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The management of Lyme disease

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The classic erythema migrans rash seen in Lyme dis The classic erythema migrans rash seen in Lyme disease is often described as resembling a bull’s eye

Lyme disease, or Lyme borreliosis, is an infectious disease caused by the spirochaete bacteria Borrelia burgdorferi.

Lyme disease is a zoonosis. Small mammals and birds carry the bacteria and transmit it to feeding larvae and nymphs of the Ixodes tick. Adult ticks feed and reproduce on a variety of larger mammals. Humans may become infected if bitten but are regarded as ‘end hosts’.

Ticks are not insects; they are arachnids and resemble small spiders. They survive in the type of humid conditions found in woodland, moorland and some urban parks and gardens, and may be brought indoors on pets or clothing.

The disease is spread by infected ticks, and B burgdorferi is usually transmitted to humans by nymph or adult ticks. Nymphs are the most likely to transmit infection. They are very small (about the size of a poppy seed), and are likely to be missed. Only one in three people who develop Lyme disease notice a tick bite.

Lyme disease is the most common vector-borne disease in the northern hemisphere and is now considered endemic throughout the UK.

The nurse may be the first healthcare professional a patient asks for advice following a tick bite or with a tick attached to their skin.

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