What is Lyme disease and why should we be tick aware?

What is Lyme disease?

Lyme disease is a bacterial infection caused by Borrelia burgdorferi, transmitted to humans through the bite of infected black-legged ticks, also known as deer ticks. Named after the town of Lyme, Connecticut, where it was first identified in the 1970s, it is an increasingly significant health concern for many of our patients. If left untreated, the infection can spread to joints, the heart, and the nervous system, leading to serious health problems.

Why is Lyme disease important?

Lyme disease is important to recognise and treat promptly because it can cause significant health issues if allowed to progress. Early treatment with antibiotics is typically effective, but delayed treatment can lead to chronic symptoms that are more challenging to manage. Unfortunately, often it is a difficult diagnosis to make as it presents with so many symptoms that mimic other illnesses.

Is it possible to get Lyme disease in the UK?

Yes.  Although it is uncommon there are around 3000 cases diagnosed each year in England. Ticks that carry Borrelia burgdorferi are found throughout the UK, particularly in grassy and wooded areas. The risk of encountering these ticks is higher in certain regions, such as the South of England and the Scottish Highlands.

How can I avoid getting a tick bite?

If you know you are going to be in an area with a high risk of Lyme disease, the following tips will help avoid being bitten

• Use insect repellent with DEET on skin and permethrin on clothing.
• Wear long sleeves and trousers, tucking trousers into socks when in wooded or grassy areas.
• Perform thorough tick checks on yourself, children, and pets after spending time outdoors.
• Promptly and properly remove any ticks with fine-tipped tweezers.

How do I spot a tick, and should I remove it?

Ticks are small, spider-like creatures that can be as tiny as a poppy seed or as large as a small pea when engorged with blood. They tend to attach to the skin in hidden areas such as the scalp, armpits, and groin. It

is crucial to remove a tick as soon as you notice it. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible and pull upward with steady, even pressure. Avoid twisting or jerking the tick, as this can cause parts to break off and remain in the skin. After removal, clean the bite area and your hands with alcohol or soap and water.

How likely is Lyme disease after a tick bite?

While not every tick bite leads to Lyme disease, the risk increases the longer the tick remains attached. Estimates suggest that 2-3% of tick bites in the UK result in Lyme disease. However, prompt removal of ticks can significantly reduce the risk of transmission. It is thought that the tick must be attached to the skin for 36 to 48 hours to transmit the bacteria. Remember, tick bites are common and not every tick bite needs antibiotics. You should contact your doctor is you develop any of the signs of Lyme disease described below.

What are the symptoms of Lyme disease?

Symptoms of Lyme disease can vary, but common early signs include:

• Rash around the bite known as Erythema migrans (EM) rash: This rash often appears as a bull’s-eye pattern at the site of the tick bite, usually within 3-30 days.
• Flu-like symptoms: Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes.

If left untreated, the infection can progress to cause:

• Additional rashes on other parts of the body.
• Neurological symptoms: Facial palsy, severe headaches, neck stiffness, and peripheral neuropathy.
• Cardiac symptoms: Heart palpitations or an irregular heartbeat.
• Severe joint pain and swelling (arthritis), particularly in the knees.

How do I test for Lyme disease?

Diagnosis is primarily based on symptoms, tick exposure, and physical findings such as the classic bullseye EM rash. Blood tests can be used to detect antibodies against Borrelia burgdorferi:

• Enzyme-linked immunosorbent assay (ELISA): This test detects antibodies and is the initial screening tool.
• Western blot test: Used to confirm positive ELISA results, this test identifies specific proteins of the Borrelia bacteria and is done in a national reference laboratory.

You can order a test to complete at home easily at Explore My Health.

How reliable are the results?

Tests for Lyme disease are generally reliable but not perfect. Antibodies can take a few weeks to develop, so tests might not detect early infections. False negatives can occur if testing is done too soon, while false positives are rare but possible.

Lyme disease is a serious but preventable condition. Awareness and preventive measures, such as avoiding tick bites and promptly removing any ticks found, are crucial. If you develop symptoms after a tick bite, please don’t hesitate to contact us here at Sloane Street Surgery. Early diagnosis and treatment are key to preventing long-term complications.

If you have any concerns about Lyme disease, book an appointment with one of our GPs or your local GP.

Article produced by Sloane Street Surgery, a private GP practice in London that provides world-class private healthcare for patients in Chelsea, Knightsbridge, Belgravia, West London, Hampshire, and beyond.