Lyme Disease – What is it & how can we reduce the risks while walking this summer?
Lyme disease is a bacterial infection, which can be extremely serious if it isn’t diagnosed at an early stage. The disease is caused by bacteria of the Borrelia type and in nearly all cases it is transferred to humans by ticks infected with these bacteria. The number of cases of Lyme has been rising steadily year on year and it is now estimated that there are 3000 new cases of Lyme disease each year (according to figures from Public Health England). However, it is widely thought that this may be an underestimate and that there may be many thousands more cases that are missed by official records. Ticks are a common feature of the British countryside, particularly during the summer months so, if you’re planning a trip in the great outdoors this summer it is important to be aware of these troublesome little creatures and the risk they pose!
A LITTLE MORE ABOUT TICKS
Ticks are arachnids – part of the spider family – and are external parasites that live off the blood of birds and mammals, e.g. humans! They are about the size of a poppy seed – before they start feeding – and are common in woodland and moorland but will live anywhere with wildlife. With a preference for mild, wet environments, the British countryside suits them just fine. There are over 20 different species of ticks in Britain, but as walkers, the most common type that we are likely to encounter is the ‘sheep tick’.
Ticks live in the soil. They cannot fly or jump, but rather they climb up tall grasses, plants, shrubs and small trees in search of a host, and bite when an animal or person brushes past. You don’t feel them latching on as they inject an anesthetic into the skin as they bite. They will bite wherever they can but prefer to find dark, moist and fleshy places like armpits, between toes or the back of your legs. In children they often bite around the hairline or behind the ears.
TIPS TO AVOID BEING BITTEN BY A TICK:
Prevention is better than the cure! The best way to avoid catching Lyme disease is to try to minimize the possibility of getting bitten by ticks in the first place. Top tips for doing this are:
• Avoid walking through areas of dense foliage like long grasses and bracken. If this kind of vegetation borders the path you are walking on, try your best to stick to the middle of the path.
• Don’t follow animal pathways through the undergrowth as the ticks thrive in these areas.
• Minimise the amount of skin you leave exposed on your legs, ankles, feet and arms. Wear long sleeve tops, gaiters (or tuck your socks into your trousers) and definitely don’t wear shorts!
• Wear light coloured clothing. This helps to show up the ticks so you can remove them before they bite.
• Check your clothing and your kit regularly to ensure that you haven’t got any extra ticks along for the ride.
• Spraying insect repellent around your legs can help to deter ticks.
It is best practice to do a full body check immediately after your walk and then again 24 hours later to make sure that you haven’t picked up any ticks. If you do find a tick during your search, remove it immediately. It is thought that during the first 24 hours the ticks will just be feeding on your blood and will not yet have transferred any bacteria to your system. Therefore, if you can find and remove any ticks during this time, your risk of infection is much reduced.
Also, remember to check your pets to make sure that they don’t have any tick bites themselves or to make sure they haven’t brought ticks home in their fur.
WHAT TO DO IF YOU FIND A TICK
The best way to remove a tick is using a specific tick hook. These come as either plastic cards, like a credit card or a small tool that looks like a claw hammer and are sold in outdoor shops and many pharmacies and rural shops. Tick hooks often come as a pack of different sized tools for different sized ticks and are relatively cheap to buy.
To use a tick hook, slide the hook under the body of the tick from one side. Lift the tool very slightly, then twist the tool in one direction only. The tick should detach after two or three turns. Once the tick has been removed it is always a good idea to clean the bite and wash your hands.
An alternative is to use a pair of fine-tipped tweezers. Get a firm grip around the head of the tick and pull it straight out. Never twist the tick using a pair of tweezers as you’ll likely leave the head embedded in your skin.
It is important never to squeeze the tick as this can cause it to disgorge its fluids back into your body, thereby increasing your chances of infection. Never use anything chemical or a lit match to encourage a tick to fall off as this has the same effect. Also, make sure you get all the head and legs out! You can check by examining the tick closely once you’ve removed it. If a small part of the head and/or legs remain, the skin will shed this naturally. However, if a larger part is left there is a chance that the disease could still be transmitted or the bite can become infected. If you are comfortable doing so, a sterile needle can be used to remove the remaining part of the tick, followed by washing and dressing the wound to avoid infection. If you don’t want to do this, it is best to seek the advice of your doctor.
Once you have removed the tick it is a good idea to get rid of it so that it can’t strike again. Ways to do this include burning it or washing it away in a sink or, if you are still outdoors, in a nearby stream.
SIGNS AND SYMPTOMS
Lyme disease is not the easiest to diagnose. The most well known and sure way to confirm a case of Lyme disease is a ‘bulls eye’ rash (erythema migrans to give its proper name) around the area of a tick bite. However, less than 50% of people who catch Lyme disease have this rash and so diagnosis will rely on other factors. If a rash does appear, it can be a good idea to photograph it as evidence, in case it disappears before you have a chance to see a doctor. Other typical symptoms of Lyme disease include:
• Stiff neck
• Muscle & joint pain
• Flu-like symptoms
The incubation period for Lyme disease isn’t known for certain and so it may take some time before any of these symptoms arise. In some extreme cases where the disease isn’t diagnosed or treated at an early stage, more severe symptoms may arise months or years later. These include:
• Pain and swelling in the joints
• Problems with the nervous system including paralysis of facial muscles (Bell’s palsy)
• Cognitive problems
• Heart problems
• Disturbed sleep
After you have removed a tick, keep an eye on the bite. If nothing happens and you don’t experience any of the above symptoms, you don’t need to do anything. However, if a rash develops, if you start to experience some of the symptoms of Lyme disease or if you are in any doubt, report it to your doctor immediately. An early course of antibiotics is needed to reduce the symptoms and minimize the chance of later complications.
John King is a qualified ML, passionate about passing on his knowledge and skills, and sharing his enthusiasm for the hills with others. He first developed his love of the outdoors in the Scottish Highlands and has explored many of the wilder and more remote corners of the Highlands, in all seasons. He has built up an intimate knowledge of the Scottish hills and glens as well as a keen interest in the ecology, geology and history of the natural environment. He also enjoys getting his hands on rock and has completed many of the UK’s classic scrambles and is a keen rock climber.