Lyme Disease
Healthy Lives
Protective Measures
Lyme Disease
Infection
Green spaces
Environment
Healthy People
Introduction
Lyme disease is a bacterial infection transmitted to humans through the bite of infected ticks, primarily sheep or deer ticks. Not all ticks carry Lyme Disease (up to 10% of all ticks). Ticks can be as small as a poppy seed and you cannot tell by just looking at the tick whether they have Lyme Disease or not. Lyme disease carrying ticks can be found in rural and woodland areas, with cases having been reported across the UK including Derbyshire.
One of the early symptom of Lyme disease can be a circular or oval shaped rash which appears generally between 3-10 days after being bitten by an infected tick. The rash doesn’t occur in all cases and can appear up to 3 months after being bitten. In addition, some people have flu-like symptoms, facial droop, nerve pains and numbness or tingling in the hands or feet.
If left untreated it can lead to serious complications affecting the nervous system, joints, and heart. People treated in the later stages of infection can respond well to antibiotics but can be left with long term damage to the joints or nervous system.
Early detection and treatment with antibiotics can prevent severe health outcomes.
Why is it important to Population Health?
Lyme disease poses a growing public health challenge due to increasing tick populations, climate change, more dog ownership and the popularity of outdoor recreational activities. Increased exposure to tick habitats in parks, woodlands, and countryside areas elevates the risk of Lyme disease transmission. If not promptly diagnosed and treated, the disease can lead to long-term disability. Delayed diagnosis may result in neurological disorders, arthritis, and cardiac issues, significantly affecting an individual’s quality of life including a potential impact on financial and emotional wellbeing.
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of Lyme disease within The Derbyshire Population Health Approach:
• Prevention
Prevention plays a crucial role in reducing Lyme disease incidence. This includes both prevention and swift removal of ticks.
It is recommended to:
- Carry a tick removal tool
- Use insect repellent
- Avoid walking through long grass
- If walking in woodland or grassy areas wear long socks or tuck trousers into socks
- Clothing should be light coloured so ticks are easy to spot
- Check everyone for ticks including pets when returning from being outdoors. Adults are often bitten on the legs but children on the neck, although bites can occur anywhere and more than one tick can be on the body.
- Any ticks that are found should be removed as quickly as possible with a correct tick removal technique.
- Any symptoms should be monitored and help from a GP should be sought.
Environmental management strategies, such as controlling deer populations and maintaining vegetation in public parks and trails, have been identified as effective measures for reducing tick numbers.
Healthcare training is another essential aspect of prevention, ensuring that General Practitioners (GPs) and healthcare providers have the knowledge to recognise Lyme disease symptoms early and provide accurate diagnoses. This is particularly important as it previously has not been a common disease in the UK and the symptoms often overlap with other conditions. The National Institute of Health and Care Excellence (NICE) guidelines recommend increased training for medical professionals to enhance detection and treatment efforts1. Community outreach initiatives also target high-risk groups such as forestry workers, hikers, and pet owners, equipping them with the necessary information to protect themselves against tick bites.
• Population
Population risk factors vary across different groups and locations. Rural and woodland areas in Derbyshire, particularly the Peak District, present a higher risk of tick exposure. Outdoor workers, including farmers, rangers, and military personnel, face increased vulnerability due to their occupational settings. Recreational activities such as hiking, camping, mountain biking and dog walking further contribute to the risk, as individuals frequent grassy and wooded areas where ticks are prevalent. An increase in dog ownership during the pandemic has increased the risk for the population. 1 in 3 dogs in a vet survey were found to be carrying a tick. Certain groups, such as children and elderly individuals, may be more susceptible to severe complications due to delayed diagnosis or misinterpretation of symptoms.
As with other diseases access to GP or healthcare can be affected by rurality and deprivation with people less likely to access healthcare in a timely way therefore adversely affecting health.
• Evidence
NICE provides guidelines recommending early diagnosis through clinical symptom recognition, particularly the presence of a rash, and laboratory testing when necessary.
UKHSA (UK Health Security Agency) has also developed risk assessment tools and public health messaging strategies to improve awareness and prevention efforts2.
Reports from UKHSA indicate that climate change has contributed to increasing tick activity in the UK, underscoring the need for proactive surveillance measures. However, gaps remain in the evidence, particularly regarding the effectiveness of tick control methods and the long-term outcomes of Lyme disease treatment. Addressing these gaps through further research could enhance the effectiveness of prevention and management strategies.
• Causes
Causes of Lyme disease are multifaceted, involving environmental, behavioural, and biological factors. Climate change has led to milder winters in the UK, which prolong tick survival and expand their populations, increasing the overall risk of transmission. Changes in human behaviour, including increased outdoor activities, tourism, and pet ownership, have heightened exposure to tick-infested areas. Additionally, shifts in biodiversity, such as an increase in deer and rodent populations, have expanded the habitats and distribution of ticks. Limited public and healthcare practitioner awareness remains a concern, as many individuals are unfamiliar with Lyme disease symptoms, leading to delays in seeking medical attention or diagnosis and, consequently, more severe health complications.
• Collaboration
Collaboration in Derbyshire is essential to effectively addressing Lyme disease, involving healthcare practitioners, local authorities, community and voluntary groups, and environmental organisations. Derbyshire County Council works closely with all partners to implement awareness campaigns.
Access to healthcare and support services is essential for Lyme disease prevention, diagnosis, and management in Derbyshire. GPs across the region provide initial assessments and treatment for suspected Lyme disease cases, with referrals to specialists available for complex or severe cases.
Online resources and helplines also provide valuable support for individuals seeking information or assistance. Websites run by the UKHSA and NHS3 offer guidance on Lyme disease prevention and treatment. Additionally, organisations such as Lyme Disease UK4 provide support groups, advocacy services, and information for those affected by the condition. These collective efforts contribute to a more informed and protected population, ultimately reducing the prevalence and impact of Lyme disease in Derbyshire.
Latest Derbyshire Data
Trend Data
Prevalence Maps of Derbyshire
The maps below illustrate various geographies for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.
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In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly. |
Slope Index
This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.
Further Analysis & Assessments
Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.
More Information & Resources
Here is a list of useful resources and information to help prevent issues related Lyme disease. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need as part of efforts to address Lyme disease.
Contributors
Claire Jones, Public Health Lead, Health Protection