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New Report Outlines Lyme Disease Management in the UK

OCT 04, 2017 | EINAV KEET
In an effort to better diagnose and treat cases of Lyme disease, the United Kingdom’s National Institute for Health and Care Excellence (NICE) has issued a draft guidance to help general practitioners and health professionals better spot cases of the tick-borne disease.

Lyme disease is transmitted to humans through the bites of black-legged ticks infected with Borrelia burgdorferi. Although most ticks don’t carry the bacteria that causes Lyme disease, bites from infected ticks can lead to initial symptoms including fever, headache, fatigue, and a telltale “bullseye” skin rash. Infections are treated with antibiotics such as doxycycline or amoxicillin. According to the Centers for Disease Control and Prevention (CDC), if left untreated, more serious symptoms can develop, including severe headaches and neck stiffness, arthritis with severe joint pain and swelling, facial palsy, heart palpitations, and inflammation of the brain and spinal cord. In the United States, the geographical distribution of Lyme disease has been growing, and the disease has also been reported in forested areas of Asia and Europe according to the World Health Organization (WHO).

In a new report, health officials from the NICE have issued an evidence review on Lyme disease in the United Kingdom and a draft guidance for the awareness of diagnosing and managing the disease. The report states that although laboratory-confirmed cases of Lyme disease have increased in the United Kingdom in the last 2 decades, the reason why is unknown. “This is thought to be a result of better reporting, increased diagnostic testing, and increased awareness by the public and healthcare professionals, but [it] may also be a result of increased spread of disease,” states the new guidance. “There is a need to increase awareness of Lyme disease as there are assumptions about where infected ticks may be found and hence the risk of Lyme disease to an individual.”

With the distribution of laboratory-confirmed cases varying by region, the report notes that high-risk areas for infection include the South of England and the Scottish Highlands. As many as 3000 new cases of Lyme disease occur in England and Wales each year; however, the scope of the disease is generally low in the United Kingdom. Still, more research is needed on the incidence and impact. The NICE report offers recommendations on how to raise awareness about the disease, highlight how infections occur, note tick habitats, improve diagnosis, and help healthcare professionals better recognize the condition.

“Lyme disease is easy to treat. However, if left undiagnosed, it can lead to more serious symptoms. These can include heart problems, arthritis and problems affecting the nervous system, for example, weakness on one side of the face,” explained Gillian Leng, MD, NICE’s director of health and social care and deputy chief executive, in a recent press release. “We want people to be diagnosed early so they get the right treatment as soon as possible. This is why our draft guidance makes a clear set of recommendations on when to diagnose Lyme disease, and when to rule it out.”

NICE will be accepting comments on the new draft guideline until November 6, 2017.
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