Following my holiday blog, I was planning to focus on skin rashes caused by insects and along came the media coverage for Zika virus, which is spread by mosquito bites. Few diseases are caused by the insects themselves with bacteria; viruses and protozoans spread when they feed or bite the host.
For many travellers heading to distant lands there is an awareness of the potential problems associated with insects but what about this country? Ticks carrying the bacteria ‘Borrelia’ causing Lyme disease are endemic throughout the UK, and reports of Lyme disease have been steadily increasing with the infection acquired in woodlands, moorlands and parks. The peak times for ticks feeding is late spring, early summer, and autumn and also during mild winters and wet summers in our current diverse climate.
In the UK, Lyme disease is known to be carried by the sheep tick (Ixodes ricinus), hedgehog tick (I hexagonus) and fox or English dog tick (I canisuga). Ticks also feed on deer, other small mammals such as mice and birds. People who live or work parts of the country where the tick is prevalent are likely to be at greater risk, as are those in urban areas with overgrown gardens or with extensive parks.
Anyone can get Lyme disease if a tick that is carrying the infection bites them. Living close to moorlands and my husband’s role in mountain rescue means there is greater awareness of the potential problems being bitten by a tick may bring. Also, for the search dogs used by team members they also have to be vigilant. Talking to one of the handlers following a training exercise on the Eastern Moors he had to remove an average of 10 ticks from his dog. So what signs should healthcare professionals look for? Diagnosis is made on both the history of possible exposure or recent tick bite, and clinically with a distinct rash: erythema migransand flu-like symptoms.
If not treated early the infection can spread and cause neurological symptoms, arthritis, skin, heart and eye problems.Further excellent resources to support practice are listed below,but remember,Lyme disease is not unique to the UKso ask about possible bites and exposure in the high-risk environments. Have they been down to the woods or moors recently, been gardening or visited a local park?Lyme disease carrying ticks can be found in urban parks and gardens as well as in the countryside.
Lyme Disease Action – lymediseaseaction.org.uk
DermNetNZ – dermnetnz.org/bacterial/lyme.html
NICE CKS (2015) – nice.org.uk/lyme-disease#!topicsummary
Travel Doctor – traveldoctor.co.uk/insects.htm#lyme
Common animal associated infections quarterly report (England and Wales):third quarter 2015; and Lyme disease 2013-2014 data –
Sandra Lawton and Stuart Thompson-McHale are the expert bloggers for the Nursing in Practice dermatology and wound care resource centre. They work together as expert bloggers; Sandra Lawton produces all dermatology blogs while Stuart writes the wound care pieces.
Dermatology: Sandra Lawton
OBE, MSc, RGN, OND, RN Child (Diploma), ENB 393, QN
Sandra Lawton is the blogger for the Nursing in Practice dermatology and wound care resource centre; her focus is dermatology.
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