Thankyou to Jenni Boocock for this great informative and comprehensive reminder about ticks, how to avoid them, what to do if you are bitten, and what to look out for after a bite. Several Bingley Harriers have taken preventative treatment against Lyme in the last couple of years, after being bitten by ticks, and Jenni is still managing the long term impact of Lyme.

At last! We are entering Spring and will soon welcome the Summer. The better weather and longer days makes getting on the trails, moorlands and fells ever more appealing.

It's recommended to check for ticks all year round because ticks are active throughout the year, they can even survive below freezing temperatures, but the highest risk period for getting Tick bites is when they are MOST ACTIVE between March-October with the warmer weather.(1)

The following will be a helpful reminder as to why and where we should check, what symptoms to look out for with respect to Lyme Disease, and ways to prevent being bitten.

I hope the Q&As will help break down the most important risk factors and information, all aimed at making sure we can continue to enjoy exploring wild places, but by having more awareness as we do so.

What is a tick? And are there many in the UK?

Ticks are classed as Arachnids not insects, they are more closely related to (and can be mistaken for) spiders or mites and can be smaller than a poppy seed in the Larva and Nymphal stages. There are 20 different species in the UK alone.
The most common species that affects human health in the UK(alongside dogs and cats), is a Hard Tick called Ixodes Ricinus (known as the Sheep or Deer Tick). See the pictures in the Header.

Why do we want to check for tick bites? And what is Lyme Disease?

The common tick Ixodes Ricinus, is the main vector (carrier) of a bacteria called Borrelia burgdorferi, which causes Lyme disease.
THANKFULLY, NOT ALL TICKS CARRY THIS BACTERIA, therefore not every tick bite will cause Lyme infection.
Lyme Disease occurs when you are bitten by a tick that is carrying the spirochete bacteria, Borrelia burgdorferi, which causes infection in humans, if left untreated it can cause debilitating symptoms and in some cases chronic disease.

Which areas of the UK are these ticks found?

This tick species is widespread across the UK, but the highest concentrations tend to be in grassy, damp, unmanaged habitats, woodlands and moorlands with high deer density, but can be found in any greenspaces including urban parks and gardens.
Suggested hotspots from Tick Surveillance Scheme are: Hampshire, Dorset, East Anglia, North Yorkshire Moors, and the Scottish Highlands.(3)

Where on my body should I check for ticks?

Ticks like to hide! Check all your creases!
They can latch on anywhere, but the common sites tend to be between your toes, sock line, behind your knees, waistline, groin, behind ears, hairline.
A good friend may have to be recruited to check the bits you can't!
Don't forget to check your pets.

What to do if you find a Tick on you?

1. Do not aggravate the tick with sprays/oils/heat, or by trying to bluntly pull them out with your fingers, as this can royally P!%# them off and cause them to vomit any infections they're carrying, and you're more likely to leave the mouthparts in your skin. Remove as promptly as you can with a Tick Twister(Chemists and outdoor shops should stock them). See link on removing ticks https://lymediseaseuk.com/tick-removal/, basically hook under the tick, do not pull, instead twist for 2-3 rotations (clockwise or anticlockwise) and the tick should release. Ideally remove ticks within 24-48hours to reduce transmission of infection. There are techniques using very fine tweezers or dental floss, but they aren't as likely to safely pull out the embedded mouthparts. Try not to squash/burst the body of the tick in the process.

2. Check elsewhere on your body for more ticks and make a mental note of where you removed any from. Taking a photo of the bite location can also help with monitoring changes to the skin in the coming days.

3. Wash the bite area with antiseptic and take a picture of the bite site . Have a shower, if there happen to be any ticks that haven't yet fully attached, this will wash them off and put your clothes on a tumble dry or hot wash to get rid of any hanging around.

4. If you've not managed to remove the tick, then contact your GP, 111 or a Chemist for advice.

5) If you were with other people when you got the tick, let them know so they can check themselves too, alongside checking your dog.

