Intended for healthcare professionals

Letters Tick bite prevention and tick removal

Lack of accurate information on the prevalence of Lyme disease in the UK

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2037 (Published 10 March 2014) Cite this as: BMJ 2014;348:g2037
  1. R Evans, consultant clinical scientist1,
  2. S Mavin, clinical scientist1,
  3. S Holden, research coordinator (primary care)2,
  4. A Munro, project coordinator3,
  5. G Gunn, professor4
  1. 1National Lyme Borreliosis Testing Laboratory, Inverness, UK
  2. 2NHS Highland Research and Development, Inverness, UK
  3. 3Centre for Health Science, Inverness, UK
  4. 4Scottish Rural College Epidemiology Unit, Inverness, UK
  1. roger.evans{at}nhs.net

The recent article on tick bite prevention and tick removal states in its advice to patients: “If bitten in a Lyme disease endemic area, consult your GP to discuss antibiotic prophylaxis.”1 Accurate data on incidence and prevalence are not available for most of the UK, so we do not know where the endemic areas are. Therefore, we believe, like others,2 that the general use of prophylactic antibiotics is not indicated. It would also increase GPs’ workload and NHS costs, as well as resulting in the unnecessary prescription of antibiotics for patients.

In Scotland, the number of laboratory positive cases of Lyme disease increased from 55 in 2002 to 308 in 2011. The greatest increase was seen in the Highlands region: 33 in 2002 to 145 in 2011. Anecdotally, GPs in the Highlands have stated that only 20% of cases are referred for testing. If this is true, the incidence of Lyme disease is seriously under-reported, and there may be a case for the use of antibiotic prophylaxis in the Highlands. However, the immediate need is for accurate, real time data that will enable a reasonable decision to be made on the use of prophylactic antibiotics.

A multidisciplinary (medical, veterinary, medical geography, and epidemiology) group of collaborators that has recently come together in Inverness intends to resolve this lack of accurate knowledge using retrospective and prospective data to design real time maps of Lyme disease in Scotland. It is hoped that this will provide clinicians and patients with up to date accurate information that will help prevent borrelia infection and lead to the early appropriate treatment of Lyme disease.

Notes

Cite this as: BMJ 2014;348:g2037

Footnotes

References

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