Lyme Disease: How Great A Threat Is It To Public Health?

How Great A Threat Is Lyme Disease To Public Health?
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It's been described as "under-researched" and a "significant threat to human health". But is Lyme disease really as huge a threat as it's been made out to be?

Over the past few years, there's no disputing Lyme disease has been cropping up more and more in the press.

Celebrities including Bella Hadid and Avril Lavigne have spoken out about suffering from the disease.

Meanwhile figures show that over the past 12 years, cases have quadrupled. In fact more than 1,100 people were diagnosed with Lyme disease in the UK in 2013, according to a NHS laboratory report.

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Lyme disease occurs from being bitten by an infected tick

Lyme disease is a bacterial infection spread to humans by infected ticks which, if not treated early on, can result in heart failure, viral-like meningitis, facial palsy, nerve damage and arthritis.

According to the NHS, Lyme disease can often be treated effectively with a course of antibiotics if it's detected early on.

The main symptom is a distinctive circular rash, which looks like a bull's eye on a dart board, at the site of the tick bite. This usually appears around three to 30 days after being bitten.

According to Public Health England, roughly one third of UK cases do not have a rash and may suffer from a fever, headache or neurological symptoms instead.

"The vast majority of tick bites do not transmit Lyme disease but, if patients are truly concerned, there are serological blood tests that detect antibodies to the infection, which can be arranged through your GP," says Dr Helen Webberley, the dedicated GP for Oxford Online Pharmacy.

"The main problem is that Lyme disease is often not thought about by the medical profession because the symptoms can be very vague," she says. "In fact, in most cases there are no significant symptoms at all."

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Tick bites can cause a distinctive rash

Recently, Phones4U founder and billionaire John Caudwell discovered that he, as well as his ex-wife and three children, had Lyme disease.

With Lyme disease cases soaring, there are now concerns over the number of ticks found in Britain's parks.

Bite protection expert Howard Carter said he found sheep and deer ticks in every London park he visited over the past year. He believes that the issue is the same for other urban parks across the UK.

"The number of ticks is increasing all the time and quite dramatically," Carter told The Sunday Times newspaper.

"People really do need to be aware of the impact these things can have on health. If you are bitten it is not a little itch that goes away after a couple of days, it can be life-changing or even fatal."

To combat the growing threat, Public Health England issued a factsheet on tick bite prevention which advises people to carry out a "tick check" after spending longer periods of time outdoors, and suggests taking simple steps to avoid coming into contact with ticks.

They have also issued advice for how to remove a tick using tweezers.

Stella Huyshe-Shires from Lyme Disease Action says there are other things being done to raise awareness, too.

According to Huyshe-Shires, PHE run awareness programmes on ticks and Lyme disease in conjunction with local councils.

"Research is also being conducted by several universities into how to get a safe message across without deterring people from outdoor exercise," she says. "And the Department of Health also issues awareness notices each year in a nationally circulated GP bulletin."

Husyhe-Shires believes the statement about Lyme disease being "one of the greatest threats to public health" is simply a "headline grabbing statement", which she doesn't agree with.

"If Lyme disease was ever shown to be transmitted person to person, then yes it might be," she says. "But there is no evidence that this is so."

Despite the various resources being deployed to try and tackle the raise in Lyme disease cases, Dr Logan from the London School of Hygiene and Tropical Medicine believes the Government isn't doing enough to prevent the issue.

"The majority of Lyme disease sufferers will say the system didn’t work for them - the diagnosis was too late, they didn’t the get the tests early enough - and for some that means it’s too late and they have been left with a life threatening condition.

"We need a review of the system."

Story continues below...

