What is Lyme Disease
Lyme disease is a bacteria infection, which can be transmitted via a tick bite or from mother to baby during pregnancy. Ticks can carry other infections such as Anaplasma and Babesia. Ticks are arachnids and can be as small as a poppy seed.
Risk of Lyme Disease
Infected ticks can be found all over the UK. Their typical habitat is woodland, heathland and parkland, but they can also be found in urban parks and even gardens. You can be bitten and infected in any month of the year, however ticks are most active in the milder months. Pets can also be bitten. This can result in them becoming infected and bringing ticks into the home.
Preventing Lyme Disease
- ● Prevention is crucial
- ● Wear insect repellent during outdoor activities and consider treating outdoor clothingwith permethrin
- ● Avoid walking through long grass and stick to pathways
- ● Wear light coloured clothing and brush off any visible ticks
- ● Wear long sleeves and long trousers
- ● If you have to walk in long grass, tuck trousers into socks
- ● Thoroughly check for ticks when you get home, including hidden places such asunder waist bands,
behind ears, hairline and groin
- ● Shower and put all your clothes in the tumble dryer to kill any ticks you may havepicked up
- ● Also use tick prevention on your pets and thoroughly check them for ticks after theyhave been outdoors
Removing A Tick
Never distress a tick once it has bitten you by using oil, your fingers, ’normal’ blunt tweezers etc. If you have not yet removed the tick, take a photo of it whilst embedded and then quickly, but safely, remove using the guidance available here.If you are unable to remove the whole tick safely, seek medical advice immediately, going to A&E if necessary.
Although you were bitten, it doesn’t mean you are definitely infected. Not all ticks are infected and an infection may not have been passed on to you. It is critical to catch any infection early and so now is the time to be very vigilant.
If you wish to get the tick tested, put it dead or alive in a sealed plastic bag and contact Lyme Disease UK for details of private testing laboratories that will send you the test results.
Complete a thorough tick check to ensure you don’t have any other bites elsewhere, remembering that ticks can be as small as a poppy seed and so bites are easy to miss.
Check people and pets who were with you at the same time. Have a shower and put all clothes in the tumble dryer on the highest heat possible or wash your clothes.
Diagnosing Lyme Disease
Draw around the bite with a biro and take another photo. Repeat the photo on a daily basis in case any rash appears (many infected people do not get a rash but some do). Look over the rest of your body each day as the rash can appear away from the bite site. Start keeping a close eye for any symptoms during the coming days/weeks/months, remembering that symptoms may fluctuate. If you do develop any, make a detailed symptom diary. Some early symptoms are listed here and also be on the lookout for changes in mood/behaviour, particularly
in children as these can be the first noticeable symptoms, especially if children are too young to articulate problems.
You may wish to go to your GP to seek their advice and get the bite listed on your medical records. The NHS will not normally provide prophylactic (preventative) treatment following a single tick bite unless there are symptoms and you have a positive test. The NHS only recommends preventative treatment for people who are pregnant or immunosuppressed.
When you go to your doctor it is important to know that at time of writing less than 3% have passed the RCGP course on Lyme disease, so may not know much about it. They may say ticks in your area don’t carry Lyme disease, however Lyme disease is present all over the UK including in some urban parks and gardens. Some advice says that ticks would need to be attached for a certain amount of time to pose a risk of infection. This is not true and a minimum time for attachment has never been proven.
In terms of testing, it can take up to 6 weeks for antibodies to be produced and so any tests before this are likely to be negative even if you are infected. Any course of antibiotics or steroids also increase the chance of a test being falsely negative. On this basis you may wish to request a test at about 6 weeks after the bite, but please remember that we do not yet have a totally reliable test for Lyme disease and a negative test can never discount Lyme disease. You can read more about testing here
Treating Lyme Disease
A bull’s eye rash (EM rash) is diagnostic of Lyme disease. This means a blood test is not necessary and treatment should start immediately. They rash normally appears 2-3 days after the bite, tends to be painless, flat and not itchy. If you don’t know what insect you were bitten by and you/your doctor isn’t sure whether it is an EM rash or an allergic reaction, you could try taking an antihistamine and/or using an antihistamine cream. If it is an allergic reaction you would expect the rash to calm down. If the doctor isn’t sure whether it is Lyme disease or cellulitis both are serious and require immediate treatment. The doctor should prescribe an antibiotic suitable for treating both.
The NHS will normally start with a 2-3 week course of antibiotics. It is important to continue treatment until all symptoms cease. It is critical that you finish the entire course.
Adults are normally prescribed doxycycline and younger children (or pregnant/breast feeding women), amoxicillin. The manufacturers of amoxicillin have guidance in the leaflet as to the appropriate dose.
Note: doxycycline can make you incredibly sensitive to the sun, ensure you stay upright for 60 mins after taking and always take it on a full stomach. You may also want to consider probiotics, ideally taken 2+ hours away from the antibiotic
Even without proof of infection, some ILADS (Lyme specialist) doctors will recommend that patients take a course of antibiotics as a precautionary measure following a bite, regardless of test results and symptoms. With proof of infection they also recommend a longer course and higher dose than the NHS typically give. The benefit of this needs to be weighed up against the risks of the treatment.
Resources
More information can be found
● www.lymediseaseuk.com
● www.enjoythecountryside.com
● www.facebook.com/LymeDiseaseUK ● www.twitter.com/UKLyme ● www.instagram.com/lymediseaseuk
Note from NTA
The US herbalist Stephen Buhner suggests a herbal protocol for acute Lyme disease and homeopathic remedies are available. These might be worth considering as a preventative measure regardless of proof of infection. They could also be considered in addition to antibiotics, if prescribed.
If you are concerned that you may have acute Lyme disease please email our team for information about the herbs and homeopathic remedies that we can supply: [email protected]
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