Ticks weren’t a big deal when I was a child. You gave them the pluck and squash treatment if you found them and that was that. Nowadays, however, ticks need to be taken seriously.
That’s because Lyme Borreliosis (Lyme disease), first recorded in Ireland in 1987, appears to be more prevalent now. It can cause flu-like symptoms and a bull’s eye rash initially, but numbness, chronic joint pain and more if left untreated. So why is the disease more prevalent here now?
Dr Eoin Healy, a research associate with the school of biological, environmental and earth sciences at UCC, believes that the growth in red and sika deer populations is the main driver.
“Allied to this, climate change, reafforestation and the reappearance of rough grazing areas due to set-aside policy and part-time farming practices, all contribute to provide an ideal environment for ticks to survive and reproduce,” he says.
“Many people think that the tick carrying Lyme disease is a different species to the one commonly found on sheep, cattle and the family dog. It is very important to be aware that it is precisely the same species (Ixodes ricinus). Anywhere up to 20% of the ticks on your farm or surrounding countryside will carry Borrelia bacteria, the infective agent that causes Lyme disease.”
Tick bite and infection
Healy explains that both the tick itself, as well as the Borrelia bacteria it carries, have evolved very clever survival strategies.
“Ticks climb on to grass stems, heather etc, and wait for a passing animal – a possible host. They are attracted to CO2 (carbon dioxide) from the breath and body of an animal or human, and grab the opportunity to cling to any skin or fur they come in contact with.”
The tick needs a blood feed to survive so it secretes an anaesthetic into your skin so that you may not know you’ve been bitten.
“It is quite possible that a tick might attach behind a person’s knee, for example, feed for several days and then drop off without the victim being aware they’d been bitten,” he says.
The infection, if the tick carries it, goes into the person’s blood stream from the bite site and may attack several organs.
“A red, circular rash – a bull’s eye ring – is the main diagnostic indicator of infection. It usually appears within a few days of a person being bitten, but only 80% of those who develop Lyme disease will get the rash.”
Difficult diagnosis
Diagnosing Lyme disease can be very difficult, he adds.
“One reason is the possible absence (20% chance) of the bull’s eye rash. A second reason is that when a person is bitten by an infected tick they may, in fact, receive a nasty cocktail of three related species of the Borrelia bacteria.
“Each of these can cause slightly different symptoms. One patient might complain of numbness or pins and needles while another might mention joint pains. A third might say they have a severe flu.
“This adds to the problems of diagnosis for over-worked rural GPs who may not yet be familiar with Lyme disease. Delayed diagnosis is very significant as it is now known that this delay can seriously reduce the success of antibiotic treatment.”
Lyme disease can often go undiagnosed or misdiagnosed as well.
“This leads to distress for victims as they don’t get the required support.”
Tough bug to tackle
The Borrelia bacteria is a tough bug to deal with, he adds.
“It goes through active phases and dormant phases, during which antibiotics may be ineffective.
“Early diagnosis and treatment are key and treatment with antibiotics is generally effective when an early diagnosis is made. Standard practice among doctors in continental Europe is for Lyme disease to be considered a possibility in tick-infested areas. This would include a considerable part of Ireland.”
How to prevent a bite
So should we all be terrified of spending time outdoors?
“If you follow a few simple tips, you can reduce your risk of contracting Lyme disease to near zero,” Healy says.
“Awareness is key to avoiding the disease.”
Dr Healy suggests the following tips when out walking in risk areas:
• Wearing long sleeved clothing.• Don’t wear shorts.• Use insect repellent. • Wearing light-coloured clothes as it is easier to see ticks on these.350 cases a year
“We have a fairly accurate estimate of the number of positive cases of Lyme occurring in the Cork/Kerry area,” he says.
