UKH

https://bigthink.com/health/prevent-lyme-disease/

Still in development but sounds great against the 8 legged little buggers

3-7% survival rate after 24 hrs and 9-11% after 30 days. That's the ticks not the people. It'll probably cost £50 a pill but might get surprised and finds it's actually affordable to use even, if you aren't Sheikh Someone-or-other. 

https://valneva.com/research-development/lyme-disease/

Lyme disease vaccine currently on course for approval in 2026 or 2027. If successful this would destroy the business model £50 a pop pills

Here's hoping. There was a vaccine some years ago (mentioned in the article) but lack of uptake got it canned. 

I’ve an interest in this as one who has been unfortunate enough to get Lymes. Firstly not all tick bites will give you Lymes, it’s estimated that 1 to 4% of bites will result in transmission. That means a lot of wasted £50’s . The way forward is vaccine for those who are at risk IMHO. 

Lotilaner is available for dogs and cats and is in wide use. https://www.noahcompendium.co.uk/?id=-4943&advancedsearch=true&page....  Another isoxazoline has been used for Malaria areas and the concept has been touted more generally.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055183/

https://www.nature.com/articles/s41598-024-56053-x

BUT
What would be the consequences of large amounts of these chemicals going through the sewers and ultimately into water courses with very broad insecticidal and acaricidal effects. A delicate balance. Definitely put your dog poo in poo bags – its not natural with ectoparasite control on board.

Eh? The damned things can undergo resurrection after 24h??! They’re worse than I thought..

As someone who tends to skip merrily* through bracken above her head in shorts in the summer, I would probably shell out for a vaccine - but taking it multiple times seems a bit steep-? 

Tbh I don't trust myself to actually find a tick that quickly, especially when camping. Also it wasn't until a mate got bitten in Canada (and I happened to have both my first aid kit with tick removers, and instructions from a recent first aid course, with me) that I realised you don't necessarily get the bulls eye at the site of the bite. Very impressive Canadian service - rushed off to a minor injuries type place despite being in the middle of nowhere, on a Sunday, given antibiotics - and sent home with instructions to find the actual tick! 

*Not actually skip; save that for the open path 

Unless NaCi has other information, I think £50 per pill was a random number that they made up. I can't see it in the article anywhere 

Thank you. The 50 quid was more a passing comment on the (arguably) inflated cost of medicines. I am unrelated to the pharmaceutical industry in any way so wouldn't have a value to what it will actually cost. 

the pill lasts 30 days in dogs!

Isn't this the same stuff that's been used on dogs forever being approved for people? If they price it silly I'm sure you'll just see a lot of dirtbag climbers with new neckwear.

Ha ha exactly what I was thinking when I read this  

The article was interesting though, until I read it I hadn't realised that it took the tick to be in place for so long -- 36 to 48 hours, for transmission if Lyme disease to be very  likely (although noting: a shorter attachment and plain bad luck could come into play).

This cheers me up that meticulous tick checking and removal can lessen the odds of getting it, even if bitten in known Lyme's areas.

Think the human flea-drop/pill approach still probably has a business model due to anti Vax (presumably this one will have Bill Gate's gene reprogramming Illuminati nano chips like all the rest) so some people will always prefer putting insecticides into their nervous system than prevention by vaccination to remain "pure blood"

There is also the benefit of more ticks dying and also protection from other tick borne diseases too. We would need multiple vaccines to target all the tick borne diseases. 

Killing ticks is good for me!

Although I will definitely take a Lyme's vaccine if one becomes available!

IIRC from what I've previously read, for the first however many hours stuff is going one way; you to the tick; after a while it starts regurgitating back into you as well, that's when transmission of Lyme and whatever else is likely to occur (if the tick is infected). All very pleasant.

I'm one of these people who doesn't seem to get bitten. I've just never seen a tick in the UK but I'm in the Lakes fairly often, definitely in bracken when it's up, and can't believe that I'm just on a run of good luck - there must be something else - maybe I smell bad or whatever.

Snap. I've never found a tick on me despite often moving in areas well frequented by deer. My son often gets them, even in a small eco area in a school playground in NW London. Sceptics would say I've just not spotted them of course.

I believe the regurgitation is normally just before they drop off or when they are 'stressed' (i.e.being pulled out - hence the need to do it quickly and 'neatly').

I had a tick on the back of my leg last year and just scratched at it - then saw just what I'd scratched off.... 

