Public surveys have revealed an extremely low level of knowledge about Lyme
disease. Few people have heard of the disease, or were aware that a bite from an infected
tick could cause the disease, or had ever carried out any safety measures against tick
bites. In fact walkers and even people taking a casual stroll in the
countryside are at risk of catching a devastating illness caused by tick bites. Lyme
disease begins innocuously but may lead to severe complications and
if untreated to death in rare cases. It is regarded as a major public health problem in
the Northern temperate zones of the world. In the United States, for instance, the disease
is endemic in a number of states and is spreading with 16000 instances of Lyme disease are
reported. It has become apparent that the disease is widespread
throughout temperate regions of the world. The disease probably affects several
hundred people a year in the United Kingdom. It is caused by a type of bacteria carried by
ticks. The first case was positively identified in England in 1985 but it is probable that
it existed long before that date.
Sheep ticks (Ixodes ricinus), which are common inhabitants
of these moorland areas, are regarded as the main distributors of
the spirochaete in Europe. The very small size of these invertebrates. makes
them difficult to avoid by people working or walking amongst rough moorland vegetation
where the ticks spend the greater part of their life. Sheep ticks are blood suckers and
are indiscriminate feeders. They do not confine themselves to feeding from sheep, but will
attach themselves to any passing animal from, for example, field mice and birds to cattle
or deer, dogs or cats or man.
Ticks are particularly prevalent during mild wet
summers which have been rather typical of the weather patterns in
the United Kingdom in recent years. They are most active between April and October. Once a
tick latches onto your skin it not only sucks the blood from the host but also
regurgitates some stomach contents into the site of the bite. The disease is transmitted
to a humans by a bite from a tick. Ticks attach themselves to humans
if they brush against the habitat of the tick which is typically the tops of bracken,
grasses and shrubs. The tick will often seek obscure areas of the body such as the
groin, armpits or the scalp. At the time of attachment to the body it and can be very
difficult to detect as it may be only two millimetres in size. The numbers of the juvenile
sheep tick have been shown by research to be particularly high in three different types of
moorland vegetation communities - bracken dominated and bilberry dominated communities.
Bracken and bilberry communities are common in many out recreation areas
in the United Kingdom including the Brecon Beacons.
The symptoms of Lyme diseases may include a rash at the actual location of the bite,
followed later by aches and weakness similar to influenza. The disease is sometimes
referred to as "The Great Imitator" because it's early signs and symptoms are similar to other diseases notably
influenza. It can be difficult to diagnose yet early diagnose is important if possible
long term effects are to be avoided. Checking yourself for a tick bite and notifying your
medical practitioner is therefore important.
Tiredness, chills and fever, headache, muscle and joint pain, swollen lymph nodes, and
the skin rash are symptoms that may be found during the early stages of the onset of the
disease. Typically the rash will appear anywhere from between 3 days to one month after a
tick bite -- but some people may never develop a rash. The rash begins as a red spot on
the skin growing to form a day large round lesion that maybe between 1" and 18"
inches in size. It may be ring shaped.
Meningitis like symptoms such as stiff neck, difficulty in concentrating, remembering
and fatigue, can occur later in the disease.
If undiagnosed the disease may progress to arthritis, and neurological problems such as
a meningitis or facial palsies.
If you have any of the above symptoms following a tick
bite or just the symptoms inform your doctor.
People who begin treatment early in the days usually recover completely. However it is
difficult to diagnose and a medical practitioner in a locality such
as an inner city where its instance may not be frequent may not think of Lyme Disease as a
first possibility. It is important that diagnose is made as early as possible after the
onset of the first symptoms. It is also important that the right strength and course
duration of antibiotics is prescribed. If after walking in a risk area (and in particular
if you know you have been bitten by a tick) you develop similar symptoms to those listed
then seek medical advice and mention this information to your practitioner. Lyme disease
can then be considered as a possible diagnosis. A blood test may be able to confirm or
otherwise the diagnosis by detecting the presence of antibodies to the organism in the
bloodstream. Treatment consists of antibiotics given under a doctor's supervision.
Walkers and others taking recreation in the countryside can protect
themselves by a taking the following precautions:
If you have any of the above symptoms following a
tick bite or just the symptoms inform your doctor.
- avoiding close contact with tick habitats when possible;
- when you undress check for ticks - they usually crawl about for several hours before
burying their feeding tube into your skin;
- remove any attached ticks by gently tugging repeatedly with tweezers at the place where
the feeding tube enters the skin (save the tick for future reference by a medical
practitioner). Try to make sure you remove the mouthparts which may be cemented in; DO NOT
apply lighted match or acid etc to tick as this may shock it into regurgitating its
stomach contents (including any possible spirochaetes)!
people who are bitten by infected ticks do not necessarily develop Lyme disease, and
spirochaetes will not normally enter the host's blood stream until the tick has been
feeding for at least 24 hours, therefore it is worth taking preventive measures to reduce
the risk by wearing protective clothing and checking for ticks;
- there is no vaccine against Lyme disease in the U.K. as yet, and clinical diagnosis is
difficult which reinforces the value of adopting preventive measures;
- keeping to the centre of foot paths when walking and avoiding brushing against possible
tick habitats whenever possible;
- spraying deet containing insect repellent on exposed skin (though not on the face and
please seek additional advice about the correct use and suitability for you of the product
- clothes can be treated with permathrin which kills ticks on contact (please take
additional advice on the other correct use and suitability for you of the product chosen);
- long trousers rather than shorts;
- walkers should tuck their trousers into their socks;
- keep shirt sleeves long and buttoned up at the wrist - particularly if walking through
high bracken for example;
- brush off clothing during and at the end of a walking day;
- wear shoes or boots rather than sandals;
- wearing light coloured clothing will help you to spot their presence;
- it is advisable to check for ticks every three or four hours;
- removing the tick after it has bitten you may not prevent infection and this is
particularly so if the tick head is left in place or if removal takes place sometime after
the tick bite, they can be difficult to remove effectively;
- If you have any of the above symptoms following a tick
bite or just the symptoms inform your doctor.
Treatment Preventive Measures
The following sites contain additional information and resources:
American Lyme Disease Foundation,
Inc. an excellent resource for information about research,
treatment, education, and prevention of Lyme Disease.
Healthline Information Resource
information about Lyme Disease for the public and professionals.
Lyme Disease Network of NJ, Inc.
Contains general information about the diagnosis, symptoms, and
treatment of Lyme Disease.
Please note that this article is intended as an introduction
to Lyme Disease and should not be considered a definitive source of advice or information
- more a starting point for understanding and preventing the disease. If in doubt please
seek medical advice. A leaflet on Lyme Disease is available from the Brecon Beacons National Park Mountain Centre.
Association Advice on Lyme Disease