HEALTH Ticks and Lyme disease

BLOOD SUCKERS?Ticks are found in woodland, bogland and long grass. 

Waiting in the long grass


Doctor's insight
Dr Ronan Clancy

Lyme disease is a relatively new phenomenon in Ireland. A disease that develops following a bite from an infected tick of the genus ixodes, it was first reported in a town called Lyme, in Connecticut, USA.
Ticks of this genus are present in many parts of the world, including the USA, continental Europe, the UK and Ireland. They are tiny, spider-like insects found in woodland, bogland and other moist long-grassy areas.
The outdoor summer paradise of Mayo and Connemara is perfect terrain for this little menace with plenty of unsuspecting rambling, hiking and hill-walking prey to feast upon.
George W Bush suffered the consequences of an unarmed tick hiding out in a grassy knoll in 2006. Not the first time the Secret Service had slipped up on presidential watch… Luckily his medics were on the ball and were able to save the president’s skin!
The tick
The larva, nymph and adult stages of the ixodes tick feed on the blood of other animals, such as birds, rodents and voles. When doing so, they pick up a nasty cork-screw shaped bacteria (spirochaete) called Borrelia burgdorferi. The tick then carries Borrelia in its salivary glands.
It passes Borrelia bacteria on to humans or other animals through a bite and seems to do this during the nymphal stage, which is at peak activity from June to October.
Ixodes ticks mate aboard deer so they tend inhabit areas with deer populations. They also live and feed upon sheep and horses, and can be picked up and carried home by house pets.
Borrelia cannot be transmitted from person to person or to humans through animal bites.
It is unknown how many cases of Lyme disease (Borreliosis) occur in Ireland each year, but is thought to be between 50 and 100 cases.

The infection
Only about one-third of patients are aware of the initial tick bite, a red swelling commonly on the leg, thigh, groin or armpit.
During the following weeks of early borrhelia infection, 70-80 percent of people will develop classic Erythema Chronica Migrans. This starts as a raised red area on the skin.
It gradually enlarges in size and then forms another ring of redness outside of the intial lesion, so it resembles a target or ‘bull’s eye’ symbol (see picture).
Other constitutional symptoms occur such as fatigue, fever, headache, swollen glands and soreness of the muscles and joints. These are similar to flu symptoms. These early symptoms usually resolve with or without treatment in about four to six weeks.
If untreated, Borrelia infection will spread from the skin to the rest of the body. There it can infect the joints and internal organs, such as the heart, brain and liver, as well as the eyes and genitals, with potentially serious consequences. These include cardiomyopathy (heart damage) and progressive Lyme Encephalitis (a condition similar to multiple sclerosis).
More commonly, Lyme disease will attack the large joints of the body, especially the knees, causing recurring arthritic swelling and pain and gradual destructive joint damage.

Avoiding Lyme disease
Unfortunately, there is no antibiotic or vaccine available to protect against Lyme disease. The best way to avoid it is awareness of the disease and tick habitats.
Taking precaution when in contact with wild animals and taking measures, such as wearing long trousers tucked into socks and using insect repellent creams like DEET in tick habitats, are important.
More important is checking yourself, your children and your clothing for ticks and the careful, gentle removal of ticks using a fine toothed tweezer when found.
Generally, antibiotics are not given following a simple tick bite. If Lyme disease is suspected, (history of a tick bite with erythema migrans or suspicious symptoms), your doctor can perform a blood test to diagnose Borrelia infection.
Treatment of suspected or established Lyme disease at any stage is with specific antibiotics and prognosis is good at all stages.

Dr Ronan Clancy is a GP at the newly opened Clancy Medical Practice, James street, Westport (www.westportgp.ie). He is in practice with Sarah Kavanagh, chartered physiotherapist.