1. Is there any way, apart from asking/observing those who have been out in the terrain, of knowing whether an area has a low, medium or high risk of ticks?
- No, is the short answer. There has not been enough research into ticks and lyme disease. Most of the evidence is anecdotal. He says it is not taken seriously due to supression and political bias and fear of a floodgate effect with potential mass hysteria and the economic impact with disasterous effects on trade and tourism.
2. What is the Lyme disease to tick incidence? ie does it depend on the area, or is one in (say) 20 ticks infected everywhere.
- In areas in US (eg. Texas) the incidence is really low at around 2% of ticks carrying borrelia, however in others (eg. conneticut and especially around Plum Island) it is 100%. They believe that it is almost 100% in the UK too.
3. Are there any precautions one can take to prevent getting ticks (apart from not orienteering of course!)?
- When I explained how frequent Orienteers get ticks he was horrified and says that he would treat everyone who had a tick in-situ for over 6hrs
and if a piece remained after removal. (I would expect most of us find ticks the next day, even after a thorough search!) I think all we can really do is wear full body cover, smear vaseline around the edges of our exposed skin/clothing interface, and change ASAP after your run and get a friend in the car park to check your skin too. Also, use an o-tom tick removal device, so that the body isn't squeezed during removal.
4. Is there any prophylactic intervention measure available for Lyme disease(eg tablets, injections, immunisations?)
-No! There was a vaccine used in the US in the '90s, however the Borrelia spirochete mutated so quickly that the vaccine was useless within 2 years. He stated it was the cleaverest bacteria on the planet and even uses "stealth pathology" to combat our immune system; if a white blood cell attacks it, it can use the white cell's membrane as a cloak to hide from the rest of the immune system.
5. Should one always expect visible or other symptoms, or can the disease be "invisible"?
If it can be invisible, should one do anything if ticks are found? or only if symptoms occur?
- Lyme disease is a CLINICAL DIAGNOSIS, so symptoms are the only thing that doctors should rely on. The Western Blot and ELISA blood tests may be negative, but if the patient has the symptoms then they should still be treated. If you have symptoms and go to your GP remind him of this, and the treatment is usually either oxytetracycline 500mg tds for 4 weeks, or doxycycline 100mg bd for 4 weeks or augmentin 625mg tds for 4 weeks. If the person has neurological symptoms then they should be admitted to hospital to get 3 months of i.v. ceftriaxone. NEVER LET YOUR GP GIVE YOU STEROIDS FOR LYME DISEASE.
6. What is the latest information that can be given to all orienteers about how to detect Lyme disease.
-Look out for erythema migrans type rash(do a google search) around any tick bite, and if you feel any serious lethargy or muscle aches etc following a tick bite then see your GP.
7. Does it reduce the risk if the ticks are removed soon after becoming attached (and if so, how soon to make a difference)?
- Try and remove ASAP. See above.
8. Is the disease caught from bigger, mature ticks only (i.e. they have bitten already and taken on the bacteria) - if so does that mean 'virgin' ticks do not carry the bacteria ?
i.e no need to worry about the insy winsy tiny little ones that have never bitten anyone (assuming that size is a reliable indicator),
Is it possible to assess risk from the size of the tick ?
or am I talking rot ?
-LIFE CYCLE
The tick (Ixodes ricinus) is a tiny spider-like creature whose appearance changes with the different stages of its life cycle. The cycle includes three feeding sessions, usually over a three year period. However, in some areas, mild winters and cool summers can modify what is described here.
Year One
Females deposit several thousand fertilised eggs in soil crevices. By the summer, the eggs have hatched in larvae, which remain inactive in the shelter of leaf litter until the following spring. It has been shown that ticks may be brought into the home and lay eggs. Regular vacuum cleaning should remove them.
Year Two
In the spring, the larvae become active, climb up vegetation and wait to attach themselves to their host, usually a small mammal such as a field mouse or vole, for a blood meal. After the feed, the larvae fall to the ground, moult into the nymph stage and remain inactive until the following spring.
Year Three
In the spring, the nymphs become active again and have a blood meal. This may be on a mouse/vole or a larger animal such as a rabbit or hare. After the feed, the nymph falls to the ground to mature into the adult stage. Adults emerging in the Autumn or, more usually, the following spring, climb up the vegetation and attach and feed on a passing host (commonly a deer, but also sheep, horses or dogs.) Mating may then take place on the host; the male dies and the female drops off. The female then lays her eggs to complete the life cycle.
Infection of the tick takes place during one of the blood meals, at which, the tick may acquire or transmit the spirochaete Borrelia burgdorferi (the cause of Lyme Disease) to the host animal . The ticks can also be born with the infection.
Lyme Disease is usually transmitted to humans by infected nymphs (during year three of their life cycle,) when they bite people. In the nymph stage, the ticks are quite small and will not be felt on the skin. Lyme Disease can also be transmitted by infected adult ticks to human beings when they emerge looking for larger hosts. As the tick feeds, it swells with the blood of the host and becomes more obvious on the skin.
9. Is there a list of centres of expertise, or expert doctors across the UK ? I'm not sure most GPs take it seriously.
-No
10. Any latency to detecting the bactiria ? (I know one Edinburgh victim who had classic symptoms and got the blood test - proved negative, so didn't get treated straight away.) Anything we can say to get a treatment - given apparent symtoms but no positive blood test ?
11. Where do ticks get the bacteria from ?
12. When would be best to get a precaustionary test ? October ? November (some time after the biting season )
-SEE ABOVE
13. Do you have any immunity having had the disease in the past?
-Yes. There is evidence that you can only get Lyme Disease 3 times and then you have built up such an immune response that you are immune.
Other interesting info:
- 98% of people with ME/CFS have Borrelia in their blood.
- 85% of brain tissue sample taken from Alzheimer's patients(post-mortem) contain a transfective piece of borellia gene spliced into the human's chromosome 11.
-You can get ticks at any time of the year, not just in the summer. Maybe we get less in the winter due to the brachen being lower.