“If we extrapolate those figures out to the whole country, you get a figure of over 350 cases per year in Ireland or eight cases per 100,000 of population. This is consistent with continental Europe figures and is considerably higher than the 13 cases of the narrowly-defined neuroborreliosis which the Health Protection Surveillance Centre (HPSC) state were reported in Ireland in 2013.”
what to check
• Check your own and your children’s skin carefully after being out for the day in woodland, forest, or near rocky outcrop, rough ground or long grass areas. Don’t rely on children to do it themselves.• Discourage children from going into knee-high vegetation in forest parks. Stick to the paths.• If there is a tick, remove with a tweezers.• Dab with antiseptic.• Photograph the tick if possible and record the date and where you were bitten.• If there is a bite, check the site every day and if there is any sign of flu-like symptoms or a red weal widening around the site then consult your doctor. Note: The Ixodes ricinus tick can look different on grass, ranging from grey to reddish-backed, depending on the stage of its life cycle.
You can be bitten by tick larva (1mm), nymph (2mm) or an adult tick (6 mm) – all life stages of the same species. The nymph is the most dangerous as a high percentage tend to be infected and can go undetected on skin because of their small size.
See www.hpsc.ie to download a leaflet about Lyme Disease.
Case study one
Charles is 37 and a farmer from the north-west. He doesn’t know what exactly he was bitten by but he has had the bull’s eye rash twice.
“I got it on my arm in my 20s and thought it was ringworm but a week later it was gone so I didn’t go to my GP. Looking back, I got bouts of sickness for about three weeks of the year, every year. Seven years ago I got the bull’s eye rash again, this time on my thumb. It was red on the outside, a wee bit like ringworm, and then it faded away.
“As time went on, I had to give up my part-time job in construction and farming was difficult too because I felt exhausted all the time. I went to all sorts of doctors and healers but got nowhere. Then I heard Ryan Tubridy talking about Lyme disease on the radio one morning and it was like my story was being told. I recognised all my symptoms.
“At one point I was so weak that I could only lift my hand to chest height and I was doing things like dropping spanners. I felt like whatever illness it was, it was taking over my life. I got very upset about it one particular day and it was that day that my wife arrived home with a telephone number for a doctor in a Dublin hospital – a tropical disease expert.
“After a blood test he started me on heavy antibiotics. I’m still on them nine months later. I have had great improvement but I still get very tired sometimes. It’s not a nice disease – everything is affected, even your mind. The simplest of things would annoy you. I’ve changed the way I eat, too, and I’m on supplements from a nutritionist to build me up. I’d say I’m 75-80% of what I should be now.
“I know Lyme disease is getting more common now. In the north-west we have a wild high rate for ticks. As soon as a lamb hits the ground it has to be treated for them.
“With Lyme disease they say that if people are treated early on they’ll do great. Fingers crossed that I’ll get off the antibiotics soon. I’m only young, with a young family. My family was great throughout all of this, especially my wife. Without her I don’t where I’d be now. She was my number one rock.”
Case study two
Clare McCahill picked up Lyme disease in Portugal. She tells us what happened.
“I was diagnosed in Portugal, where Lyme disease is common and recognised. Once I presented at the hospital, 10 days after being bitten, with the symptoms – the fever and the bull’s eye rash – I was diagnosed immediately.
“Initially I didn’t know what was wrong with me. I thought it was a flare up from being bitten by mosquitoes. I was very ill that first week, with a high temperature and delirium.
“I had four courses of antibiotics before it came under control. You have to get antibiotics at the right time in the cycle of the bacteria that’s in your blood. If you don’t get them at the right time it doesn’t deal with it. It then goes into another cycle (dormant then active).
“It was a really heavy antibiotic, doxycycline – poxy doxy, I call it. I was so weak that summer – totally fatigued with brain fog as well. Now in 2015 I’m probably 85% of what a normal 48-year-old should be. I still have chronic fatigue and have to pace myself. I have to have a regular routine in order to cope. I was really active before getting Lyme disease but now I’m not.
“In Portugal I heard people talk about tick fever but I thought it was something sheep and cattle got. I didn’t think humans got it or that it was serious.
“Only that Chris, my partner, remembered reading an article in a magazine about Lyme disease, we might not have known. It’s very important that people know about Lyme disease and watch out for ticks.”
