Lyme disease

About Lyme disease

Ticks that carry the bacteria responsible for Lyme disease are found throughout the UK, the Republic of Ireland and in other parts of Europe and North America.

If Lyme disease is not treated or treatment is delayed, there's a risk you could develop severe and long-lasting symptoms.

Signs and symptoms of Lyme disease

Early symptoms

Many people with early-stage Lyme disease develop a distinctive circular rash at the site of the tick bite. The rash can appear up to three months after being bitten by a tick and usually lasts for several weeks. Most rashes appear within the first four weeks.

About the rash:

• often described as looking like a bull's-eye on a dart board
• the affected area of skin will be red and the edges may feel slightly raised
• size of the rash can vary significantly and it may expand over several days or weeks
• typically it's around 15cm (six inches) across, but it can be much larger or smaller than this
• some people may develop several rashes in different parts of their body
• around one in three people with Lyme disease won't develop this rash

Not everyone with Lyme disease gets the rash. Some people also have flu-like symptoms in the early stages, such as:

• tiredness (fatigue)
• muscle pain
• joint pain
• headaches
• a high temperature (fever)
• chills
• neck stiffness

Later symptoms

More serious symptoms may develop several weeks, months or even years later if Lyme disease is left untreated or is not treated early on. These can include:

• pain and swelling in the joints (inflammatory arthritis)
• problems affecting the nervous system – such as numbness and pain in your limbs, paralysis of your facial muscles, memory problems and difficulty concentrating
• heart problems – such as inflammation of the heart muscle (myocarditis) or sac surrounding the heart (pericarditis) heart block and heart failure
• inflammation of the membranes surrounding the brain and spinal cord (meningitis) – which can cause a severe headache, a stiff neck and increased sensitivity to light

Some of these problems will get better slowly with treatment. They can persist if treatment is started late.

A few people with Lyme disease go on to develop long-term symptoms similar to those of fibromyalgia or chronic fatigue syndrome. 

When to see your GP

You should see your GP if you develop any of the symptoms above, after being bitten by a tick (or think you may have been bitten).

Make sure you let your GP know if you've spent time in woodland or heath areas. Diagnosing Lyme disease is often difficult as many of the symptoms are similar to other conditions.

A spreading rash some days after a known tick bite should be treated with antibiotics. This is without waiting for the results of a blood test.

Blood tests can be carried out to confirm the diagnosis after a few weeks. These can be negative in the early stages of the infection. You may need to be re-tested if Lyme disease is still suspected after a negative test result.

How you get Lyme disease

If a tick bites an animal carrying the bacteria that cause Lyme disease the tick can also become infected. The tick can then transfer the bacteria to a human by biting them.

About ticks:

• can be found in any areas with deep or overgrown vegetation where they have access to animals to feed on
• common in woodland and heath areas, but can also be found in gardens or parks
• they don't jump or fly, but climb on to your clothes or skin if you brush against something they're on
• they then bite into the skin and start to feed on your blood

Generally, you're more likely to become infected if the tick remains attached to your skin for more than 24 hours.

But ticks are very small and their bites are not painful. You may not realise you have one attached to your skin.

People at risk and where ticks are found

People who spend time in woodland or heath areas in the UK, the Republic of Ireland and other parts of Europe or North America are most at risk of developing Lyme disease.

Most tick bites happen in late spring, early summer and autumn. This is because these are the times of year when most people take part in outdoor activities, such as hiking and camping.

It's thought only a small amount of all ticks carry the bacteria that cause Lyme disease.  Being bitten doesn't mean you'll definitely be infected.

Treating Lyme disease

If you develop symptoms of Lyme disease, you will normally be given a course of antibiotic tablets, capsules or liquid.

Your GP will discuss your treatment with you.

There's currently no clear consensus on the best treatment for post-infectious Lyme disease.

This is because the underlying cause is not yet clear. Be wary of internet sites offering alternative diagnostic tests and treatments that may not be supported by scientific evidence.

Preventing Lyme disease

There is currently no vaccine available to prevent Lyme disease. The best way to prevent the condition is to be aware of the risks when you visit areas where ticks are found and to take sensible precautions.

You can reduce the risk of infection by:

• keeping to footpaths and avoiding long grass when out walking
• wearing suitable clothing in tick-infested areas (a long-sleeved shirt and trousers tucked into your socks)
• wearing light-coloured fabrics that may help you spot a tick on your clothes
• using insect repellent on exposed skin
• inspecting your skin for ticks, particularly at the end of the day, including your head, neck and skin folds (armpits, groin, and waistband) – remove any ticks you find as soon as possible
• checking your children's head and neck areas, including their scalp
• making sure ticks are not brought home on your clothes
• checking that pets do not bring ticks into your home in their fur

How to remove a tick

If you find a tick on your or your child's skin:

• remove it by gently gripping it as close to the skin as possible
• use a pair of tweezers that won't squash the tick (such as fine-tipped tweezers), or use a tick removal tool (available from pet shops or vets)
• pull steadily away from the skin without twisting or crushing the tick
• wash your skin with water and soap afterwards, and apply an antiseptic cream to the skin around the bite
• don't use a lit cigarette end, a match head or substances such as alcohol or petroleum jelly to force the tick out (as this may cause the tick to regurgitate potentially infected material into the skin, which may increase the risk of infection)

Some veterinary surgeries and pet shops sell inexpensive tick removal devices. These may be useful if you often spend time in areas where there are ticks.

• Find out more about Lyme disease on the NHS website

More useful links

• How to use your health services