Comment by dofm
1 day ago
Nothing really to do with public healthcare. It is literally that there is almost no medical or social experience in the UK of actually seeing developed Lyme disease up close, because it has historically been so unusual, so there are no protocols.
A few thousand cases every year now, when the first indigenous case ever properly recorded in the UK was only in 1986, and it's not like in the USA where really wide areas are high risk. Some of the pockets of highest risk Lyme in the UK are no more than a few miles across.
Nurse stations and pharmacy clinics are great at properly removing ticks if you know you have been bitten, and from there you will now get good advice about Lyme.
But a system that has no endemic experience of Lyme is just not going to test for it. Because it's remote, and people are usually unaware they have been in risk areas, and often unaware they've even been bitten.
1986 is forty years ago. We have Lymes disease in Scotland (I know someone who has it), and a large deer population which has not been properly controlled with substantial remote areas. (Much smaller than the USA but big enough to be reservoirs for the disease.)
> 1986 is forty years ago.
Epidemiologically recent (and also dofm-recent because I'm old).
But the graphs typically show that Scotland ballooned in the last twenty years, from below a hundred a year into the thousands.
Apparently in the UK it is now mostly stable, so it is endemic in deer. Much more common in middle-aged people who are I guess more likely to walk the dog and be keen active gardeners.
In looking this up, I found that keds cannot transmit Lymes, and that many ticks catch Lymes from smaller hosts such as mice, before transmitting it to humans. This raises another issue... If an area is largely owl free (as most cities and open fields are) then that means more rodents and smaller vectors which can provide a reservoir for the infection to spread.
The deer thing is annoying. They have been mostly bred as game animals, and yet they aren't treated as game anymore for the most part so their numbers have exploded.