Lyme disease may not be a common health condition that you hear about as it is seen quite rarely. But it is important to be aware of it, especially if you visit forests and woody areas. This is because Lyme disease can be transmitted to humans via the bite of a tick, which are found in woodland areas.
The purpose of this article is to help you gain a better understanding of Lyme disease, what causes the disease, the signs and symptoms, and how Lyme disease can be managed and treated.
Lyme disease (or lyme borreliosis) is a bacterial infection which is transmitted to humans by infected ticks.1 Ticks are very small and resemble spider-like creatures. They are around 1mm to 1cm long so they can be very hard to spot. For ticks to stay alive they have to feed on the blood of other animals Because of this, ticks can become infected with a bacterium called Borrelia burgdorferi, which is responsible for causing Lyme disease It is important to know that not all ticks are infected with tis bacterium. It may be difficult to know that you have been bitten by a tick as you won’t feel their bite and you may not experience any itching or swelling at the site of the bite. Ticks can stay attached to a human and feed on their blood for many days.
It is estimated that there are about 2000 to 3000 new cases of Lyme disease each year across England and Wales.2 Ticks are more active during the spring/summer months when it is warmer, but they can still be active during winter months They are usually found in woody areas, forests, or areas with long grass
Causes of lyme disease
Lyme disease is caused by the bacterium Borrelia burgdorferi.1 Ticks usually get infected with this bacterium from other animals, such as deers or mice It is then transmitted to humans by infected ticks when they attach to the skin and feed on blood. The bacterium Borrelia burgdorferi can then enter the bloodstream. Usually, more than 36 hours are required for the bacterium to be transmitted from a tick to a human If the tick is removed quickly enough, the chance of getting Lyme disease reduces.
As ticks are found in forests, woody or shrubby areas, and in long grass, if you find yourself frequently in these areas (i.e if you live, work or hike in or near these areas)then that increases your likelihood of being bitten by a tick and potentially getting Lyme disease.1 One particular risk factor is the time of year. Ticks are more active during the warmer months, so you may have an increased risk of coming across a tick.2
Signs and symptoms of lyme disease
Lyme disease symptoms can appear after a person has been bitten by an infected tick. You may not even notice that you have been bitten by a tick as they are very small and you may not feel any itching from their bite. There are 3 different stages of progression of Lyme disease – early localised, early disseminated, and late disseminated.3 Symptoms can vary from person to person as well as the severity of these symptoms.
- Early localised disease - Early symptoms usually occur 1 to 28 days after the tick bite Many people experience a rash at the site of the tick bite, which is also known as erythema migrans.3 The rash starts as a red circle around the tick bite and then spreads further away from the site of the bite, so it may resemble a bull’s-eye. This rash usually doesn’t itch, burn, or feel painful, but the area may feel warm. During the early localised stage, you may also experience flu like symptoms. These can include a headache, fever, fatigue, muscle aches or pains, and swollen lymph nodes Some people may experience visual problems such as eye redness
- Early disseminated disease - This stage occurs if the disease hasn’t been treated Symptoms appear 3 to 12 weeks after the person becomes infected and they are more severe than the symptoms from the previous stage.3 You may experience fever, headache, dizziness, muscle pain, chest pain, irregular heartbeat, and double vision Some people may struggle with concentration, changes in personality, become more irritable, or develop depression.Very rarely people may experience a reddish small, raised bump or swelling on the earlobe or nipple This is also known as borrelial lymphocytoma3
- Late disseminated disease and can occur months or years after the person becomes infected. Symptoms of this stage occur due to Lyme disease not being treated earlier. Commonly, during this late stage of the disease, lyme arthritis in the joints is seen which is accompanied by swelling, pain, and stiffness. Also, a skin condition known as acrodermatitis chronica atrophicans can present, especially in older women This develops as red or blueish lesions on the back of the hands and feet. Some people can develop meningitis, bell palsy, heart problems, or can have problems affecting their nervous system
If you have any signs, symptoms, or concerns surrounding Lyme disease then it is important to consult with your doctor about this. The earlier Lyme disease is diagnosed, the easier it is to treat the symptoms associated with the disease.
