Enjoy the outdoors but be tick aware

Be tick smart

Much has been written speculating about the effects of tick bites. Ticks can certainly be dangerous, with 3,000 people in the UK being diagnosed with Lyme disease (caused by tick bites) – and the numbers could well be higher, as many cases may be either be undiagnosed or unreported (in the US it is 300,000 diagnosed each year). A recent article in the Independent is a good reminder to review the latest thinking on the topic.

Lyme disease is a bacterial infection primarily transmitted by ticks, typically found in wooded and grassy areas, including urban gardens and parks. Ticks are most active between March and October.

High-risk areas for infected ticks are the south of England and the Scottish Highlands though infection is possible in other areas. Most tick bites don’t transmit Lyme disease and prompt, correct removal of the tick reduces the risk of transmission.

What are the symptoms of Lyme disease?

Lyme disease is caused by a spirochete - a corkscrew-shaped bacterium called Borrelia burgdorferi. Lyme is called “The Great Imitator,” because its symptoms mimic many other diseases. It can affect any organ of the body, including the brain and nervous system, muscles and joints, and the heart.

People may (or may not) get a red rash that:

  • Increases in size and may sometimes have a central clearing
  • Is not usually itchy, hot or painful
  • Usually becomes visible from one to four weeks (but can appear from three days to three months) after a tick bite and lasts for several weeks
  • Is usually at the site of a tick bite.

Other symptoms of early Lyme disease may present as a flu-like illness (fever, chills, sweats, muscle aches, fatigue, nausea and joint pain). Some patients have a rash or Bell’s palsy (facial drooping).

Patients with Lyme disease are frequently misdiagnosed with chronic fatigue syndrome, fibromyalgia, multiple sclerosis, and various psychiatric illnesses, including depression. Misdiagnosis with these other diseases may delay the correct diagnosis and treatment as the underlying infection progresses unchecked.

Check your symptoms via a great resource using the link at the bottom of the page.

Preventing Lyme disease

  • Walk on clearly defined paths to avoid brushing against vegetation
  • Wear light-coloured clothes so ticks can be spotted and brushed off
  • Use insect repellent such as DEET
  • Check for ticks regularly - ticks prefer warm, moist places on your body, such as the groin, waist, arm pits, behind the knee and hair lines, so look out for anything as tiny as a freckle or a speck of dirt. Young children are commonly bitten on the head/scalp so need to be carefully checked around the neck, in and behind the ears and along the hairline. Check yourself, your children and your pets too.

Removing ticks

The safest way to remove ticks is by using a pair of fine-tipped tweezers or a tick removal tool. If you have been bitten:

  • Remove ticks as soon as possible
  • The safest way to remove a tick is to use a pair of fine-tipped tweezers or a tick removal tool
  • Grasp the tick as close to the skin as possible
  • Pull upwards slowly and firmly, as mouthparts left in the skin can cause a local infection
  • Clean the bite area, and monitor it for several weeks for any changes.

Contact your GP or NHS 111 immediately if you begin to feel unwell with flu-like symptoms or develop a circular red rash. Remember to tell them you were bitten by a tick or recently spent time outdoors.

If Lyme disease is not diagnosed and treated early, it may become late-stage or chronic. This may also occur when early treatment is inadequate. Lyme disease may spread to any part of the body and affect any body system. Typically, it affects more than one body system and can cause life-changing problems.

Good resources: https://www.nice.org.uk/guidance/ng95/chapter/Recommendations#management and https://www.lymedisease.org/

See below for a symptom checker.