48 hrs later shivering, sweats, aching joints and headaches - flu-like. No bull-ring rash. A couple of days later NHS 111 got me an immediate GP appointment and a blood test on the day, anti-biotics prescribed there and then. It took nearly two weeks to get the results back (from Porton Down - well I never!) and I was positive for early stage antibodies. I was told that the antibodies actually change as the infection progresses. More anti-biotics and a second blood test showed they had nailed it. Everyone at the surgery was really interested - there's only about 1,500 lab confirmed cases per year in England and Wales though that's undoubtedly a big 'under-report'.

I'm intrigued that they bothered testing. My husband and I have both had antibiotics for Lyme's and neither of us were tested. My husband wasn't even seen by the doc (nothing to do with Covid or recent shortages, this was about 8 years ago). He called and described his symptoms to doc, told of recent tick removal, and was told there is as a prescription waiting at reception for him. 

Maybe different practice in English and Scottish NHS? 

It sounds very quick for antibodies to have developed (hence the question over the value of testing)(it can be argued that a negative baseline is useful), which may suggest you'd actually acquired the infection sometime earlier...

(And also your acute illness may have been something else). Also what are usually called bullseye rashes can have multiple causes ..(there is another very distinctive each which may come later).

(NB I'm not saying the antibiotics were not needed, just highlighting the stochastic  nature of the process and difficulty of 'proof'). You can send your tick off...

Andy Say did state that he got the antibiotics prescribed on the same day that he called the NHS.

Your post reads as though it is trying to find fault with the English system, but surely what happened in his case was exemplary, medication prescribed instantly and then a test to confirm that Lyme disease was indeed the problem

Well it would be about 7 days after picking the tick up that my blood was taken for testing and, as I said, the antibody results indicated early stage infection. I DIDN'T have a rash. 

And I'm guessing the reason for the test was a) simple curiosity and b) trying to check whether it WAS something else. Personally I'm quite comfortable with my GP Practice bothering to test rather than simply stuffing me with antibiotics and sending me home.  

Are you suggesting that a blood test that shows positive for Lyme antibodies might actually NOT be indicative of Lyme Disease?

I'd think it's simply good practice to test to try to ascertain the root cause of symptoms as opposed to just prescribing pills with no further investigation.

I could tell you a long story about the saga of my problems with the DPF on my van. It's a £1500 part.  Turns out it was simply a faulty temperature sensor preventing self-cleaning. A £40 part.  Moral: accurate diagnosis is good 😉

From the article cited:

"If a tick bites you, your only hope of avoiding disease is to find and remove the parasite before it can make you sick."

If afraid that is total bull. Studies in Europe estimate that only 1% to 5% of tick bites may lead to Lyme disease. On average, approximately 4% of ticks are infected in England and Wales, though up to 10% has been recorded.

The problem with Lyme Disease is that the test is notorious for giving a false negative. If you have had a tick bite and have symptoms consistent with Lyme Disease, it is still probably wise to be prescribed antibiotics even if the first test is negative*. It is much more easily treated as early as possible.

* this is my simplistic lay-person understanding. I don't know whether it is the guidance in Scotland but I would not be surprised.

I'm in Highland. I've had 4 reactions to ticks over the years, 2 of which had skin reactions 2 didn't. One had a big red blotch, the other a very short lived small bulls eye. 

My GP ordered blood tests for the last couple of encounters in 2022 & 2023. I've been prescribed doxycycline every time without issue. Both the blood tests were negative. My GP surgery takes it pretty seriously as lots of folks get sick with Lyme up here. 

The tests aren't great. According to my GP it can take anywhere up to 6 weeks for you to develop antibodies meaning someone rocking up with a bulls eye from a very recent bite will often test negative. 

A better approach would probably be to test 6 weeks after finishing the antibiotics or if the person has ongoing symptoms. 

Anyone feeling unwell after a bite should just be given the option to take the antibiotics though as catching it early is way better than waiting getting really sick and needing multiple different drugs to treat it. 

Guidance from UK Health Security Agency - "In the UK, Lyme disease is an uncommon infection and can be successfully treated with antibiotics as per National Institute for Health and Care Excellence (NICE) guidelines....If you have a classic bullseye rash, then you should be treated for Lyme disease without the need for a test. If you have a recent tick exposure and symptoms of Lyme disease (but no bullseye rash), guidance to NHS doctors in England is to take a blood sample and send it for testing at an NHS or UKHSA laboratory."

BUT but but....

The widespread use of antibiotics is NOT a good thing. They should be appropriately targeted.

No! (though diagnosis and testing for Lyme disease is quite complex). You describe an evolving antibody response so it is very likely that you had Lyme Disease. What is interesting is that your first blood test (? 7 days after the bite, less than that after onset of symptoms) was showing signs of the infection (and onset of symptoms after 48hours is quick). That is more compatible with you having acquired the infection rather longer ago than the bite you (nearly didn't) notice.  You may have had an earlier bite - perhaps by a smaller (younger) instar, for example - which went unoticed.

