Lyme disease

Ticks are tiny spider-like creatures found throughout the UK and elsewhere, most commonly in grassy and wooded areas. Only a small number of ticks carry the bacteria responsible for Lyme disease so most tick bites are harmless.

Lyme disease has early (stage one) and late (stage two and three) symptoms:

• Stage one – a rash with flu-like symptoms
• Stage two – inflammation throughout the body (such as arthritis) as the bacteria spreads
• Stage three – a range of ongoing problems affecting different systems in the body such as the nerves and joints

There’s estimated to be around 2,000 to 3,000 cases of Lyme disease in England and Wales each year. It isn't passed on between people. You’re more at risk of becoming infected if you work outdoors or visit the countryside often.

It’s usually easier to treat if it’s diagnosed early, using antibiotics.

Stage one

The initial Lyme disease symptom is a circular, red rash (called erythema migrans) at the site of the tick bite, often described as a bullseye rash. This usually appears within four weeks of being bitten. Some people also experience flu-like symptoms such as fever and headaches.

Stage two

If left untreated, the bacteria can spread to other areas of the body, which can cause a range of more serious symptoms. Problems include:

• Joint problems – from mild pain to severe inflammation (arthritis)
• Heart problems – myocarditis (inflammation in the heart), chest pain and palpitations
• Nerve and brain problems – such as facial paralysis (Bell’s palsy), encephalitis or meningitis (inflammation in the brain or surrounding tissues)
• More rashes similar to erythema migrans elsewhere on your body

Stage three – chronic Lyme disease

Ongoing symptoms can occur months to years after infection, often after a period of no symptoms at all. Stage three symptoms include:

• Ongoing arthritis
• Confusion, memory problems and difficulty concentrating
• Neuropathy – numbness, nerve pain or tingling
• Fatigue
• Depression or mood changes

Remember – not all ticks carry the bacteria, so if you’ve been bitten, there’s usually no need to worry unless you have symptoms.

Your GP will usually be able to diagnose early Lyme disease if you have the distinctive rash and flu-like symptoms.

However, not everyone will get the rash and many of the symptoms are associated with other diseases, making Lyme disease difficult to diagnose.

Blood tests can help confirm or rule out Lyme disease, but they’re not always conclusive – especially in the early stages.

Prevention

Avoid tick bites by:

• Staying away from long grass and overgrown vegetation
• Wearing long sleeved shirts and long trousers when outdoors in tick-prone areas
• Inspecting your body for ticks and showering after being in a tick-prone area
• Using tick repellents (such as sprays that contain DEET)
• Regularly checking pets for ticks in their fur

If you’ve been bitten by a tick, it normally takes 24 to 48 hours for a tick to pass on the bacteria. Therefore, you should try to remove it as soon as possible to reduce your risk of infection.

Stage one

Antibiotics will usually clear the infection and prevent the disease from progressing.

Stage two or three

If you have severe symptoms of Lyme disease, then your GP will refer you for strong intravenous antibiotics (injected directly into your blood).

Some people find that their symptoms continue, even after having a second course of antibiotics. It’s unclear why this happens, and there’s currently no cure for ongoing symptoms. Your GP will refer you to a doctor specialising in your symptoms (eg a rheumatologist for joint inflammation or a neurologist for nerve problems). They may also recommend regular check-ups and further investigation into other causes of your symptoms, such as:

• Fibromyalgia
• Chronic fatigue syndrome