What is Lyme Disease?

Lyme disease is caused by Borrelia, a spirochete bacteria. It’s the most common tick-borne infectious disease in the northern hemisphere and there are multiple strains of the bacteria. Lyme disease is endemic in many parts of the United Kingdom, particularly in woodland or heath-land areas but disease carrying ticks can also be found in cities and gardens.


Embedded 'nymph' tick next to a fine tip pencil
Embedded ‘nymph’ tick next to a fine tip pencil.

Transmission of Lyme disease can occur when bitten by an infected tick. Other modes of transmission includ congential transmission from mother to baby. Although Borrelia has been found in biting insects such as mosquitoes and spiders, there is not yet  enough research to prove that the disease can be transmitted via them.

Blood, tissue and organ donation, along with sexual transmission are all cause for concern, but again there is not enough research being done in this area. The CDC state that, “Although no cases of Lyme disease have been linked to blood transfusion, scientists have found that the Lyme disease bacteria can live in blood that is stored for donation.” Until more is known, it would be wise for Lyme patients past and present, to avoid donating their blood or tissue and we aim to continue raising the issue with the Department of Health.

Symptoms can start with an erythema migrans (EM) rash, often described as a bulls-eye rash, but the rash can also be more irregular, which sometimes leads to a misdiagnosis of ringworm or cellulitis. It’s important to note that not every Lyme disease patient will experience or remember a rash, as figures state that the rash appears in two out of every three Lyme patients. The rash may not appear straight away. We advise people to draw a ring around suspicious looking rashes to track any potential changes.

Symptoms of Lyme disease can include malaise, unexplained flu-like symptoms, soreness and achiness, light and noise sensitivity, cogntitive problems, fatigue, a stiff neck, facial palsy, numbness and tingling,  Left untreated, the infection can spread anywhere in the body leading to around 70 recognised symptoms . People can develop issues with their endocrine and neurological systems and experience musculoskeletal, cardiac, dermatological and neuropsychiatric problems.

Patients don’t always remember a bite and the NHS two-tier testing has been widely criticised as flawed with one paper reporting a false-negative rate of 66.8% in early Lyme disease. At present, there is no gold-standard test for Lyme disease which can rule out the illness and there is no test for cure.

What everyone does appear to agree on is that if caught early, Lyme disease should be easier to treat, enabling the patient to return to full health. The chances are, the longer an infection is left untreated, the harder it will be to combat.

‘Chronic Lyme disease’ is not a medically accepted term in the UK however independent Lyme treating practitioners use it to describe long-term symptoms and complications and also what happens if the patient is not diagnosed early on after being infected or if initial treatment has failed.

Research shows that the Borrelia bacteria can persist, even after intense treatment, and it is also thought by some members of the medical and scientific community that the presence of other infections, could be a possible reason for a wide variation in disease patterns, progression and treatment outcomes.

There are numerous aspects of the Lyme disease to consider and as such, it is a hotly contested subject surrounded by heated debates which frequently play out in the media, worldwide.

There is variability in knowledge among NHS clinicians, from those who have little or no knowledge of Lyme disease at all, to those who have completed the RCGP Lyme disease course and those who read and update their clinical knowledge.The RCGP toolkit for Lyme disease can be found here.

Many patients, frustrated by the lack of care they receive on the NHS, turn to private doctors and clinics and undergo testing by foreign laboratories whose results are not accepted by the NHS. The charity Caudwell LymeCo collaborated with LDUK in order to explore patient experiences on the NHS in numerous surveys and results can be found here.


Nymph (baby) ticks, male and female adult ticks
Nymph (baby) ticks, male and female adult ticks.