be tick aware

by Health Protection Agency's Chief Executive Pat Troop

Summer has begun and everyone is eager to get outside to enjoy the weather. Many of us will be out exploring forested, woodland, heathland areas and suburban parklands. However before you head off, you should be aware of the risk of tick bites.

Health Protection Agency reports show that there has been a rise in the number of people infected by ticks carrying Lyme borreliosis (also known as Lyme disease). A significant number were acquired in the course of activity holidays, including walking, trekking and mountain-biking. Peak times for tick bites are late spring, early summer and autumn.

Areas where infection has been acquired in the UK include popular holiday destinations such as Exmoor, the New Forest, the South Downs, parts of Wiltshire and Berkshire, Thetford Forest, the Lake District, the Yorkshire moors and the Scottish Highlands.

symptoms

The most common symptom is a slowly expanding rash which spreads out from a tick bite, usually after about five to fourteen days. It is not usually particularly painful or itchy but may gradually enlarge over many weeks if not treated with antibiotics. However it will eventually disappear without treatment. Other 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 and to other parts of the body, including the nervous system, joints and other organs, and some patients may develop complications caused by tissue damage.

Since 2003, the number of people being infected has increased year on year from 292 reported cases in 2003, to a provisional figure of 684 in 2006. At the same time, there has also been a significant rise in infections known or believed to have been acquired overseas – in the United States, France, Germany, Austria, Scandinavia, and Eastern Europe.

Ticks are very small (about the size of a pin head), and can easily be overlooked, so it is important to be aware of the risk of a tick bite. Check for ticks attached to your skin regularly and remove them promptly. Infected ticks are very unlikely to transmit the organism if they are removed within 24 hours of becoming attached.

how to minimise risks

To minimise the risk of being bitten by an infected tick:

• 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.
• Check that ticks are not brought home on clothes.
• Consider using insect repellents, e.g. DEET-containing preparations.
• Inspect skin frequently and remove any attached ticks.
• At the end of the day, check again for ticks, especially in skin folds.
• Make sure that children's head and neck areas, including scalps, are properly checked.
• Check that pets do not bring unfed ticks into the home on their fur.

treatment

You can remove ticks 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. Covering the tick with creams or volatile oils or using lighted cigarette ends or match heads are not recommended.

• For further information about Lyme borreliosis and tick bite prevention along with useful organisations visit the HPA website.

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(March 2007)