HEALTH & BEAUTY
Lyme disease Lyme disease is an infection passed to humans by a bite from a tick infected with an organism called Borrelia burgdoferi.
T
icks are tiny, spider-like creatures that live in long grass and woodland in the Southern UK, Scotland and Europe as well as North America. Tick bites only cause Lyme disease if the tick has itself been infected and only a minority of ticks in the UK are infected. Public Health England estimates that there are 2,000–3,000 new confirmed cases of Lyme disease each year in England and Wales, with 15% of cases contracted outside the UK. Tick activity increases in spring and peaks between April and June, reducing over the summer months. However, it can increase again in early autumn, and continues at low levels throughout the winter. Typically, people infected with Lyme disease develop a rash (erythema migrans), usually within four weeks, but sometimes as long as 12 weeks after a tick bite. Not everyone develops this rash (up to 30% do not). The most typical rash resembles a bulls eye on a darts board with a red centre and then a circle of redness around the centre gradually spreading outward. Rashes may also appear on other parts of the body, away from the original bite. If Lyme disease is not treated at this early state, after a few weeks or months, a proportion of people can go on to develop a Stage 2 (‘early disseminated’) condition, with symptoms that vary but can include a chronic form of erythema migrans, carditis heart problems such as myocarditis (inflammation of the heart muscle), pericarditis (inflammation of the heart sac), paralysis of facial nerves, a form of meningitis, or nerve pain. Some people can develop a late form of the disease (Stage 3 or ‘late disseminated’) with pain and swelling in a joint (an arthritis), nerve problems – such as pain or numbness or paralysis of the limbs - or trouble with memory or concentration or a form of meningitis. Some people may go on to get a persistent fatigue called a post infectious or chronic fatigue.
To avoid getting Lyme disease, try to avoid tick bites by: • covering your skin while walking outdoors - tuck trousers into socks • use insect repellent on clothes and skin – products containing DEET are best • stick to paths whenever possible • wear light-coloured clothing so ticks are easier to spot and brush off • Check for ticks after a walk especially in skin creases If you find a tick latched onto the skin you should remove them safely: • Use fine-tipped tweezers or a tick-removal tool. You can buy these from some pharmacies, vets and pet shops. • Grasping the tick as close to the skin as possible, slowly pull upwards, taking care not to squeeze or crush the tick. Dispose of it when you have removed it. • Clean the bite with antiseptic or soap and water. • You do not need to do anything else unless you go on to develop a rash or flu like symptoms and in this case, you should contact your GP telling them that you have had a tick bite. The treatment for Lyme Disease, if it is diagnosed in the early stages, is a course of antibiotics and does not usually need a blood test, although if there is some doubt, your GP may take one to help with diagnosis. Two tests are taken and may need to be repeated if negative in the early stages. Those who develop the later stage symptoms will usually be referred to a consultant for blood tests and diagnosis. n References www.cks.nice.org.uk/lyme-disease www.lymediseaseaction.org.uk www.nhsinform.scot www.nhs.uk/conditions/lyme-disease
Dr Annabelle Mascott is a doctor at Woolwell Medical Centre
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