Is There Lyme Disease in England?
Lyme disease occurs across England and Wales.
Ticks remain a growing public health concern.
Debate continues over persistent symptoms after treatment.
Is there Lyme disease in England? Yes. Lyme disease is increasingly recognized across the United Kingdom, including England and Wales. However, disagreement continues among researchers regarding the frequency of persistent symptoms following infection.
According to reporting in the BMJ, neurologic Lyme disease in England represents a late complication occurring in approximately one in ten cases. Patients with neurologic involvement appear more likely to report persistent symptoms such as fatigue and difficulty concentrating.
“Those that have confirmed neurological Lyme disease in England—a late complication present in about one in 10 cases—have a higher rate of long-term subjective symptoms, such as fatigue and poor concentration,” writes Harvey.
Debate Over Chronic Lyme Disease in England
Some researchers involved in the discussion questioned how commonly persistent symptoms occur after Lyme disease.
Matthew Dryden, consultant microbiologist for Hampshire Hospitals NHS Trust, suggested that most patients diagnosed with Lyme disease recover without long-term complications. Harvey summarized the view that “in most cases, patients with true Lyme do not develop chronic symptoms,” though the term “true Lyme” was not clearly defined.
The disagreement reflects a broader debate seen internationally: many patients recover after treatment, while others continue to report fatigue, neurologic symptoms, pain, cognitive problems, or reduced functioning after therapy.
Concerns About Treatment Risks
Other clinicians raised concerns about complications associated with prolonged antibiotic therapy.
Sarah Logan, a consultant in the tropical diseases unit at University College London Hospital, described a patient who “contracted an infection from a long-term intravenous line that had been fitted abroad to provide antibiotics for Lyme disease.”
She also noted that some patients developed Clostridium difficile infection or drug-resistant infections after extended antibiotic treatment.
Concerns About Limited Treatment Options in the UK
Critics of these positions note that discussions often focus heavily on treatment risks without fully addressing the risks of untreated Lyme disease or the limited treatment options available to patients in parts of the UK healthcare system.
Some patients seek medical care outside the United Kingdom when symptoms persist after standard therapy.
For additional context, see Why Lyme Disease Tests the Limits of Medicine and Recovery from Lyme disease.
Lyme Disease Risk in England
Regardless of differing opinions regarding persistent symptoms, ticks remain a significant concern in England.
As Tim Brooks, clinical services director at Public Health England’s rare and imported pathogens laboratory, explained, “You’re just as likely to contract Lyme disease in your back garden as you are in the countryside.”
Approximately 1,000 laboratory-confirmed Lyme disease cases are reported annually in England and Wales. In addition, an estimated 2,000 cases are treated in primary care each year without positive laboratory testing.
These numbers suggest that Lyme disease remains an important public health issue throughout the United Kingdom.
Clinical Takeaway
Lyme disease in England is real, increasingly recognized, and sometimes associated with persistent symptoms following treatment.
While opinions differ regarding the interpretation of chronic symptoms, the ongoing debate helps explain why some patients continue to seek additional evaluation and treatment when recovery does not follow the expected course.
Related Articles
- Infected ticks prevalent in urban areas in the United Kingdom
- Patients can die when Lyme carditis is not treated
- High number of Lyme disease diagnoses through the winter in England
Reference
- Harvey A. Lyme disease: chronic illness is rare, say experts. BMJ. 2019 Oct 10;367:l5975.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Even at 1 in 20…. that’s 5%…. 5% of 1000 people is 50 people! That’s lo-balling it too. It makes me angry that so many use Statistically “low” numbers to justify willful ignorance and failure to perform vital research on diagnosis and treatment.
I’ve got neurolyme. I probably had Lyme for well over a decade before treating it. Treated Lyme plus Bartonella & babesia with antibiotics 5 yrs ago and I’m still making progress in returning to a “normal” lifestyle where activity won’t create body pain, fatigue & sever headaches. My neuro-/phsych testing showed I’m in the 5-9% for my age in certain categories. Recovery is very slow & yes, every lab test I did back in 2015 had me CDC positive & I’ve had no other health issues so this all has to be due to the Lyme(+). Even the small fiber Neuropathy & occipital headaches are just part of my recovery efforts.
This sounds like rubbish, given the hundreds of sufferers I’ve met personally. Typical.
This disease is hell. (25+ yrs)
totally agree as a Lyme Recipient I can tell you the U.S has a greater number of Lyme cases annually, that are chronic, and thanks to the big pharma, we’ll never have a cure 🙁
In the USA where Lyme disease has been notifiable since 1991, and where 14 states have yearly incidence (2018 figures) ranging from 7.3 to 63 times higher than England and Wales, the CDC nevertheless admit that it is probable that the true incidence is 10 to 12 times higher than the number of reported cases. This is in a country where many of the population and doctors are alert to the risks, signs and symptoms of the infection.
But in England and Wales, where most doctors have never knowingly seen a case and probably would not know how to recognize most cases, Public Health England (PHE) claim that only half or at most two-thirds of cases go unreported.
That means that PHE claim to detect cases up to 4 times more efficiently than the USA.
Hurrah!
https://www.facebook.com/download/preview/2207622942892196/
And how exactly would they know? I think it’s just guesswork on their part, as they never follow patients up and there is never any meaningful gathering of statistics on these things. Meanwhile, there are over 11000 members of the Lyme Disease UK Facebook group. When I first got Lyme disease in 2016 there were 6000 members this group.