Tick-borne Lyme disease may be three times higher in the UK than previous estimates, and might top 8,000 cases in 2019 alone, a study suggests.
Higher rates of Lyme disease in neighbouring countries have sparked concerns that current estimates of the annual number of UK cases might be too low.
Lyme disease is a bacterial infection that can be spread to humans by infected ticks – and it’s usually easier to treat if it’s diagnosed early.
In 2018, Public Health England (PHE) said there were 1,641 laboratory-confirmed cases of Lyme disease in England and Wales – and it’s thought there are between 1,000 and 2,000 additional cases of Lyme disease each year that aren’t confirmed by a laboratory.
In the 2018 study, published in the online journal BMJ Open, researchers drew on anonymised medical information submitted by doctors to the nationally representative Clinical Practice Research Datalink (CPRD) between 2001 and 2012. This database covers around 8.4 million people from 658 general practices, equivalent to around 8% of the UK population.
They categorised diagnoses of Lyme disease as those that had been diagnosed clinically (42%), suspected and treated (47%), or considered possible and treated (11%).
One in five of those treated were in their 40s, with similar proportions in their 50s (just over 18%) and 60s (just over 17%). Around half the cases were among women and girls (53%) and half the cases occurred in the summer.
Scotland had the highest number of Lyme disease cases, possibly because of its wetter climate and popularity as a hiking destination, the researchers said. It was closely followed by South Central and South West England – but all regions of the UK were affected.
The annual total number of cases recorded in the CPRD increased from 60 in 2001 to 595 in 2012. The figure for 2012 is around three times higher than previous estimates have suggested, which means if these trends continue, the number of new UK cases could top 8,000 by the end of 2018, researchers said.
This study is observational, but the researchers say the findings point to the need for further preventive measures.
What causes Lyme disease?
Lyme disease is an infection caused by a type of bacteria that is carried by some species of ticks. In Europe, it’s thought 1-5% of tick bites will lead to Lyme.
PHE told HuffPost UK it saw a small increase in laboratory-confirmed cases of Lyme disease in 2018, which follows the trend of the past few years.
It’s believed the rise is due to changes in the distribution of ticks, improved awareness among the public and healthcare professionals, and increased testing.
What are the symptoms?
The main early symptom of Lyme disease is a bull’s eye rash around the tick bite, however not all people will experience this which can make diagnosis tricky.
The rash can appear up to three months after being bitten, states NHS Choices, although many appear within the first month. In most cases, the rash will last for several weeks – during which time you should see a GP.
Other early symptoms of Lyme include aching joints and muscles, headaches, tiredness, and a high temperature. You might feel like you have flu.
Dr Tim Brooks, clinical services director of the Rare and Imported Pathogens Laboratory at Public Health England, told HuffPost UK that cases of Lyme disease with a characteristic bullseye rash will be diagnosed based on the patient’s symptoms, meaning they won’t need laboratory testing.
“So numbers of laboratory-confirmed cases underestimate the total number of new Lyme disease cases each year,” he explained.
[Read More: The Legacy Of A Lyme Disease Diagnosis]
How can you prevent it?
It’s important to be aware of ticks, especially when spending time outdoors. “Greater awareness of the risks may lead to more rapid diagnosis and treatment which is important to prevent long term morbidity,” said researchers.
High-risk areas include grassy and wooded areas in southern England and the Scottish Highlands, with ticks being most active in the spring and summer months.
People are advised to cover bare skin while walking outdoors and avoid dense vegetation, particularly wooded or grassy areas in moist and humid environments. The NHS recommends tucking trousers into socks if you’re entering areas with long grass. Insect repellent can help deter ticks, too – you can use it on your clothes and skin.
Where possible, stick to paths and wear light-coloured clothing so ticks are easier to spot and brush off. Adults should keep an eye out for signs of ticks or tick bites on their pets and children, too.
“Where possible, stick to paths and wear light-coloured clothing so ticks are easier to spot and brush off.”
Ticks can be hard to spot on the body and people may be unaware they’ve been bitten, so PHE recommends carrying out regular tick checks.
If you do spot a tick, use fine-tipped tweezers or a specialist tick-removal tool to grab it as close to the skin as possible. Slowly pull upwards, taking care not to squeeze or crush the tick, and dispose of it when you’ve removed it. Make sure you clean the bite with antiseptic or soap and water afterwards.
The risk of getting ill after being bitten is low, says the NHS. You don’t need to do anything else unless you become unwell. But if that happens, it’s important to see your GP sooner rather than later.
If left untreated, Lyme disease symptoms can progress to numbness of the limbs and temporary paralysis of facial muscles. In rare cases, it can lead to inflammation of the heart muscles, which can cause the heart to beat irregularly.
“When you visit your GP or call NHS 111, remember to tell them where you have been and if you remember being bitten,” advises Dr Brooks.
How is it treated?
Oral antibiotics are the most common treatment used for early-stage Lyme disease. In severe cases, antibiotic injections are sometimes used. The good news is that if Lyme disease is spotted early, treatment can be effective.