I dunno if the GPs in Scotland do things differently or if it's just my GP. I'm just glad my GP practice takes Lyme seriously. 

I appreciate there are issues with antibiotic resistance etc but personally if I've a skin reaction or symptoms I'd rather take the doxycycline than wait and see. My wee brother had systemic Lyme and it ain't nice nor is the treatment to get rid of it. 

Sure- but we're not talking about mechanical parts or sensors and a "Replace x part and y works properly again" so not a particularly relevant fable.

A more fitting way of explaining it would be "It's most likely the £40 temperature sensor so we'll crack on and replace that while it takes a few weeks check to see if it's the £1500 DPF because if we do nothing the DPF could explode and render the whole van incapacitated" (I know that's nonsense mechanically but I hope it makes the point!)

We're talking about progression of a pretty nasty, life changing disease that can be fairly easily sorted if treated early even without a 100% diagnosis.

It's a risk vs benefit thing. The benefits of starting someone with a tick bite and a rash (especially in an area of high Lyme's prevalence ) on treatment early far outweigh the risks from the treatment- and it would be considerably less risky than sitting on our hands waiting weeks for a 100% diagnosis- which we may not even be able to to get- while the disease progresses.

I had a tick bite a few years go. Then flu like symptoms about 4 days after removal. No bullseye. Phoned the doc, they arranged a blood test, it came back negative and that was the end of it.

If what you say is true they took a bit of a risk with me. Turned out all fine in the end, but you know, what if it didn't. In the south east so a bit of a Lyme's hot spot.

Removed one from my son yesterday, we think it must have been there for about 2 days so need to watch him closely now. 

The amount of ticks we get our way, I'd buy the pill.

I think Andy’s ´early stage antibodies’ comment probably relates to the antibodies detected being IgM (antibodies switch isotypes, eg to IgG during the course of an infection). Although, if the samples went to Porton, they may have done something more sophisticated by looking at the immunodominant epitopes being targeted.

Details here if anyone is interested:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849240/#:~:text=As%20the%20an....

Did a Goat, Bull, Tortoise circuit in Lower Eskdale on Sunday. Got back to the car to discover a tick crawling across my trouser leg at thigh height. First one of the year.... perhaps you could share your hygiene regimen with the rest of us...

🤷‍♂️

Like Michael, they don’t seem to like me. There have been trips where everyone else got multiple while covered up and deeted and I got none wearing shorts and flip-flops.

Maybe they think it’s too good to be true, and hence a trap! 🤣

Spot on. And yes, the test was conducted, to my amusement, at Porton Down.  My GP was very informative though he did acknowledge I probably knew more about Lyme Disease than he did 😂

I used to do some patent work at Porton and always enjoyed my visits.  Although I never quite got used to the site security guys carrying submachine guns!

Had a vaccine, two dose for Lyme disease here in Italy, earlier this year. Seemed sensible seeing as most times out in the mountains, either I pick up a tick or the dogs covered in them.

its only just started to be available & only available for forestry workers, guides, outdoor workers etc, had to pay but seemed sensible to me.

Interesting, I didn't think it had got through all the trials yet but that's brilliant if it's starting to be offered to people.

Given how much the wee critters like biting me I'll be happy to pay for it once it is available in the UK.  

I think they also regurgitate after around 12 hours or so, and at similar intervals after that, to enable them to continue feeding without the blood clotting. 

Ti's a good paper.

It skirts around timings rather, but it does support the thought that antibodies (of any sort) appearing that quickly (?5 days of onset of symptoms) is a bit unusual. .eg. fig 1. Anyway, that idea doesn't seem to be wanted.

(I was always intrigued by the Porton Down Security knowing who you were before you got there...)

Yes, always been reminded of that scene in Brazil when I've visited.

"Don't you want to see any identification?"

"No need, sir."

"But I could be anyone."

"No, you couldn't, sir."

They did request ID, of course...

I'd be concerned about TBE too now it's established in the UK. From ECDC:-  "The European subtype is associated with milder disease, with 20–30% of patients experiencing the second phase, mortality rates of 0.5–2%, and severe neurological sequelae in up to 10% of patients. In children, the second phase of illness is usually limited to meningitis, whereas adults older than 40 years are at increased risk of developing encephalitis, with higher mortality and long-lasting sequelae in those over the age of 60."

Just had my third dose of TBE paid for via travel clinic at local pharmacy. We go to places where it's endemic in the summer most years thus figured worth it was well paying for.