Sarah's Health Notes: Lyme Disease Alert
I’m on my annual summer mission to persuade everyone to trouser up for tramps in the long grass whether you’re in country fields or urban parks. I wrote this feature last year but the message is exactly the same again and will be in the years to come. So, as I take off for a few days’ rambling, I’m saying it all over again – and really, really hoping that everyone, every age, takes notice!
Down here in Dorset, we’re surrounded by footpaths by fields where sheep, cattle and horses graze and deer roam, foxes and badgers are rife – even the odd hedgehog, and mice and voles scuttling around in the grass and undergrowth. Yes, it’s rural bliss. It’s also prime hunting ground for ticks, the tiny critters that piggyback on all these beasts.
The problem is that the ticks feed on the blood of their hosts (little vampires!) and about 10% of them ingest the infectious bacteria (Borrelia burgdorferi) that cause Lyme disease, which is virtually always transmitted to people by the bite of an infected tick.
Like many people living in the country, I used to blithely pull off ticks from my horses with bare fingers, squishing them under my nails. Then, some 15 years ago, I started to hear stories about neighbours being diagnosed with Lyme disease and suffering long-term debilitating symptoms. These can be serious enough for sufferers to give up working and may include neurological problems.
Nowadays I wouldn't dream of removing ticks on my horses or a person unless I was wearing gloves and I would always use tweezers or a special tick remover. A clear description of how to remove a tick is here, on the website of the campaigning charity and support group Lyme Disease Action.
Equally, I used to happily go for a tramp ‘off piste’ in shorts or sockless. These days I wear long trousers and long socks (preferably trousers tucked in to socks – not the best look but really worth getting over that) and firmly ‘nudge’ anyone with me to do the same. I have a little shudder when I see neighbours or visitors striding out in shorts. Yes, it’s a good way to tan your legs but it’s also an invitation to ticks. In any case, it’s always worth checking all over when you get back to make sure there are no ticks lurking. Remember they may lurk in clothing too.
It’s not just country dwellers that are at risk of ticks. According to Nice (National Institute for Health and Care Excellence), town gardens and parks, particularly those with eco-friendly long grass, also pose a risk. Find the most recent Nice guideline on Lyme disease here.
Early symptoms of Lyme disease can include headache, fatigue, fever, facial palsy (some degree of paralysis which occurs especially in small children) and, in about two thirds of cases but importantly not all, a signature ‘bull’s eye rash’. If not diagnosed and treated, the disease may spread to affect the whole body including eyes, joints, heart and brain. The precise number affected in the UK is hard to be sure of but Lyme Disease Action estimates that there are ‘perhaps 10,000 cases every year’, a significant number unreported.
Lyme disease is a bacterial infection so if it’s recognised early it can be simply treated with antibiotics, usually a 28-day course. If it’s not treated early, it may be difficult to cure.
Some of the early symptoms overlap with a range of other conditions including flu (and now also Covid-19) so people don't always seek medical help. If they do go to their GP, the doctor may not always recognise potential Lyme disease and several people I know have found it difficult to convince their doctor of the possibility they may have Lyme disease. There are tests but none are reliable, so a negative result may not rule out Lyme disease; even if, as happened to a neighbour, the doctor thinks it does - despite the patient having all the symptoms. Nice states: ‘Do not rule out diagnosis if tests are negative but there is high clinical suspicion of Lyme disease’.
There are now various sources of information for GPs, available via the Royal College of General Practitioners website. This includes an e-learning course on Lyme disease developed by the RCGP in partnership with Lyme Disease Action.