Signs of Lyme disease, how to get tested and why you need to watch out for ticks this summer

Summer is here and it’s time to head out into the great outdoors. But as we venture into green spaces, it’s more important than ever to be aware of the causes, symptoms and consequences of Lyme disease. Lyme disease is an infection caused by a type of bacteria carried by certain species of ticks, which we are more likely to be exposed to outdoors.

And while health advisers say ticks and the risk they pose shouldn’t stop people from enjoying the outdoors, there are things everyone can do to avoid being bitten and reduce the risk of ticks. risk of infection.

This is what Lyme disease is, how it is treated and how we can prevent it, according to experts from the UK Health Security Agency (UKHSA).

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What is Lyme disease?

Lyme disease is an infection that can be transmitted to people bitten by an infected tick. People are more likely to encounter ticks when doing activities in the countryside or in other green spaces such as woods, some parks or urban gardens.

Ticks are small spider-like creatures that feed on the blood of birds and mammals, including humans. They vary in size, usually between 1mm and 1cm long and they have six or eight legs.

They can be found wherever there is wildlife, usually in woodland and heathland, common variations being sheep and deer ticks. They do not fly or jump, but climb on animals or humans when they come close to them.

Ticks are most active in the spring and summer when the weather warms up, but can be found year-round. It is estimated that around 3,000 cases of Lyme disease are diagnosed each year in England.



A nymph sheep tick

In the UK, Lyme disease is a rare infection and can be successfully treated with a full course of antibiotics. This is the case for most people who get Lyme disease, but if left untreated, the infection can spread to the nervous system and other areas of the skin, joints or, in in rare cases, to the heart. If the nervous system or heart is affected, injected antibiotics may be offered.

A very small number of people treated for early Lyme disease may 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 is recommended that you speak to your doctor if symptoms return or do not improve.

There is no reliable evidence that Lyme disease can be transmitted by other bites (eg mosquitoes, flies, fleas, spiders or lice) and it cannot be transmitted from a person to another through touching, kissing or sexual activity with a person with dementia. infection.



A deer tick

What are the signs of Lyme disease?

It is very important to watch for Lyme disease symptoms and check for ticks after visiting green spaces where they may be present. Prompt removal of ticks can reduce your risk of contracting Lyme disease.

Tick ​​bites are usually not painful and sometimes only cause a red lump to form where you were bitten. However, in some cases, they can cause:

  • swelling
  • itching
  • blisters
  • bruises

Early recognition of symptoms can ensure that if you do develop the disease, you can receive the earliest diagnosis and treatment from your GP. If you are bitten by an infected tick, your symptoms will usually develop one to four weeks after being bitten, however, they can appear anytime between three and 30 days after exposure.

Symptoms include a spreading, circular red rash that may appear as a rash like the image below, as well as non-specific flu-like symptoms. Although many people associate the disease with the rash, a third of people do not report having seen it.

Other signs to look out for include muscle or nerve pain or a drooping facial appearance when the nerves to the muscles around the upper face are affected. If you have developed symptoms after being bitten by a tick or spending time outdoors, contact your GP immediately or call NHS 111, mentioning where you have been and if you remember being bitten.



A deer tick can transmit the pathogen that causes diseases such as babesiosis and Lyme disease

Are cases of Lyme disease increasing?

Studies in Europe estimate that one to five percent of tick bites can lead to Lyme disease, according to the UKHSA. On average, between 2.5 and 5.1% of ticks are infected in England and Wales, although this range can fluctuate between regions and years.

Since data collection began in 2005, there has been a general trend of increasing Lyme disease cases, although year-to-year fluctuations have been observed. In 2021, there were a total of 1,156 laboratory-confirmed cases of Lyme disease in England and Wales.

The increase 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 tick encounters due to changes in wildlife populations and habitat modification that may have led to changes in tick distribution across the country.



American dog tick

What is “chronic Lyme disease”?

There is no agreed-upon 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 nonspecific symptoms, including chronic fatigue and unexplained neurological symptoms, even when there is no evidence of past or current Lyme disease infection.

The nonspecific symptoms overlap with those of several other conditions, including fibromyalgia and chronic fatigue syndrome, which can be triggered by common infections such as glandular fever virus and, more recently, COVID-19.

Should I get tested by the NHS or a private lab? Is there a difference?

If patients have recent exposure to ticks but no rash, the advice to NHS doctors in England is to take a blood sample and send it to an NHS or UKHSA laboratory for analysis. The tests work by looking for antibodies that someone infected with Lyme disease would produce.

Antibodies take some time to reach detectable levels. Therefore, tests performed during 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 advises people to exercise caution with private testing and seek advice from their NHS doctor before spending money on private testing or treatment, as some private laboratories and clinics offer testing and treatments for Lyme disease that may not be supported by scientific evidence.

Diagnostic tests carried out outside the NHS can also produce false positives when the test is positive for Lyme disease when the patient does not actually have it.

How can I prevent Lyme disease?

When walking in green spaces, consider wearing clothes that cover your skin to prevent ticks from accessing a suitable place to bite, health experts say. Use an insect repellent such as DEET and consider wearing light-colored clothing so you can easily spot ticks and brush them off.

After spending time outdoors, check yourself, your clothes, your pets, and others for ticks. Remove any attached ticks as soon as you find them 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 are showing symptoms, contact your GP and agree to the treatment offered to you, the UKHSA says.

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