Facts About Lyme Disease
There Are Two Types Of Ticks With Lyme(01 of11)
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Canada has two kinds of ticks that spread Lyme disease: the western blacklegged tick, which is found in British Columbia, and the blacklegged tick, which is found in other parts of the country. In Canada, Lyme-carrying ticks are most often found in southern British Columbia; southeastern and south-central Manitoba; southern, eastern, and northwestern Ontario; southern Quebec; southern New Brunswick and Grand Manan Island; and parts of Nova Scotia. However, ticks do attach themselves to birds, which means they can be found in areas other than those where Lyme is considered endemic. (credit:pennstatenews/Flickr)
Who Is Most At Risk?(02 of11)
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While anyone can get a tick bite, people who work outdoors or participate in outdoor activities are more likely to be in areas where ticks are found. Take precautions against tick bites while golfing, fishing, hiking, camping, and hunting, Health Canada advises.
Lyme Disease In Canada (03 of11)
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Overall, Lyme disease cases in Canada are increasing: the government reported 128 cases in 2009 and 682 in 2013. But while the incidence of Lyme disease is rising in some parts of the country, it's holding steady in others, says Dr. David Patrick, an infectious disease specialist at the University of British Columbia. “Canada is a whole bunch of different ecosystems,” hes says, which means there are many different environments for ticks. More Lyme is being seen in southern Nova Scotia and southern Ontario, he say, up to 50 per cent of ticks on the Niagara peninsula. By contrast, Lyme is only found in 1 in 200 ticks in British Columbia where this level has remained constant for some time.
Know Your Local Risk(04 of11)
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Because risk can vary so greatly across the country, it’s important to know what it’s like where you live, Patrick says. The Canadian government works with experts and public health organizations across the country to track tick populations and Lyme disease incidence.
Everyone Should Be Aware(05 of11)
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But everyone should be aware: “It doesn’t matter where you live,” Patrick says. “People should know about tick prevention.” While Lyme disease is the most common disease spread by ticks, others are a concern as well. And even if you live in an area with low incidence of Lyme disease, that doesn’t mean the individual tick that bit you doesn't have Lyme.
Preventing Lyme Disease(06 of11)
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If you are hiking in the woods or in an area known to have ticks, stick to the middle of the trail, Patrick advises. Wear long pants and a long-sleeved shirt, and consider using an insect repellent with DEET, he says. Afterwards, have someone help you do an allover tick check — the bites are painless, so you may have been bitten without realizing it.
Symptoms To Watch Out For(07 of11)
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If you’ve been bitten by a tick, watch for the symptoms of Lyme disease over the coming days or weeks. You may see a mark where you were bitten — many people say it has a bulls eye shape, round with a clearing in the centre. Patrick points out that the clearing may not be obvious. “If you have a rash after a tick bite, you want to see a doctor,” he says. Some people also experience fever, chills, tiredness, swollen lymph nodes, or fatigue after a tick bite. And if things progress, you could have more serious symptoms like sore joints, arthritis, heart rhythm issues, and nervous system issues. It’s uncommon, but Lyme disease can be fatal if left untreated.
How To Remove A Tick(08 of11)
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Blacklegged ticks can range in size from that of a poppyseed to a pea. If you do find a tick embedded under your skin, it’s important to remove it quickly and completely. With a pair of tweezers, grab the tick under the body, where the mouth connects to the skin, and pull it out steadily (get someone else to help if it’s too hard to reach by yourself). “What you’re trying to do is not leave the mouth parts behind,” Patrick says. Once the tick is removed, wash or disinfect the area.
Get The Tick Tested(09 of11)
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In most parts of the country you can get the tick tested for Lyme disease, Patrick notes. If you remove a tick, try to save it in a plastic bag or pill bottle and record the date and location of the bite. Ticks can be submitted to the National Microbiology Lab, which tests them to determine where in the country blacklegged ticks are being found and what the risk levels are.
Watch Out For Pets(10 of11)
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Pets can get Lyme disease — dogs are particularly at risk. However, animals like dogs cannot spread Lyme to humans, Health Canada says. However, pets can carry infected ticks into your home or yard, so check your animals, particularly if they’ve been in wooded or overgrown areas. (credit:shutterstock)
How To Treat Yourself(11 of11)
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Lyme disease is often treated with a two to four weeks of antibiotics, though some people require a longer course of treatment. “The recommended courses of antibiotics do a very good job of eliminating the organism,” Patrick says. However, for some people, symptoms can persist for six months or longer after treatment. Always speak to your doctor if you are concerned.

But Husyhe-Shires says the problem of Lyme disease is actually more complex than that.

"Firstly, ticks carrying Lyme disease are everywhere in the UK," she says. "It is a relatively new disease in the UK and public and health professionals are insufficiently aware of it."

"Secondly, doctors are unaware that there are genuine uncertainties in diagnosis and in treatment and often fail to diagnose and treat appropriately," she adds.

"This especially applies to consultants who have a fixed view that Lyme disease can be diagnosed definitively by the blood tests and is treatable with a couple of weeks of antibiotics."

Finally, she says that the people reading incorrect information online and seeking advice abroad adds fuel to the fire and creates a bigger problem.

She says members of the public read about the many symptoms of Lyme disease and think it "might apply to them".

"They then seek a positive test result from unaccredited laboratories overseas," she explains. "This fuels the fire and doctors back off further thinking, 'patients read incorrect information on the internet'.

"Because some people genuinely do go undiagnosed and untreated, patients are always able to point to this to show that their view of a massive problem is correct.

"There really is a lot of incorrect information bandied around online and in the press, doctors are always able to point to this to show that the problem is massively overstated."

She adds: "Everyone becomes polarised and no one will meet in the middle ground, where the science is, and try to genuinely address the real problems."