Gastrointestinal & Zoonoses

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Gastrointestinal & Zoonoses

Lyme Disease


Lyme disease is caused by infection with Borrelia burgdorferi and is transmitted to humans through the bite of an infected tick. Infection is acquired by immature ticks from infected small wild mammals, which act as a reservoir of the organism. Prolonged feeding (>24 hours) of infected ticks on a human can result in disease. Geographical distribution of the disease in Europe closely follows that of the known range of the tick vectors and ramblers and campers are at increased risk of disease due to their greater exposure to the disease vectors. The true incidence of the disease is unknown due to incomplete detection and reporting of cases, but is estimated to be 0.3 per 100,000 in the UK.

Main clinical features

These follow a tick bite (although this may go unnoticed). A rash develops which usually has the appearance of a reddened circle that expands away from the bite and clears in the centre. The skin may be warm but is not usually painful. Early localised disease may be associated with “flu-like” symptoms of malaise, fatigue, lethargy, headache and joint and muscle aches. Other, more severe, manifestations of the disease include arthritis of large joints, meningitis and myocarditis, all of which may occur without the rash.

Incubation period

Transmission of B. burgdorferi does not take place until the tick has been in place for > 24 hours. The skin syndrome usually occurs within 1 month of the tick bite. Other manifestations may take several weeks or months to develop.


Voluntary laboratory reports.

Tick and tick Borne Disease Factsheet

Annual Surveillance Tables