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GPs given help to spot Lyme disease

NICE guidance on rare but treatable condition

Adrian O'Dowd

Monday, 25 September 2017

GPs and other health professionals are being given help in identifying and treating Lyme disease in draft guidance issued today by NICE (National Institute for Health and Care Excellence). 

Lyme disease spreads to humans through an infected tick bite and is estimated to affect as many as 3,000 people a year in England and Wales, according to Public Health England. 

NICE’s draft guidance outlines when doctors can diagnose Lyme disease without the need for tests and when they should investigate further. 

If a person has had a tick bite and a circular red rash, known as erythema migrans, the draft guidance recommends that GPs diagnose and treat Lyme disease with antibiotics. 

Specific tests to help diagnose Lyme disease are also outlined in the draft guidance and these tests, called ELISA and immunoblot, look for antibodies created by the body’s immune system to fight the infection. 

If these tests are negative but unexplained symptoms persist, the draft gudance advises doctors to seek a second opinion from a specialist. 

Doctors should not diagnose Lyme disease just because a person has been bitten by a tick but has no other symptoms, adds the draft guidance. 

Saul Faust, professor of paediatric immunology and infectious diseases at the University of Southampton and chair of the guideline committee, said: “Lyme disease may be difficult to diagnose as people can have common and unspecific symptoms, like a headache or fever, and they may not notice or remember a tick bite. 

“Our draft guidance will give GPs and hospital doctors clear advice on how to diagnose if they think Lyme disease is a possibility.” 

Professor Gillian Leng, NICE’s director of health and social care and deputy chief executive, said: “Lyme disease is easy to treat. However, if left undiagnosed, it can lead to more serious symptoms. This can include heart problems, arthritis and problems affecting the nervous system, for example, weakness on one side of the face. 

“We want people to be diagnosed early so they get the right treatment as soon as possible. This is why our draft guidance makes a clear set of recommendations on when to diagnose Lyme disease, and when to rule it out.” 

Consultation on the advice closes on 6 November.

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