1. Lyme disease, also known as Lyme borreliosis, is a zoonotic bacterial infection caused by the spirochaete Borrelia burgdorferi, transmitted via the bite of an infected tick.
  2. It is the most common tick-borne disease in the northern hemisphere and is increasing in incidence. It can affect adults and children of any age.
  3. Ticks, the vector for Lyme disease can be found throughout the UK and Ireland - in urban parks and gardens as well as rural areas.
  4. Ticks feed on and are carried on wild mammals and birds. Their bite is usually painless. They can be very small and may go unnoticed.
  5. Prompt correct tick removal decreases the risk of infection. There is no proven minimum time of attachment needed for transmission of infection.
  6. An erythema migrans (EM) or bull’s eye rash is diagnostic. It may be atypical and may be absent in at least 30% of cases. Serology is not required. Antibiotic treatment should be initiated - as per NICE guidance NG95.
  7. Early symptoms may be flu-like and non-specific (with or without an EM rash).
  8. Diagnosis can be difficult and should be based on a detailed clinical history (including travel history) and examination.
  9. Lyme serology tests may be unreliable, especially in early disease. A negative test does not exclude the diagnosis. There is no test of disease activity or cure.
  10. Early diagnosis and adequate treatment provide the best chance of cure. Late diagnosis and inadequate treatment may result in continuing health problems.
  11. There is no international consensus on the required duration of treatment.
  12. There is no international consensus on the cause and management of persistent symptoms.

Image of EM rash

Erythema migrans