Lyme disease could be FOUR TIMES as common as official figures estimate because thousands of people get treated without a diagnosis
- Researchers led by a former medical statistician looked at GP records for the UK
- They found thousands more people were treated for Lyme disease in 2012
- Patients may be given antibiotics without ever getting diagnosed, they said
- It’s important for doctors to be cautious because delaying treatment is risky
Lyme disease may be four times more common than official figures let on, according to scientists.
Researchers in the UK estimate more than 8,000 people will get the illness this year alone, despite official records showing just 1,746 cases in 2017.
Unreliable reporting of Lyme disease cases and treatment without diagnosis may be masking the true toll of the infection, which is spread by ticks.
Instead of looking at nationally recorded cases, scientists trawled through data from 658 GP practices with around 8.4million patients to estimate more likely figures.
The team said the difference between official rates and their own could be down to doctors being cautious and treating patients without an official diagnosis.
The study comes just weeks after the NHS regulator told doctors to give antibiotics immediately if they suspect Lyme disease, instead of waiting for test results.
Researchers went through GP records and found thousands of patients were being treated for Lyme disease without ever being diagnosed, suggesting official statistics of the number of people who catch the infection were inaccurate
Experts led by a retired medical statistician in Oxford, Dr Victoria Cairns, who was once diagnosed with Lyme disease herself, studied the GP records.
They included figures for the number of people who were treated because they may have Lyme disease, as well as those who were officially diagnosed.
This bumped up the number of patients for 2012 by more than 6,000.
Official figures from Public Health England and Health Protection Scotland show there were 1,247 cases in England, Scotland and Wales in 2012.
But Dr Cairns and her team found 7,738 patients were either diagnosed with or, crucially, treated for, Lyme disease in the same year.
They found that 1,913 suspected cases of Lyme disease were treated, alongside 468 possible ones – on top of those which were officially diagnosed.
This suggested the true rate of the illness is significantly higher and, based on the jump, they estimated more than 8,000 people would be diagnosed this year.
Dr Cairns said: ‘This is really just showing there are many more cases than previously, officially estimated.
‘I think GPs certainly know about it, the issue is really for the public to know so that they go to the GP to get diagnosed.
‘Because that’s really the big problem with Lyme disease – some people don’t get diagnosed quick enough and then they go on to get long-term problems.’
Lyme disease is a bacterial infection spread by the bites of ticks – small, dark-coloured insects which feed on the blood of mammals.
They tend to wait on plants and grab onto animals or people when they brush past, burying their head into the skin and clinging on.
Ticks must be carefully removed with tweezers because pulling them can rip off their heads inside someone’s skin and increasing the risk of infection.
How to remove a tick: Ie tweezers or a tick-removal tool to grasp the tick as close to the skin as possible (pictured), then slowly pull the tick upwards without crushing or breaking its body. Make sure all traces of the insect are gone then wash the wound
MOTHER SHARES PHOTO OF HER ‘BULLSEYE’ LYME DISEASE RASH
A mother has shared a photo of the ‘bullseye’ rash that turned out to be a sign of her Lyme disease.
Kate Allen, 28, from Leicester, spotted raised bumps on her skin after walking her dog through long grass in the park in 30°C (86°F).
Three days later, she had expanding circular red areas on both legs with a clear centre forming a pattern, some reaching 12 inches (30 cm) across.
Feeling feverish, lethargic, and more forgetful, a doctor diagnosed a mild form of Lyme disease – an infection spread by ticks.
Kate Allen, 28, has shared a photo of her ‘bullseye’ rash to raise awareness of the early signs of Lyme disease after she contracted the infection
Spotted early, it can be diagnosed with antibiotics. But left untreated, Lyme disease can have serious complications.
Ms Allen said: ‘All I did was go on a family dog walk in a field – I didn’t notice straight away. That is the worrying thing. I did start to notice the bites later in the evening.
‘The symptoms began when I started to feel very tired. I had a temperature and became more forgetful than usual.’
Ms Allen, who runs a caravan hire company and has three children, went to the pharmacist but they insisted she saw a doctor who confirmed she had been bitten by a tick.
She said: ‘I almost didn’t go doctors as it wasn’t painful but if you look up just how serious this can be I’m so so glad I did.’
The doctor prescribed a 21-day course of antibiotics to treat the disease and stop it from spreading.
However, she said: ‘I still feel very worried as the antibiotics aren’t a guarantee.’
Ms Allen shared a picture of her rash to help raise awareness for the disease and it has been since shared over 187,000 times.
She said: ‘I would urge anyone to keep an eye on any bites as I shrugged it off only went to the pharmacist as I googled the rash and they insisted going doctors straight away.
‘It’s great to see the power of social media in a positive light to spread awareness.’
Symptoms of Lyme disease include a bullseye-shaped rash and flu-like fever, muscle and joint pain, headaches and tiredness.
Antibiotics can usually cure the infection but if it’s left untreated symptoms may carry on for years and even lead to permanent joint or nerve damage.
The National Institute of Health and Care Excellence (NICE) this month said that if people have the tell-tale bullseye rash and are likely to have Lyme disease they should get treatment right away.
It said at the time: ‘It’s important that patients begin their treatment as soon as possible in order to reduce the risk of infection spreading and causing lasting damage to the body.’
Waiting for tests could add weeks or even months to the treatment time, it said.
The Oxford team wrote in their paper: ‘From 2009 to 2012, the number of treated suspected cases continued to increase, unlike the number of clinically diagnosed LD cases, suggesting greater caution among the GPs and willingness to treat the illness early before confirming the diagnosis.
‘Greater caution by GPs is reasonable as rapid treatment is important to avoid longterm problems.’
Figures from Public Health England show the number of Lyme disease cases in England and Wales almost doubled from 797 in 2007 to 1,579 in 2017, the most recent data.
Data from Scotland, where the illness is allegedly more common, show cases have fallen from 230 in 2007 to 167 in 2017, according to Health Protection Scotland.
Dr Cairns’s research drew criticism from one researcher at the University of East London who said their figures were probably an ‘overestimation’.
Professor Sally Cutler added: ‘The authors discuss various factors that could account for the rise in Lyme disease cases, such as increasing public awareness of the disease and therefore more people visiting a health professional and being diagnosed.
‘If this accounts for these increases, we should start to see a plateau, but neither this study or reportable cases have shown this to date.
‘Alternatively, climate change might enable ticks to remain active for longer, lengthening the time available for a tick to infect a human.’
The research was published in the journal BMJ Open.
WHAT IS LYME DISEASE?
Lyme disease is caused by a bacteria that is transmitted to humans through the bite of infected black-legged ticks.
The most common symptoms of the disease are fever, headache, fatigue and a skin rash called erythema migrans.
The disease can typically be treated by several weeks of oral antibiotics.
But if left untreated, the infection can spread to the joints, heart and nervous symptoms and be deadly.
WHAT HAPPENS WHEN YOU ARE INFECTED?
During the first three to 30 days of infection, these symptoms may occur:
- Fever
- Chills
- Headache
- Fatigue
- Muscle and joint aches
- Swollen lymph nodes
- Erythema migrans (EM) rash
The rash occurs in approximately 80 per cent of infected people.
It can expand to up to 12 inches (30 cm), eventually clearing and giving off the appearance of a target or a ‘bull’s-eye’.
Later symptoms of Lyme disease include:
- Severe headaches and neck stiffness
- Additional rashes
- Arthritis with joint pain and swelling
- Facial or Bell’s palsy
- Heart palpitations
- Problems with short-term memory
- Nerve pain
Source: CDC
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