White middle class woman are the most likely to be struck down by Lyme disease, suggests new research.
The potentially deadly bacterial infection has become increasinly common in the UK because of the hot weather, and there’s been a rise in the number of cases in the last 17 years.
Six in 10 cases involved women, with the age groups most at risk being between 61 and 65 and six to 10-year-olds.
The illness develops after being bitten by an infected tick when walking in a grassy area in spring and summer.
The ticks, which attach to human skin, are tiny – some just the size of a poppy seed – so often go unnoticed.
Now the characteristics of victims in England and Wales have been identified for the first time.
Hospital patients are mainly white, female and living in areas of low deprivation, say British scientists.
Lyme disease causes rashes, fatigue and achy, stiff or swollen joints. Other symptoms include headaches, dizziness, fever, night sweats and sleep disturbances – and even cognitive decline.
Most cases are successfully cleared up with antibiotics. But if left untreated it can be life-changing – and even fatal.
Study corresponding author Dr John Tulloch, an expert in zoonotic infections at Liverpool University, said: ‘These data display a predominance of female cases of certain age groups – most of whom identify as white.
‘The reasons for this are hard to explain, but could be related to differences in health seeking behaviour between women and men and an increased exposure to tick habitats due to leisure activities in children and older people, as opposed to occupational exposure in younger adults.’
The study, published in the journal BMC Public Health, was based on information collected from 2,361 hospital patients between 1998 and 2015.
Out of the 1,877 patients for whom ethnicity was recorded 1,803 identified themselves as white.
Dr Tulloch said: ‘The apparent association between ethnicity and Lyme disease is most likely due to sociocultural and behavioural reasons, for example living in areas that are more likely to see a higher abundance of disease-transmitting ticks.’
There was also a steady increase in incidence over time – with cases peaking each August and higher rates in central southern and western England.
The analysis funded by the National Institute for Health Research (NIHR) may inform and help target health promotion messages.
Dr Tulloch said: ‘In the United Kingdom information relating to infected Lyme disease patients’ characteristics, where they live and how they are managed within the National Health Service (NHS) is not fully understood.
‘Through our analysis of NHS hospital data we were able to identify demographic information about Lyme disease patients accessing hospitals for management and treatment and, for the first time, start to describe how they progress through the healthcare system.’
The number of new cases rose from 0.08 per 100,000 people in 1998 to 0.53 in 2015. The exact cause remains unclear, said the researchers.
Factors could include increased awareness by the public and an increase in referrals by family doctors.
Based on geographical information in the health records most infections occurred in the south west of England.
The local authorities with the highest number were Purbeck with 3.13 cases per 100,000 people per year, New Forest (2.58 cases), and East Dorset (2.32 cases).
Lyme disease patients were more likely to live in rural rather than urban areas.
Dr Tulloch said: ‘Almost all parts of England and Wales reported Lyme disease cases attending hospitals with clear hotspots of disease in central southern England.
‘This highlights that while Lyme disease poses a risk across both countries, for the majority of people the risk is likely to be very low.’
The authors also found 30% of Lyme disease hospital admissions in England and 67.6% in Wales originated from the A&E department.
The findings suggest a poor understanding of the recommended care pathways for symptoms related to Lyme disease by the general population.
Dr Tulloch said: ‘It would be unlikely that the numbers of patients admitted in our study have acute/severe presentations of disease that require immediate hospital attendance.
‘Further work is needed to explore why so many patients would seek treatment at a hospital when, for the majority of cases, management could occur at primary care level.’
He added: ‘Being aware of the signs and symptoms of Lyme disease is important so patients can receive early diagnosis and treatment from their family doctor.
‘Symptoms typically develop up to three weeks after being bitten by a tick and include a spreading circular red rash or flu-like symptoms.
‘When patients visit their GP or call NHS 111, it’s important to tell them where patients have been and if they remember being bitten.’
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