A Tick-ing bomb?

A Tick-ing bomb?

I have been unable to cycle for 18 months now and may never cycle again because of Lyme disease. This is a tick-borne disease and I most likely caught the tick while mountain biking across moorland or in woods. It might be worth warning members to take precautions. (I’ll never wear shorts again.) This disease seems to be on the increase and can have serious consequences.

Nicky King

Lyme disease is a bacterial infection caused by Borrelia burgdorferi, transmitted to humans following a bite from an infected tick. It may cause a characteristic erythema migrans rash, flu-like symptoms including fatigue, and sometimes neurological, joint and cardiac issues. Prognosis is very good if treated early with appropriate antibiotics.

True incidence is unknown but estimated to be 1,000-3,000 people each year in the UK, with many cases being undiagnosed. In the UK, infection occurs in areas of woodland and heath including the New Forest, Exmoor, South Downs, Lake District, and the Scottish Highlands.

In people with erythema migrans rash and a history of a recent tick bite or possible exposure to ticks, a clinical diagnosis of Lyme disease can be made without testing. In those without a rash, where the diagnosis is less certain, a blood test may be required.

The classic erythema migrans rash is a central red spot surrounded by clear skin that is ringed by an expanding red rash (like a bullseye) though this appearance can vary. It usually starts 7-10 days following the tick bite but can be anywhere from 3-33 days.

Minimise risk of tick bites by avoiding long grass and vegetation. If you can tolerate it, wear long sleeves and long trousers or tights tucked into socks. Light-coloured clothing can make it easier to identify ticks on your clothes. Consider using an insect repellent (some clothing is treated with this), inspect skin frequently, and remove any attached ticks as soon as possible, checking that ticks are not brought home on clothing.

To remove a tick, gently grip it close to the point of skin attachment using fine-toothed tweezers or a tick removal device, then pull slowly. Prophylactic antibiotics are not routinely needed following tick bite but seek medical advice if symptoms of Lyme disease develop.

Dr Matt Brooks

Cycling GP

Health     Q&A     Lyme disease

This Q&A was published in 'Cycle' the magazine for members of Cycling UK. To contact the experts, email your technical, health, legal or policy questions to editor@cyclinguk.org or write to Cycle Q&A, PO Box 313, Scarborough, YO12 6WZ

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