Lyme-carrying ticks feed on human blood eye of science/SPL

The UK National Institute for Health and Care Excellence (Nice) has named areas in southern England and the Scottish Highlands as being high risk regions for Lyme disease. However, the body also warned that infection can occur in many other places.

Around 2,000 to 3,000 new cases of Lyme disease are thought to occur in England and Wales every year. But in a draft guideline, Nice said that prevalence data is incomplete, and the body has called for a large study into Lyme disease in the UK.

Lyme disease is a bacterial infection spread by ticks, and can lead to conditions like meningitis, facial paralysis or heart failure if left untreated. UK areas known to have a particularly high population of ticks include Exmoor, the New Forest, the South Downs, the Lake District, the North York Moors, and the Scottish Highlands. Ticks are also relatively common in parts of Wiltshire, Berkshire, Surrey, West Sussex and Norfolk.


Not everyone who gets bitten by a tick will be infected with Lyme disease, as only a small proportion carry the bacteria that cause the condition. However, Nice has suggested that cases of Lyme disease are underestimated in the UK because family doctors and hospital clinicians are not required to report the number of cases they see.

Antibiotic treatment

“Lyme disease may be difficult to diagnose as people can have common and unspecific symptoms, like a headache or fever, and they may not notice or remember a tick bite,” says Saul Faust, of the University of Southampton, UK, who worked on Nice’s new guildeline.

“Our draft guidance will give GPs and hospital doctors clear advice on how to diagnose if they think Lyme disease is a possibility,” says Faust.

One of the clearest signs of Lyme infection are characteristic “bulls eye” lesions around the site of a tick bite, although in some countries this is also caused by a different type of tick-borne infection that requires different treatment.

Nice is recommending that GPs prescribe antibiotics to treat the condition, but that patients be referred to a specialist if symptoms persist.

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