'Stay safe' warning after 1,500 confirmed cases of rare disease

People are being urged to take precautions this spring due to a rare disease that can cause severe symptoms.

Lyme disease is an infection caused by a spiral-shaped bacteria called Borrelia burgdorferi. The infection is predominantly spread to humans through the bite of an infected tick.

Ticks have been found across every county of the UK and are mainly found in grassy areas and woodland, but have also been found in urban parks and gardens. It is estimated that up to 10% of ticks in the UK carry Lyme disease.

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The UK Health Security Agency (UKHSA) estimates there are 1,500 laboratory confirmed cases of Lyme disease per year, with an estimated 1000-2000 more cases diagnosed clinically. Research published in 2019 suggests that the real number could be at least three times higher.

If you are bitten it is important to keep an eye out for any symptoms that may develop during the coming days, weeks, or months. Symptoms of Lyme disease may have a delayed onset and can fluctuate.

The most obvious sign of Lyme disease is an erythema migrans (EM) rash, often referred to as a bull’s-eye rash. This is diagnostic of the infection and treatment should be started straight away, without needing to wait for a blood test.

However, around a third of people with Lyme disease don’t develop this rash and its appearance can be atypical. It doesn’t always look like the classic ringed type rash, and can have a solid or bruise-like appearance and look very different on darker skins.

The behaviour of any rash after a tick bite is the most important thing to be aware of. An EM rash takes at least three days, and in some cases up to three months, to appear.

It generally isn’t itchy, painful, or hot, and gradually spreads outwards. Redness or itchiness immediately after a tick bite is usually a histamine reaction.

Not everybody develops an EM rash, so it’s important to look out for other possible symptoms of Lyme disease such as "summer flu", headaches, stiff neck, facial palsy (especially in children), fatigue, joint and muscle pain, and generally feeling very unwell.

Some people with Lyme disease develop more severe symptoms months or years later and this is more likely if treatment is delayed. These more severe symptoms can include joint pain and swelling, nerve problems, memory problems, and heart problems.

Blood tests for Lyme disease are not always reliable, so a clinical diagnosis sometimes needs to be made, based on a combination of medical history, symptoms, and exposure to ticks.

Ahead of Lyme Disease Awareness Month in May, the charity Lyme Disease UK is urging people to be vigilant. As part of its "stay safe" campaign, it advises people to:

• Take effective tick repellent on outdoor trips and a tick removal tool.

• Permethrin-treated outdoor clothing should also be considered for high-risk activities and occupations.

• Avoid walking through long grass and stick to pathways wherever possible.

• Wear light-coloured clothing, as this will make it easier to spot ticks and brush them off.

• Wear long sleeves and tuck trousers into socks.

• Shower and carry out a thorough tick check on yourself, children, and pets when you get home.

• Remember that ticks can be as small as poppy seeds, so careful checking is key. Pay special attention to the hairline and behind the ears of young children.

• Talk to your vet about tick prevention products for pets and check them daily for ticks.

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