To diagnose Lyme disease, a doctor will ask about your signs, symptoms, and also ask if you may have come into contact with ticks. Blood tests can be carried out to diagnose Lyme disease by checking for positive antibody levels against the bacterium that causes Lyme disease.1
Management and treatment for lyme disease
Once a diagnosis of Lyme disease has been made, your doctor will prescribe a course of antibiotic treatment. Usually, a course lasts up from 10 to 14 days, but in more severe cases it may be necessary to take antibiotics for a 28 day course.1 Commonly doxycycline, amoxicillin, or ceftriaxone are used and they are prescribed as an oral dosage form such as a tablet In some complex cases, where the cardiac and nervous system are involved, it may be necessary to give antibiotics through a vein Symptoms should improve after a course of antibiotics, but this may take some time. In cases where there hasn’t been improvement or symptoms have become worse, then a doctor will refer you to a specialist in hospital.
There are also preventative measures that can be taken to avoid getting bitten by a tick. These measures relate to when you are going to places where ticks are found, such as forests, woody or shrubby areas, and areas with long grass:
- Ear clothes that cover your body and head and tuck your trousers into your socks
- Wearing lighter coloured clothes can help to detect ticks so they can be removed before they have bitten you
- Using insect repellent can reduce the chances of ticks getting onto your clothes
- Stay on clear paths and avoid overgrown areas, as ticks can get on your clothes when brushing past trees or bushes
- After visiting areas where ticks may be found, remember to check your body, any children, and pets to make sure there aren’t any ticks present
- If a tick is found then it is important to remove them correctly. This is done by gently pulling near the mouth or head of the tick using tweezers or a tick removal tool
What are the stages of lyme disease
The 3 different stages of Lyme disease are progressive and are known as early localised, early disseminated, and late disseminated disease. The details of each stage can be found in the signs and symptons section
How is lyme disease diagnosed
A doctor will usually ask about your signs, symptoms, and ask if you may have come into contact with ticks. A blood test will be carried out to diagnose Lyme disease.
Can I prevent lyme disease
To prevent Lyme disease, you need to avoid being bitten by a tick. This means that it is better to stay away from areas such as forest, woody or shrubby areas, and areas with long grass as this is where ticks are found. It is important to remember that not all ticks are infected with the bacterium that causes Lyme disease so don’t panic if you are bitten.
Who are at risks of lyme disease
Ticks are found in forests, woody or shrubby areas, and in long grass so risk factors include going or working in areas where ticks live. Another risk factor is the time of year because ticks are more active during the warmer months.
How common is lyme disease
Lyme disease is rare with around 2000 to 3000 new cases of Lyme disease every year across England and Wales.2
When should I see a doctor
You should see a doctor if you have any signs or symptoms of Lyme disease.
Lyme disease is caused by the bacterium Borrelia burgdorferi. It is transmitted to humans via infected ticks when they attach to the skin and suck blood. Symptoms of Lyme disease vary and become severely worse if the disease is not treated. Usually, during the early Lyme disease stage, people may experience a rash at the site of the tick bite and this may be accompanied by flu like symptoms. The earlier Lyme disease is detected the easier it is to treat and usually a course of antibiotics is prescribed to help with the symptoms. Any concerns to do with Lyme disease should be discussed with your doctor.
- Steere AC, Strle F, Wormser GP, Hu LT, Branda JA, Hovius JWR, et al. Lyme borreliosis. Nat Rev Dis Primers [Internet]. 2016 Dec 15 [cited 2023 Mar 10];2(1):1–19. Available from: https://www.nature.com/articles/nrdp201690
- Lyme disease: How common is it? [Internet]. NICE. [cited 2023 Mar 10]. Available from: https://cks.nice.org.uk/topics/lyme-disease/background-information/prevalence/
- Skar GL, Simonsen KA. Lyme disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2023 Mar 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK431066/