that the tick population has been rising for several decades in North America and Europe because winters are getting milder.
“Specifically, if we’re not having truly hard-freeze winters with multiple days of a very hard freeze, the tick population manages to survive pretty well. And as a result, in the spring, when the adult ticks lay eggs, those eggs are able to hatch,” Marconi said.
Marconi said climate change has resulted in trees producing more acorns and nuts, which mice and other small rodents feed on. When there are more rodents, ticks have more hosts, also called reservoirs, to infect and continue spreading the bacteria.
Race for a human Lyme disease vaccine
Marconi, who has been studying Lyme disease since the early 1990s, has been on the front lines of developing a human vaccine for the disease. His laboratory and research led to a veterinary vaccine for Lyme disease used to protect dogs called Vanguard CR Lyme.
There is no currently approved vaccine to treat humans with Lyme disease in the U.S., but Pfizer is in the midst of stage 3 clinical trials, the last stage before a drug can come to market.
The Pfizer product is a four-dose vaccine: three shots in the first year and then a fourth 14 months after the original dose.
The VCU team is working on a competing vaccine that will provide effective immunity without as many booster shots. However, development has been challenging because of the unique microbiology of the Lyme disease-causing bacteria.
Marconi predicted that Pfizer’s Lyme disease vaccine will likely be on the market by 2027, but he said he’s concerned that the vaccine skepticism of Health and Human Services Secretary Robert F. Kennedy Jr. and others in the Trump administration could delay vaccine development.
“Vaccines are the most cost-effective way to deal with infectious diseases,” said Marconi, adding, “It’s really a really unfortunate situation that there is this anti-vaccination movement occurring both in the government as well as in the public.”
Timberlake and other celebrities raise awareness
Timberlake wrote in his Instagram announcement that we need “to be more transparent about my struggles so that they aren’t misinterpreted.”
The pop singer had to make several cancellations or postponements during his tour, each time citing injury or illness. Timberlake postponed a show in New Jersey by one week and canceled two performances in Oklahoma City, Oklahoma, and Columbus, Ohio.
Hosts of other celebrities disclosed Lyme disease diagnoses in recent years, including Ben Stiller, Shania Twain, Justin Bieber, Avril Lavigne, and Amy Schumer.
Marconi said celebrities bringing attention to the disease is good, but the most important thing is to be informed about whether you live in a high-risk area.
“Until vaccination is firmly in place, it’s really important for people to be aware of the risks that are around them,” he said.
How to protect yourself
Once you know if you live in a high-risk area, you can take several steps to prevent tick bites and take action quickly if they occur.
Experts recommend so-called “tick checks,” which involve thoroughly examining your body after spending time outside.
“It’s important that if one gets bitten by a tick, they remove it promptly,” Marconi said. “I also suggest saving the tick because there are many places that will identify the tick for you and tell you whether it’s even the right type of tick that can transmit Lyme disease.”
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The Food and Drug Administration recommends wearing light-colored clothing with long pants and sleeves. The agency also says to “tuck pant legs into socks and shoes, and tuck shirts into pants.”
It is possible to treat clothing and outdoor equipment with insect repellent containing 0.5% permethrin, but cat owners should avoid these products because the chemical is toxic to felines.