Case scenario:

A 28-year-old man, who spent the previous weekend camping in the New Forest, has recently developed a rash. He did find and remove a live tick from his left leg on the Sunday evening. He had a mild fever but is otherwise well. He has no past medical history of note and is not taking any medication. He is worried about Lyme disease.

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References

• CDC - Centers for Disease Control and Prevention, 2016. Signs and Symptoms of Untreated Lyme Disease.
• ECDC - European Centre for Disease Prevention and Control, 2016. Factsheet about Borreliosis
• Lyme Disease Action. Information about ticks. [accessed August 2020] 
• Lyme disease Action. Spirochetes and Borrelia. [accessed August 2020] 
• MedlinePlus, 2018. Lyme disease. 
• Cook MJ, 2015. Lyme borreliosis: a review of data on transmission time after tick attachment. Int J Gen Med. 8: 1–8. 
• Millins C, et al, 2016. Heterogeneity in the abundance and distribution of Ixodes ricinus and Borrelia burgdorferi (sensu lato) in Scotland: implications for risk prediction. Parasites & Vectors, 2016, 9, 595.
• NICE NG95, 2018. Lyme disease.
• Public Health England, 2018. Lyme disease: guidance, data and analysis.
• Stanek G, et al, 2012. Lyme borreliosis. Lancet. 2012 Feb 4;379(9814):461-73. doi: 10.1016/S0140-6736(11)60103-7. 
• US Department of Health and Human Sciences, Centers for Disease Control and Prevention. Lyme disease: What you need to know. [accessed August 2020]