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Be tick aware!

Thursday, 29 March 2012
Public Health Wales is reminding people during Tick Bite Prevention Week (26 March – 1 April) to be aware of the risk of tick bites as very occasionally these can cause Lyme disease.
The latest provisional figures just released by the Health Protection Agency (HPA) and the Zoonoses Section of Public Health Wales Communicable Disease Surveillance Centre (CDSC) indicate there was an increase to 905 reported cases of Lyme borreliosis (also known as Lyme disease) in 2010, compared with 863 cases reported in England and Wales for 2009 and 813 cases in 2008. Case numbers have increased annually since 2003, due in part to an increase in awareness and improvements in reporting and case ascertainment with more cases of early infection being reported.
As in previous years, the majority of cases (741/905, 82%) were acquired in the UK with over eighty per cent of these identified in residents of the southern counties of England, especially the south-east and south-west health regions, a pattern reflected in reports in previous years.
However, not all cases of Lyme disease are confirmed by laboratory testing and, as in previous years, the overall number of Lyme disease cases in England and Wales is estimated at between 2,000 and 3,000 cases a year. Incidence of Lyme disease acquired in England and Wales remains low compared to some other European countries or in North America.
There were nine cases of Lyme disease confirmed in Welsh residents in 2010. Of these, all but one were UK-acquired.
Many of the infections, which are more likely to occur during late spring, early summer and autumn, are contracted while people are participating in outdoor activitietypical 'bullseye' rash seen in Lyme Diseases such as walking, mountain biking, trekking or camping. Areas which tend to be more affected include Exmoor, the New Forest, the Lake District, Yorkshire Moors, and other National Parks, although smaller wooded and heathland areas in many other parts of the country can also harbour infected ticks.
The most common symptom of Lyme disease is a slowly expanding rash which spreads out from a tick bite, usually becoming noticeable after about three to fourteen days. It is not usually significantly painful or itchy and may gradually enlarge over many weeks if not treated with antibiotics, but will eventually disappear even without treatment. Other flu-like symptoms, including tiredness, headaches, aches and pains in muscles and joints may also be present.
If the infection is untreated the bugs may spread in the bloodstream to other parts of the body, including the nervous system, joints and other organs, and some patients may develop complications caused by tissue damage. It is important that infections are recognised and treated at an early stage to avoid the risk of developing these more serious complications.
Tests to identify Lyme borreliosis infection have improved considerably over the past few years and treatments are readily available and highly effective.
Lyme disease infections cannot be passed person-to person, nor from other animals. The main feeding hosts for ticks are small mammals such as field mice and voles, and birds including blackbirds and pheasants. Areas inhabited by deer are particularly suitable habitats for ticks, but not every tick infested area has a high risk of Lyme disease.
Although most ticks do not carry the infection, to minimise the risk of being bitten by an infected tick Public Health Wales advises people to:
  • Keep to paths and away from long grass or overgrown vegetation if possible, as ticks crawl up long grass in their search for a feed.
  • Wear appropriate clothing in tick-infested areas (long sleeved shirt and long trousers tucked into socks). Light coloured fabrics are useful, as it is easier to see ticks against a light background
  • Consider using a DEET-containing insect repellent
  • Inspect skin frequently and remove any attached ticks (infected ticks are very unlikely to transmit the organism if they are removed within a few hours of attachment.)
  • At the end of the day, check carefully again for ticks, especially in skin folds (ticks are very small-about the size of a poppy seed and they can easily be overlooked),
  • Make sure that children's head and neck areas, including scalps, are properly checked
  • Check that ticks are not brought home on clothes
  • Check that pets do not bring ticks into the home on their fur
Ticks can be removed by gently gripping them as close to the skin as possible, preferably using fine-toothed tweezers or similar implements, and pulling steadily away from the skin. Some veterinary surgeries and pet supply shops sell inexpensive tick removal devices, which are useful for people frequently exposed to ticks. Do not use lighted cigarette ends or match heads to remove ticks.
More information about Lyme borreliosis is available from: http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=25420
Lyme disease leaflets produced in conjunction with The Royal Parks and New Forest District Council are available at: http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1271256716650
Further Information on Lyme disease can be found on the NHS Choices website: http://www.nhs.uk/Conditions/Lyme-disease/Pages/Introduction.aspx
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