How To Recognise Lyme Disease

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Q: I am 51 and used to be very active in my job as a country ranger. Recently, however, I feel very tired, my lower body aches, and my legs feel weak. Someone suggested this could be lyme disease. Could you explain what this is, and the treatment?

A: Lyme disease is a bacterial infection spread through tick bites. The pinhead-sized ticks are common in the northern hemisphere, in gardens, woods, moors and parks, both country and town. They also settle on animals, such as deer, horses, dogs, sheep and cows. In the UK, they are mostly active from April to October. However, not all ticks carry lyme disease, and infection rates in tick populations vary by species and geographic areas.

Lyme disease causes a wide range of symptoms, according to the campaigning support group Lyme Disease Action. Early signs, within two to 30 days of a bite, may include a circular red ‘bull’s-eye’ rash at the site, facial palsy and flu-like symptoms (such as fatigue, fever, headaches anda stiff neck). Other symptoms, usually of more advanced, untreated disease, include muscle and joint pain, and disturbances of coordination, hearing, sight, digestive system and sleep. The illness may lead to heart problems or disturb the central nervous system.

Diagnosis is difficult because the symptoms of lyme disease overlap with other conditions, and vary with individuals. Almost half of those affected do not notice the original tick bite and never see the characteristic rash.

Your GP can organise a blood test to see if your body has produced antibodies to fight the infection. Many patients have positive results within three to six weeks of being bitten. However, in some people, antibodies are not always produced in detectable amounts for several weeks, or even months, after infection.

Some sufferers never produce enough antibodies to achieve a positive blood test. If you have a negative test result but are symptomatic, your doctor will need to rule out other possible conditions, because there is no definitive test that can rule out lyme disease. However, be aware that some GPs do not recognise the signs even though this is an increasingly common problem.

The treatment for lyme disease is antibiotics. Diagnosed and treated at an early stage, it is usually curable, but the outcome may not be so good if it is diagnosed late. A 21- to 28-day course of treatment is recommended but there have been no good-quality European trials to test whether longer courses of treatment might be better. Lyme disease acquired through work is a reportable occupational disease under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations. More information is available from lymediseaseaction.org.uk, which also has helpful tips on prevention.

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Website of the week: undiagnosed.org.uk

This is the website of Swan (Syndromes Without a Name), a charity that offers support and information to the families of children and teens with undiagnosed genetic conditions. It was founded in 1999 by the grandmother of a severely disabled undiagnosed child and now has more than 2,500 members. Research suggests that between 30 and 40 per cent of special-needs children do not have a specific diagnosis. Many members feel isolated and experience difficulties claiming benefits and accessing support services. Swan exists to help.

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