Monitor for symptoms

You're likely to have some reddening of the bite site in the first few days which is a normal histamine inflammatory response, and does not tend to need any medical intervention, but if this continues to get sore, bigger or rash like, then seek medical advice from your GP.
Symptoms of Lyme in the coming days-months can present as: Rash at bite site or elsewhere, not always itchy and can appear between 3days to 3months after, varies in shape and size but the classic Erythema Migrans (EM) rash associated with Lyme, is like a Bullseye/target shape but can look like bruising.

If you do develop an EM rash, this means you have been infected with Lyme, contact your GP and they will want to start treatment immediately. If you don't get an EM rash, its less likely, but not impossible to still have been infected (Only two thirds of people will get an EM rash, so it's important to keep in mind any symptoms you start with in those 3 months after a tick bite, especially if you've had exposure to those high risk areas).

OTHER SYMPTOMS
Below, Lyme Disease UK (LDUK) describe the common symptoms in the early and late stages of Lyme:

EARLY SYMPTOMS: The "Great Imitator"
• Fatigue
• Muscle and joint pain
• Headaches
• Fever and chills
• Neck stiffness
• Nausea
• Digestive issues
• Bull’s-eye rash, known as Erythema Migrans (EM). This is diagnostic of Lyme disease but it isn’t always present.
LATE SYMPTOMS
• Pain and swelling in the joints (inflammatory arthritis)
• Problems affecting the nervous system – such as peripheral neuropathy, paralysis of facial muscles (Bell’s palsy)
• Cognitive problems such as memory issues, word finding difficulties and ‘brain fog’
• Headaches and migraines
• Heart problems – such as inflammation of the heart muscle (myocarditis) or peridcardial sac surrounding the heart (pericarditis), heart block and heart failure
• Inflammation of the membranes surrounding the brain and spinal cord (meningitis) – which can cause a severe headache, stiff neck and increased sensitivity to light
• Disturbed sleep – either too little or too much
• Fatigue and post exertional malaise
• Dysautonomia – dysfunction of the autonomic nervous system causing issues with heart rate, blood pressure etc
• Vision and hearing problems
• Vertigo and dizziness
• Anxiety and depression
(4)

PREVENTION
Carry a Tick Twister on longer runs and/or use repellants known to work against ticks,
"Smidge" is my go to. This year, Lyme Disease UK (LDUK) recommend the product "THEYE" which is Alcohol and Deet free(see LDUK for discount codes for this product and Tick Twisters: https://lymediseaseuk.com/prevention/)
Wear long trousers or longs when running.
Ticks can be sent off to the Tick Surveillance Scheme (TSS) to help map locations and species of ticks (they do not test the ticks for infectious diseases)(3)- see link in references.

TAKE HOME MESSAGES

• Check for ticks especially if you are going to higher risk areas of the country, or Sheep/Deer populated woodlands, fells and moorlands with long grasses and ferns.

• It's important to re-iterate that NOT ALL TICKS CARRY BACTERIA THAT CAUSES LYME, but the best way to prevent possible infection, is to remove the tick correctly and promptly, and monitor for any symptoms within the few months after a bite.

• If you have managed to read this far, thanks! Tick check, spread awareness and keep enjoying the outdoors!

References:
(1)https://www.lymediseaseaction.org.uk/about-ticks/
(2)https://ticksafety.com/tick-identification/international-tick-species/castor-bean-tick/
(3)https://www.gov.uk/guidance/tick-surveillance-scheme#:~:text=UKHSA's%20Tick%20Surveillance%20Scheme%20helps,activity%20and%20their%20host%20associations.
(4)https://lymediseaseuk.com/symptoms/

Thankyou to Jenni Boocock for this great informative and comprehensive reminder about ticks, how to avoid them, what to do if you are bitten, and what to look out for after a bite. Several Bingley Harriers have taken preventative treatment against Lyme in the last couple of years, after being bitten by ticks, and Jenni is still managing the long term impact of Lyme.