Be aware of Ticks and Lyme disease

I have a friend who was lucky to have spent their childhood roaming the New Forest.  Less fortunately, a disease lay deep within her bloodstream for decades: the result of being bitten by a tick infected with Lyme disease while she explored the forest as a child.  The disease was only recently diagnosed, after she underwent multiple tests for symptoms that for some time made her suspect multiple sclerosis.

Her experience resonated deeply with me.  I spent my youth on Dartmoor when the removal of several dozen feeding ticks off my body at bath time was a common, often daily, chore.

Everyone who spends time in the outdoors should be aware of Lyme disease, and with the coming of Spring, now’s a good time to become TICK-AWARE.  Next week is also National Tick Bite Prevention week.

What is a tick?

A tick is an external parasite that feeds on the blood of mammals and birds.  In the UK there are two families of ticks, hard ticks and soft ticks, and it is usually hard ticks that spread Lyme disease:

1. The most common ticks to transmit Lyme disease are Ixodes ricinus (also known as the sheep tick, deer tick, wood tick, and castor bean tick)
2. Ixodes hexagonus (the hedgehog tick)

What is Lyme disease?

Lyme disease, or Lyme borreliosis, is an infectious disease caused by the bacterium Borrelia burgdorferi that can be carried by a tick, and which can be transfered to humans by a tick bite.  The disease is classified by the World Health Organisation as an infectious or parasitic disease.  The name ‘Lyme’ comes from a town of the same name in Connecticut where US researchers first identified the disease, although in Europe it has been known by various other names for centuries.

When infected by the disease it may take anything from two to 32 days for symptoms to show.  Early symptoms include feeling generally unwell or flu-like, headache, muscular aches or pain, stiff neck, joint pain, tender glands and sensitivity to temperature, sound and light.  Sometimes a characteristically-shaped and expanding ‘bull’s eye’ skin rash may  appear, which is termed Erythema migrans or ‘EM rash’.

If left untreated patients can develop a range of symptoms termed ‘late-stage’ or ‘Chronic Lyme disease’, which can include my friend’s MS-type symptoms, plus arthritis, sleep disturbance, cognitive difficulties or chronic fatigue syndrome-like symptoms.

When are ticks active in the UK?

Ticks are generally more active between March and June. There is another peak in activity between August and October.  During the winter, ticks are normally less active.  Be aware when travelling abroad as the climate will affect tick the timing of activity, while there may also be different tick species present too.

Prevention of ticks

After hatching a larval tick will seek a host (‘questing’), where it waits in ambush on low vegetation with its forelegs outstretched.  A tick can sense chemicals, heat and movement from a passing host.  As a host brushes by, the tick will latch on using hooks on its forelegs.  Once on the host it searches for a suitable feeding site.  Be warned: ticks like the warmest parts of your body, check especially around your ankles, behind the knees, under the armpits and around your groin, although they can start feeding anywhere.

Preventing ticks can be difficult.  Being aware of the potential is an important first step.  During certain times of year (see above) you would be wise to think twice about entering dense ground vegetation especially, in my experience, bracken and tall grasses/sedges/rushes.  Long clothes that cover exposed skin, especially legs, may be a good idea in practice but not always practical during summer heat.  You could try tucking your trousers into your socks too.  Smooth rather than coarse or wooly fabrics may be better at repelling ticks.  Pale colours will show up crawling ticks en route to some warm part of your body.  Some insect repellents also claim to be effective in reducing tick infestation including Mosi-guard and Deet.

What to do if you find a feeding tick

You should remove a feeding tick as soon as you can although when first attached (i.e. before swollen) a nymph they can be hard to spot.  Get into a routine after being outside to check yourself.  Make sure you remove a tick carefully as it is possible to leave its head behind in your skin, where it can lead to infection.  I recommend that you visit some of the links below, some of which include step by step practical guidance with illustrations, on how to remove a tick.

Gabriel Hemery

Find out more

• Lyme Disease Action – An excellent initiative with masses of important and accurate information.  You can even purchase a tick remover.
• National Tick Bite Prevention week – news, information downloads, car stickers and much more besides.
• Borreliosis and Associated Diseases Awareness UK – medical information, including some graphic images of infection stages.
• Best Practice Guides – very clear guide including prevention suggestions.
• National Health Service – The NHS page on Lyme Disease.
• Lyme disease – Wikipedia entry