Look Out For Lyme

Overview

Lyme disease (also called Lyme borreliosis) is an infection caused by bacteria that can be passed to people through the bite of an infected tick. Ticks are tiny, spider-like creatures that live in long grass, woodland, moorland and some parks. They attach to the skin and feed on blood. If an infected tick stays attached long enough, the bacteria can get into your body. Lyme disease can be treated, and most people make a full recovery, especially when it is picked up early.

It is not common, but cases are rising. In the UK a few thousand cases are estimated each year, with higher numbers in parts of Scotland, southern England and some heathland and woodland areas. It is also found across Europe, North America and parts of Asia.

Anyone can get Lyme disease, at any age. It is more likely in people who spend a lot of time outdoors — walkers, campers, gardeners, farmers, forestry and conservation workers, and children who play in long grass. Pets can carry ticks into the home, so pet owners are also at slightly higher risk.

Symptoms

Common symptoms

• A rash that slowly grows bigger over several days. It may be round or oval, and sometimes looks like a bull's-eye target. It usually appears 1 to 4 weeks after the bite and is often not sore or itchy.
• Flu-like feelings: high temperature, chills, headache, tiredness, aching muscles and joints.
• Feeling unusually drained, sometimes for weeks.
• A stiff or aching neck.
• Swollen or painful joints, often the knees, which can appear later on.
• Tingling, numbness or nerve pain in the face, arms or legs (less common).
• A drooping side of the face (facial palsy). This needs to be checked by a doctor.

Symptoms in children

• The rash can be easy to miss. Check the scalp, hairline, behind the ears, armpits, groin and nappy area.
• Young children may be irritable, sleepy, off their food, or complain of headaches and tummy aches rather than saying they feel unwell.
• A drooping face, a swollen joint or a bad headache should be checked the same day.
• Children often do not remember being bitten, so tell your doctor if they have been playing outdoors in grassy or wooded areas.

Symptoms in older adults

• Tiredness, aching joints and feeling generally unwell can be mistaken for ageing or another long-term condition.
• Symptoms can be less typical, and a rash may be harder to spot if skin is difficult to see or check.
• Confusion, falls or a high temperature together need prompt medical advice.
• Mention any recent gardening, walking, travel or time in the countryside — it helps your doctor piece things together.

Causes

Main causes

• A bite from a tick that carries Borrelia bacteria.
• The tick usually needs to stay attached for many hours, often 24 hours or more, before the bacteria can pass into your body. Removing ticks quickly greatly lowers the risk.
• Not all ticks carry the bacteria, and many bites cause no infection at all.
• It is not spread between people, and you cannot catch it from pets or farm animals — though animals can bring ticks into your home.

Risk factors

• Walking, camping or working in long grass, woodland, heathland or moorland.
• Living in, or travelling to, areas where infected ticks are known to live.
• Gardening, farming, forestry, conservation work, hiking and mountain biking.
• Wearing shorts and short sleeves without any tick repellent.
• Having a pet that brings ticks indoors.
• Not checking your skin after being outdoors, or not removing ticks promptly.

When to see a doctor

See a doctor urgently if:

• You have a spreading round or oval rash.
• You feel fluey, achey or exhausted after a tick bite or after time in a risk area.
• Part of your face is drooping, or you have new numbness or nerve pain.
• A joint is hot, swollen and painful.
• You are getting worse rather than better, or new symptoms are appearing.

Book a routine appointment if:

• You found a tick and are not sure it came off completely, or the skin around the bite looks red and infected.
• You have ongoing tiredness, aches or trouble concentrating weeks or months after a possible tick bite.
• You want advice before travelling to an area where ticks are common.
• You have questions about whether testing is needed.

Diagnosis

Your doctor will usually ask about your symptoms, any rash, and whether you have been outdoors or found a tick. If you have the typical spreading rash, that alone is enough to make the diagnosis, and treatment can start straight away without any test. If there is no rash, your doctor may arrange a blood test. These tests are not reliable in the first few weeks, so an early negative result does not always mean you do not have the infection.

