As the warmer months roll around the chances of being bitten by a tick increases.
With that in mind, it's more important than ever to be aware of the causes, symptoms and consequences of Lyme disease - an incurable disease caused by tick bites.
The UK Health Security Agency says Lyme disease is a bacterial infection that can be passed onto humans when they are bitten by an infected tick. People are most likely to encounter them when doing things in the countryside or in green spaces like woodland, some urban parks or gardens.
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Ticks are most active in spring and summer but can be found all year round, with 3000 estimated cases of Lyme disease diagnosed in England every year. This is what Lyme disease is, how it is treated and how we can avoid it, according to UK Health Security Agency (UKHSA) experts, as reported by Manchester Evening News.
What is Lyme disease?
Lyme disease is an infection that can be passed to people when they are bitten by an infected tick. People are most likely to encounter ticks when doing activities in the countryside or other green spaces such as woodland, some urban parks or gardens.
Ticks are small, spider-like creatures which feed on the blood of birds and mammals, including humans. They vary in size, usually between 1mm to 1cm long and they have either six or eight legs.
They can be found anywhere there is wildlife, usually in woodland and moorland areas, with common variations being the sheep and deer ticks. They do not fly or jump but climb on to animals or humans as they brush past.
Ticks are most active in the spring and summer months when the weather warms up but can be found all year round. There are estimated to be around 3000 cases of Lyme disease diagnosed in England each year.
In the UK, Lyme disease is an uncommon infection and can be successfully treated with a full course of antibiotics. This is the case for most people who contract Lyme disease, but, if left untreated, the infection can spread to the nervous system and other areas of the skin, joints or, in rare cases, to the heart. If the nervous system or heart is affected, then injected antibiotics may be offered.
A very small number of people treated for early Lyme disease can develop more severe symptoms months or years later, however, this is usually if the treatment they receive is delayed or not completed. If you are exposed to Lyme disease, it’s recommended that you speak to your doctor if symptoms return or don’t improve.
There is no reliable evidence that Lyme disease can be transmitted by any other bites (for example from mosquitoes, flies, fleas, spiders, or lice) and it cannot be transmitted from person to person by touching, kissing or sexual activity with someone with the infection.
What are the signs of Lyme disease?
Looking out for symptoms of Lyme disease, and checking yourself for ticks after you go to green spaces where they may be present is very important. Prompt tick removal can reduce your chances of acquiring Lyme disease.
Tick bites aren't usually painful and sometimes only cause a red lump to develop where you were bitten. However, in some cases they may cause:
- swelling
- itchiness
- blistering
- bruising
Rapidly recognising symptoms can ensure that if you are developing the disease you can receive the earliest diagnosis and treatment from your GP. If you are bitten by an infected tick your symptoms will typically develop one to four weeks after being bitten, however, they can appear anytime between three to 30 days after exposure.
Symptoms include a spreading circular red rash, which may appear as a bulls-eye rash like the image below, as well as non-specific flu-like symptoms. Although a lot of people associate the disease with the rash, one-third of people don’t report seeing one.
Other signs to look out for include muscle or nerve pains or a drooping facial appearance when the nerves to the muscles around the upper part of the face are affected. If you have developed symptoms after being bitten by a tick or spending time outdoors, immediately contact your GP or call NHS 111, mentioning where you have been and if you remember being bitten.
Are cases of Lyme disease increasing?
Studies in Europe estimate that one to five per cent of tick bites can lead to Lyme disease, says the UKHSA. On average, between 2.5–5.1 per cent of ticks are infected in England and Wales, although this range can fluctuate in different areas and across years.
Since data collection began in 2005, there has been a general trend of increasing cases of Lyme disease, although yearly fluctuations have been observed. In 2021, there were a total of 1,156 laboratory-confirmed cases of Lyme disease in England and Wales.
The rise in total cases may be due to a combination of increased awareness of Lyme disease as well as improved surveillance, better access to diagnostics, increased potential for encounters with ticks due to changes in wildlife populations and habitat modification that may have resulted in changes in tick distribution across the country.
What is ‘chronic Lyme disease'?
There is no agreed definition of the term ‘chronic Lyme disease’ among doctors so it can mean different things to different people. Some people use the term chronic Lyme disease to describe a range of non-specific symptoms including chronic tiredness and unexplained neurological symptoms, even when there is no evidence of past or current Lyme disease infection.
The non-specific symptoms overlap with those of several other conditions including fibromyalgia and chronic fatigue syndrome, which can be triggered by common infections such as the glandular fever virus, and more recently COVID-19.
Should I get tested by the NHS or a privately funded laboratory? Is there a difference?
If patients have a recent tick exposure but no bull’s eye rash, guidance to NHS doctors in England is to take a blood sample and send it for testing at an NHS or UKHSA laboratory. The tests work by looking for antibodies that a person infected with Lyme disease would produce.
The antibodies take some time to reach levels that can be detected, therefore, tests carried out within the first four weeks of infection may be negative and may need to be repeated on a fresh blood sample taken four to six weeks after the first test.
The UKHSA recommends that people exercise caution with private tests and speak to their NHS doctor for advice before spending money on private tests or treatments, as some private laboratories and clinics offer tests and treatments for Lyme disease which may not be supported by scientific evidence.
Diagnostic tests done outside the NHS may also produce false positives where the test shows positive for Lyme disease when the patient does not actually have it.
How can I prevent Lyme disease?
While walking in green spaces, consider wearing clothing that covers your skin to make it more difficult for ticks to access a suitable place to bite, say health experts. Use insect repellent such as DEET and consider wearing light coloured clothing so that you can easily spot ticks and brush them off.
After spending time outside, check yourself, your clothing, your pets and others for ticks. Remove any attached tick as soon as you find it using a tick-removal tool or fine-tipped tweezers.
More information can be found on the NHS website. If you think you have been bitten by a tick and have symptoms, contact your GP and accept the treatment that is offered to you, says the UKHSA.
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