Ticks weren’t a big deal when I was a child. You gave them the pluck and squash treatment if you found them and that was that. Nowadays, however, ticks need to be taken seriously.
That’s because Lyme Borreliosis (Lyme disease), first recorded in Ireland in 1987, appears to be more prevalent now. It can cause flu-like symptoms and a bull’s eye rash initially, but numbness, chronic joint pain and more if left untreated. So why is the disease more prevalent here now?
Dr Eoin Healy, a research associate with the school of biological, environmental and earth sciences at UCC, believes that the growth in red and sika deer populations is the main driver.
“Allied to this, climate change, reafforestation and the reappearance of rough grazing areas due to set-aside policy and part-time farming practices, all contribute to provide an ideal environment for ticks to survive and reproduce,” he says.
“Many people think that the tick carrying Lyme disease is a different species to the one commonly found on sheep, cattle and the family dog. It is very important to be aware that it is precisely the same species (Ixodes ricinus). Anywhere up to 20% of the ticks on your farm or surrounding countryside will carry Borrelia bacteria, the infective agent that causes Lyme disease.”
Tick bite and infection
Healy explains that both the tick itself, as well as the Borrelia bacteria it carries, have evolved very clever survival strategies.
“Ticks climb on to grass stems, heather etc, and wait for a passing animal – a possible host. They are attracted to CO2 (carbon dioxide) from the breath and body of an animal or human, and grab the opportunity to cling to any skin or fur they come in contact with.”
The tick needs a blood feed to survive so it secretes an anaesthetic into your skin so that you may not know you’ve been bitten.
“It is quite possible that a tick might attach behind a person’s knee, for example, feed for several days and then drop off without the victim being aware they’d been bitten,” he says.
The infection, if the tick carries it, goes into the person’s blood stream from the bite site and may attack several organs.
“A red, circular rash – a bull’s eye ring – is the main diagnostic indicator of infection. It usually appears within a few days of a person being bitten, but only 80% of those who develop Lyme disease will get the rash.”
Difficult diagnosis
Diagnosing Lyme disease can be very difficult, he adds.
“One reason is the possible absence (20% chance) of the bull’s eye rash. A second reason is that when a person is bitten by an infected tick they may, in fact, receive a nasty cocktail of three related species of the Borrelia bacteria.
“Each of these can cause slightly different symptoms. One patient might complain of numbness or pins and needles while another might mention joint pains. A third might say they have a severe flu.
“This adds to the problems of diagnosis for over-worked rural GPs who may not yet be familiar with Lyme disease. Delayed diagnosis is very significant as it is now known that this delay can seriously reduce the success of antibiotic treatment.”
Lyme disease can often go undiagnosed or misdiagnosed as well.
“This leads to distress for victims as they don’t get the required support.”
Tough bug to tackle
The Borrelia bacteria is a tough bug to deal with, he adds.
“It goes through active phases and dormant phases, during which antibiotics may be ineffective.
“Early diagnosis and treatment are key and treatment with antibiotics is generally effective when an early diagnosis is made. Standard practice among doctors in continental Europe is for Lyme disease to be considered a possibility in tick-infested areas. This would include a considerable part of Ireland.”
How to prevent a bite
So should we all be terrified of spending time outdoors?
“If you follow a few simple tips, you can reduce your risk of contracting Lyme disease to near zero,” Healy says.
“Awareness is key to avoiding the disease.”
Dr Healy suggests the following tips when out walking in risk areas:
• Wearing long sleeved clothing.• Don’t wear shorts.• Use insect repellent. • Wearing light-coloured clothes as it is easier to see ticks on these.350 cases a year
“We have a fairly accurate estimate of the number of positive cases of Lyme occurring in the Cork/Kerry area,” he says.