Tests that may be done

• A blood test that looks for antibodies your body makes against the bacteria. It is most useful a few weeks after the bite.
• A second, confirmatory blood test if the first one is positive.
• Tests on joint fluid or spinal fluid in rare cases where there is joint swelling or nervous system symptoms.
• Routine blood tests to check your general health.

What to expect at your appointment

You will be asked about your symptoms, your recent time outdoors and any travel. Your doctor will look at the rash and examine you, including your joints and nerves. If the rash is typical, treatment can start at the first appointment. Blood test results often take a week or more, so your doctor may decide to begin treatment before the results come back.

Treatment

Lyme disease is treated with antibiotics — medicines that kill bacteria. The earlier treatment starts, the better. Most people need a short course and recover fully. The exact antibiotic, the dose and how long you take it depend on your symptoms, your age, whether you are pregnant and any allergies, so your doctor will choose what suits you.

Self-care at home

• Take the medicine exactly as prescribed and finish the whole course, even if you feel better.
• Rest when you feel tired and drink plenty of fluids.
• Ask your pharmacist which pain relief is suitable for you, and follow their advice.
• Take a photo of any rash and note down new symptoms, so you can show your doctor how things have changed.
• Build activity back up slowly rather than all at once.
• Tell your doctor if you are not improving or if new symptoms appear.

Medical treatments

Treatment is usually a course of antibiotic tablets. For more serious or later-stage problems, such as nervous system or heart involvement, antibiotics may need to be given through a drip in hospital. A small number of people keep feeling tired or foggy after finishing treatment. Talk to your doctor about this — more antibiotics are not usually the answer, and other support can help. Never take leftover or borrowed antibiotics.

Living with this condition

Most people are back to normal within a few weeks of finishing treatment. Tiredness can linger, so plan rest into your day and build activity back up gradually. Ask for a follow-up appointment if your symptoms are not settling as you expected.

Lifestyle tips

• Increase activity slowly — short walks and gentle stretching first, then a bit more as you feel able.
• Keep sleep regular, as tiredness is one of the most common lingering symptoms.
• Make a tick check part of your routine after being outdoors.
• Wear long sleeves and trousers in long grass, and ask your pharmacist about a suitable tick repellent.
• Check pets for ticks with a fine-toothed comb.
• Ask family or friends for practical help while you recover.

Diet and exercise

There is no special diet for Lyme disease. Regular balanced meals and enough water support recovery. Gentle, steady exercise helps with tiredness and stiff joints, but start slowly and stop if you feel wiped out. If you were very unwell, check with your doctor before going back to intense exercise.

Mental health and emotional wellbeing

Lyme disease can leave you feeling anxious, frustrated or low, especially if tiredness or 'brain fog' (difficulty thinking clearly and concentrating) lasts a while. Being unable to work or do normal things can be hard. These feelings are common and worth mentioning to your doctor — support is available. If you feel hopeless or have thoughts of harming yourself, contact your local emergency number or a crisis support service straight away.

Prevention

You can greatly lower your risk, although no method is perfect. Ticks are most active in spring and summer but can be found all year. Stick to paths where possible, cover up, use a repellent, check your whole body and your pets afterwards, and remove any tick as soon as you find it. Use fine-tipped tweezers, grip the tick close to the skin and pull steadily upwards without twisting, then wash the area.

Vaccines

There is currently no routine vaccine available for people against Lyme disease in the UK or most other countries. Research into human vaccines is ongoing. A vaccine is available for dogs in some places, so ask your vet.

Screening programmes

There is no screening programme for Lyme disease. The best check is a personal one: look over your skin after any time spent in grassy or wooded areas.

Complications

If left untreated

• Spread to joints, causing long-lasting swelling and pain (Lyme arthritis).
• Nervous system problems such as a drooping face, nerve pain, numbness or a meningitis-like illness.
• Heart problems such as an irregular heartbeat or dizziness (rare).
• Ongoing tiredness, aches and difficulty concentrating.
• Later-stage problems are still treatable, but recovery can take longer.

Long-term outlook

The outlook is good. Caught early, Lyme disease is usually cured with a short course of antibiotics, and most people feel back to normal within weeks. A small number of people have tiredness or aches that last longer. This usually improves over time, and your doctor can help you manage it.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.