Lyme Disease
Information taken from the LDA (Lyme Disease Action)
website
1. What is Lyme disease?
Lyme disease, also known as Lyme borreliosis, is an infectious
disease caused by the bacterium Borrelia burgdorferi. Early
symptoms can develop within weeks. They may include tiredness,
chills, fever, headache, muscle and/or joint pain, swollen lymph
glands and blurred vision. A characteristic skin rash called
erythema migrans may appear. It is generally a circular rash that
may clear in the centre, resulting in a "Bull's eye" appearance. It
can expand and move around the body.
If early symptoms are not recognised, serious complications can
develop weeks, months, or even years later. Later stage symptoms
include arthritis in the large joints, which can recur over many
years. Nervous system problems are common, e.g. numbness,
meningitis (with fever, stiff neck and severe headache), Bell’s
palsy (paralysis of the facial muscles) and memory problems. Some
people experience irregularities of the heart rhythm.
Lyme disease should be diagnosed by a physical examination and
medical history. Laboratory testing may in some cases support this
clinical diagnosis. Diagnosis based on tests alone is not reliable
– a negative result does not mean that the disease is not present.
Symptoms can mimic those of other diseases. Diagnosis is easiest
when there is a skin rash but this occurs in under 50% of
patients.
2. How does Lyme disease infection occur?
In nearly all cases it is transmitted to humans by the bite of a
tick infected with these bacteria. In a population of ticks, only
some will carry the infection.
3. What are the symptoms of Lyme disease?
Lyme disease can affect any part of the body and cause many
different symptoms. The commonest symptoms relate to the person
feeling unwell, having flu-like symptoms, extreme tiredness, muscle
pain, muscle weakness, and joint pain, upset digestive system,
headache, disturbances of the central nervous system and a poor
sleep pattern. In some cases a characteristically shaped, expanding
‘bull’s eye’ rash appears on the skin. However, a rash in any form
is not a universal symptom. If the rash does occur, it is termed
Erythema migrans or EM rash. It may manifest in a chronic form and
be known as Erythema chronicum migrans or ECM rash. The list of
symptoms known to be associated with Lyme disease is long and
diverse. The symptom pattern varies from person to person.
4. How prevalent is Lyme disease in the UK?
The number of cases confirmed by blood testing has risen from
292 in 2003 to 768 in 2006. The Health Protection Agency (HPA)
acknowledges that confirmed cases do not necessarily reflect all
the cases of the disease. HPA official estimates suggest there
could be up to 3,000 new cases occurring in the UK every year. The
true number of cases is not known, and may be higher still. Since
full recovery may not take place in many cases, the total number of
people affected is accumulating.
5. Who gets Lyme disease and Why?
In the United Kingdom, Lyme disease is carried by the sheep
tick, Ixodes ricinus. This tick can also feed on deer and other
wild mammals and birds. The tick prefers to live in woods, heath
and moorland, although it does not occur exclusively in these
habitats. People who live in the parts of the country where the
tick is prevalent are likely to be at greater risk. Anyone can get
Lyme disease if a tick that is carrying the infection has bitten
him or her.
6. What is the treatment for Lyme disease?
The outlook varies from person to person. Whilst it is extremely
unusual for the illness to be fatal, symptoms can range from mild
to very severe. It is not in a patient’s best interests for the
disease to remain untreated. Treatment is with antibiotics and is
most effective if started as early as possible in the disease. If
treatment is delayed there is less chance of a full recovery.
7. Do other diseases accompany Lyme disease?
Several other infections can sometimes be found in tick
secretions. If these are also passed into the bloodstream, they too
may establish and complicate the symptoms and outlook.
8. Will my doctor treat me for Lyme disease?
If you have this diagnosis your doctor should treat you.
However, many doctors are not familiar with treating Lyme patients.
In this case, you may do better to see a doctor who is familiar
with the disease. Response to treatment varies from patient to
patient.
9. Can Lyme disease be prevented?
There are many measures you can take to protect yourself from
ever falling victim to this nasty infection. There is however, no
vaccine available at present. Prevention relies on people being
aware of the risk that ticks present and using sensible measures to
avoid being bitten. These measures include wearing suitable
clothing and frequently checking the skin for ticks. It is also
essential to know how to remove a tick properly if it is still
present and to go promptly for medical advice if you notice any
symptoms. Lyme disease Action publishes a leaflet about tick
removal.