“If we extrapolate those figures out to the whole country, you get a figure of over 350 cases per year in Ireland or eight cases per 100,000 of population. This is consistent with continental Europe figures and is considerably higher than the 13 cases of the narrowly-defined neuroborreliosis which the Health Protection Surveillance Centre (HPSC) state were reported in Ireland in 2013.”
what to check
• Check your own and your children’s skin carefully after being out for the day in woodland, forest, or near rocky outcrop, rough ground or long grass areas. Don’t rely on children to do it themselves.• Discourage children from going into knee-high vegetation in forest parks. Stick to the paths.• If there is a tick, remove with a tweezers.• Dab with antiseptic.• Photograph the tick if possible and record the date and where you were bitten.• If there is a bite, check the site every day and if there is any sign of flu-like symptoms or a red weal widening around the site then consult your doctor. Note: The Ixodes ricinus tick can look different on grass, ranging from grey to reddish-backed, depending on the stage of its life cycle.
You can be bitten by tick larva (1mm), nymph (2mm) or an adult tick (6 mm) – all life stages of the same species. The nymph is the most dangerous as a high percentage tend to be infected and can go undetected on skin because of their small size.
See www.hpsc.ie to download a leaflet about Lyme Disease.
Case study one
Charles is 37 and a farmer from the north-west. He doesn’t know what exactly he was bitten by but he has had the bull’s eye rash twice.
“I got it on my arm in my 20s and thought it was ringworm but a week later it was gone so I didn’t go to my GP. Looking back, I got bouts of sickness for about three weeks of the year, every year. Seven years ago I got the bull’s eye rash again, this time on my thumb. It was red on the outside, a wee bit like ringworm, and then it faded away.
“As time went on, I had to give up my part-time job in construction and farming was difficult too because I felt exhausted all the time. I went to all sorts of doctors and healers but got nowhere. Then I heard Ryan Tubridy talking about Lyme disease on the radio one morning and it was like my story was being told. I recognised all my symptoms.
“At one point I was so weak that I could only lift my hand to chest height and I was doing things like dropping spanners. I felt like whatever illness it was, it was taking over my life. I got very upset about it one particular day and it was that day that my wife arrived home with a telephone number for a doctor in a Dublin hospital – a tropical disease expert.
“After a blood test he started me on heavy antibiotics. I’m still on them nine months later. I have had great improvement but I still get very tired sometimes. It’s not a nice disease – everything is affected, even your mind. The simplest of things would annoy you. I’ve changed the way I eat, too, and I’m on supplements from a nutritionist to build me up. I’d say I’m 75-80% of what I should be now.
“I know Lyme disease is getting more common now. In the north-west we have a wild high rate for ticks. As soon as a lamb hits the ground it has to be treated for them.
“With Lyme disease they say that if people are treated early on they’ll do great. Fingers crossed that I’ll get off the antibiotics soon. I’m only young, with a young family. My family was great throughout all of this, especially my wife. Without her I don’t where I’d be now. She was my number one rock.”
Case study two
Clare McCahill picked up Lyme disease in Portugal. She tells us what happened.
“I was diagnosed in Portugal, where Lyme disease is common and recognised. Once I presented at the hospital, 10 days after being bitten, with the symptoms – the fever and the bull’s eye rash – I was diagnosed immediately.
“Initially I didn’t know what was wrong with me. I thought it was a flare up from being bitten by mosquitoes. I was very ill that first week, with a high temperature and delirium.
“I had four courses of antibiotics before it came under control. You have to get antibiotics at the right time in the cycle of the bacteria that’s in your blood. If you don’t get them at the right time it doesn’t deal with it. It then goes into another cycle (dormant then active).
“It was a really heavy antibiotic, doxycycline – poxy doxy, I call it. I was so weak that summer – totally fatigued with brain fog as well. Now in 2015 I’m probably 85% of what a normal 48-year-old should be. I still have chronic fatigue and have to pace myself. I have to have a regular routine in order to cope. I was really active before getting Lyme disease but now I’m not.
“In Portugal I heard people talk about tick fever but I thought it was something sheep and cattle got. I didn’t think humans got it or that it was serious.
“Only that Chris, my partner, remembered reading an article in a magazine about Lyme disease, we might not have known. It’s very important that people know about Lyme disease and watch out for ticks.”
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