3 ms·

I have a friend who got a tick bite on holiday in America many years ago. Turns out they got Lyme disease but no doctors in the UK were experienced with it so t

by afavour 2mo ago

I have a friend who got a tick bite on holiday in America many years ago. Turns out they got Lyme disease but no doctors in the UK were experienced with it so they dealt with years of misdiagnosis. I really hope any education effort can get out ahead of that.

dofm 2mo ago
Yeah. I think we simply did not see it enough and to be honest far too few doctors ask the "have you travelled" question about unusual disease. It is better now, but I think the "could it be?" thought doesn't occur because the incidence has been low. There is a more severe risk around rabies. We basically do not have it in the UK or Ireland; it has been eliminated for over a century except a tiny incidence of a virus in the same family in bats. But because we have essentially eradicated it, doctors do not often think to ask about it, even in people who have travelled, which led to someone suffering awfully last year. And since a dog bite or even a fox bite in the UK or Ireland carries literally zero risk of rabies, those who are bitten or scratched while travelling abroad do not have it uppermost in their mind.
- rnvannatta 2mo ago
  The 'have you traveled' question is much less useful with Lyme disease, because it takes potentially years to kick in. It's still important to ask, but it's not going to be surefire for Lyme disease.
deleted 2mo ago
[deleted]
KellyCriterion 2mo ago
Thats interesting, since there is a lot of research around face palsy & recovery in UK.
- _puk 2mo ago
  Yep. About 20 years ago my gran got to the facial palsy stage of Lyme's before it was even considered and diagnosed by a visiting locum doctor who'd grown up in another country. Antibiotics were given, her face recovered (albeit slowly). It's a horrendous disease.
  - KellyCriterion 2mo ago
    May I ask: Did the muscles on the side of the face with the affection also restore or does she have an muscle-atrophy until today on that side?
    - _puk 2mo ago
      The muscles came back over time. She had a droopy face that side for probably a year. But eventually you couldn't notice
throw93949990 2mo ago
Publicly founded health systems are terrible whe. dealing with Lyme disease. It is impossible to simply and clearly diagnose, and separate ill people from "simulants". Something like "back pain" ormother chronic illnesses.
- dofm 2mo 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.
  - nephihaha 2mo ago
    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.)
    - dofm 2mo ago
      > 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.

by afavour 2mo ago

dofm 2mo ago

Yeah. I think we simply did not see it enough and to be honest far too few doctors ask the "have you travelled" question about unusual disease. It is better now, but I think the "could it be?" thought doesn't occur because the incidence has been low. There is a more severe risk around rabies. We basically do not have it in the UK or Ireland; it has been eliminated for over a century except a tiny incidence of a virus in the same family in bats. But because we have essentially eradicated it, doctors do not often think to ask about it, even in people who have travelled, which led to someone suffering awfully last year. And since a dog bite or even a fox bite in the UK or Ireland carries literally zero risk of rabies, those who are bitten or scratched while travelling abroad do not have it uppermost in their mind.

rnvannatta 2mo ago
The 'have you traveled' question is much less useful with Lyme disease, because it takes potentially years to kick in. It's still important to ask, but it's not going to be surefire for Lyme disease.

deleted 2mo ago

[deleted]

KellyCriterion 2mo ago

Thats interesting, since there is a lot of research around face palsy & recovery in UK.

_puk 2mo ago
Yep. About 20 years ago my gran got to the facial palsy stage of Lyme's before it was even considered and diagnosed by a visiting locum doctor who'd grown up in another country. Antibiotics were given, her face recovered (albeit slowly). It's a horrendous disease.
- KellyCriterion 2mo ago
  May I ask: Did the muscles on the side of the face with the affection also restore or does she have an muscle-atrophy until today on that side?
  - _puk 2mo ago
    The muscles came back over time. She had a droopy face that side for probably a year. But eventually you couldn't notice

throw93949990 2mo ago

Publicly founded health systems are terrible whe. dealing with Lyme disease. It is impossible to simply and clearly diagnose, and separate ill people from "simulants". Something like "back pain" ormother chronic illnesses.

dofm 2mo 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.
- nephihaha 2mo ago
  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.)
  - dofm 2mo ago
    > 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.