Ticks
10.What are ticks and what do they look like?
Ticks are small, blood sucking arthropods related to spiders,
mites and scorpions. There are many different species of tick
living in Britain, each preferring to feed on the blood of
different animal hosts. If given the opportunity some of them will
feed on human blood too.
There are four stages of the life-cycle: egg, larva, nymph, and
adult.
To the naked eye the larvae look like specks of soot, while
nymphs are slightly larger, pinhead or poppy seed size. With their
eight legs, nymph and adult ticks resemble small spiders.
Once a tick has started to feed, its body will become filled
with blood. As the blood sac fills the adult tick generally becomes
lighter in colour and can reach the size of a small pea, generally
grey in colour. Nymph ticks only swell slightly. The tick bite
itself is totally painless and most people will only know they have
been bitten if they become aware of a feeding adult tick attached
to them. However, it is the pinhead size nymph that is the most
likely to bite you.
11.What do ticks eat?
Ticks feed on the blood of just about any bird or mammal and
some reptiles too. They pick up Lyme disease and other infections
from these animals, e.g. mice, voles, squirrels, blackbirds,
pheasants and seabirds, which naturally carry the diseases. Ticks
carry more diseases than any other invertebrate host. If an
infected tick subsequently bites you, it may transfer one or more
of the diseases into your bloodstream.
A tick can be born with the disease that its infected mother
tick carries. So, all three feeding stages of the life cycle,
larva, nymph and adult, are capable of transmitting disease.
12.When are ticks active?
Cold temperatures reduce tick activity, so ticks are most active
from April to October. During warm winters & in certain areas
of Britain, ticks 'quest' for blood throughout the whole year.
Ticks may survive for more than a year without food & their
bodies can remain in a dormant state for long periods. Because
their bodies dry out easily, lack of moisture can be fatal to them
at these times, e.g. hot, dry summers & very cold or dry
winters.
13. Where will the tick bite me?
Many people are unaware that they have been bitten because the
ticks are tiny and their bites are usually painless. Ticks can
attach anywhere on your body, so you do need to check all over. For
adults it is particularly important to check armpits, groin, navel,
neck and head. In addition, on children, ticks are also frequently
found on the head at the hairline.
14. What diseases can a tick carry?
Three of the diseases that can be caught from a tick bite in
Britain are, Lyme borreliosis, Babesiosis and Ehrlichiosis.
Globally, the list of diseases is much longer.
15.Tick Removal
Your main aims are to remove all parts of the tick’s body and to
prevent it releasing additional saliva or releasing its stomach
contents into your bite wound.
DO use a proprietary tick removal tool
(available at many vets and pet shops).
These tools will grip the head of the tick.
Alternative Methods to the tick removal tool are pointed
tweezers or cotton thread.
- Tweezers: Grasp the tick as close to the skin
as possible without squeezing the tick’s body, pull the tick out
without twisting – there may be considerable resistance.
- Cotton: If no tools are available, rather than
delay use a cotton thread - Tie a single loop of cotton around the
tick’s mouthparts, as close to the skin as possible, then pull
gently upwards and outwards
DO commence by cleansing the tweezers with
antiseptic. After tick removal, cleanse the bite site and the
tweezers with antiseptic.
DO wash hands thoroughly afterwards.
DO save the tick in a container in case you
develop symptoms later (label with date and location). The Health
Protection Agency are currently running a scheme to investigate
ticks, although they do not routinely test them for infection,
details from the HPA
website.
DO NOT squeeze or twist the body of the tick,
as this may cause the head and body to separate, leaving the head
embedded in your skin.
DO NOT use your fingernails to remove a tick.
Infection can enter via any breaks in your skin, e.g. close to the
fingernail.
DO NOT crush the tick’s body, as this may cause
it to release its infected stomach contents into the bite
wound.
DO NOT try to burn the tick off, apply
petroleum jelly, nail polish or any other chemical. Any of these
methods can cause discomfort to the tick, resulting in
regurgitation, or saliva release.
Information taken from the LDA (Lyme Disease Action)
website www.lymediseaseaction.org.uk
Contact Environmental Health
Email: envhealth@dover.gov.uk
Telephone: 01304 872230
