19 August 2012
Thousands of Scots at Lyme disease risk due to poor public awareness and lack of data
A rapidly increasing number of Scots is
being exposed to the danger of contracting Lyme disease from infected
tick bites. And poor public awareness, a lack of scientific data and
ineffective technologies for tick removal mean that, without further
intervention, the number of cases of the disease could continue to rise
significantly in the years ahead.The warning has been issued by Xeroshield, a Roslin-based life sciences company behind a major new study of ticks and Lyme disease in Scotland, due for completion later this year. As part of the study, more than 1,000 members of the public have so far responded to an online survey with almost two in three describing the level of public information currently available about ticks and Lyme disease as ‘inadequate’ or ‘non-existent’.
The survey also reveals a generally poor level of understanding about how to deal with ticks once bitten, with many people putting themselves at greater risk of infection by resorting to inappropriate techniques to remove ticks from their skin. These include using fingers or a naked flame, or covering the tick with petroleum-based products.
Xeroshield has warned that the number of confirmed cases of Lyme disease in Scotland, which has risen elevenfold in the past decade to more than 300 in 2010, is likely to be masking a much greater problem. The company highlights recent research by the University of Bristol which found one in 200 dogs in the UK to be carrying ticks infected with Lyme disease, suggesting that at least 2,500 Scottish dog-owners could be exposed to Lyme disease each year, with many more from dog-free households equally at risk.
Xeroshield has also drawn attention to a major evaluation of manual tick removal devices for cats and dogs conducted by veterinarians in 2006[1]. The evaluation found that even the most effective mechanical devices available on the market only removed the entire tick in 20-30% of cases. In the remainder of cases, the tick’s mouthparts would be left in the skin, leaving the host exposed to potential infection with Lyme disease.
Xeroshield is working on the development of a tick removal device for humans and pets that it anticipates will be significantly more effective than any of the mechanical devices currently available. Funded by the UK Technology Strategy Board, Xeroshield’s current study is contributing to plans by the company to develop the device, combined with a laboratory service for the detection of Lyme disease in ticks collected and immobilised using the device.
Lyme disease is a tick-borne illness which, without prompt treatment, can cause debilitating long-term human health problems including nervous damage and psychological alterations. Ticks are prevalent in Scotland and most commonly found in wooded or bushy areas or amongst heather and bracken. They attach themselves to the skin of a host and feed on its blood. Ticks infected with Lyme borreliosis can transmit the disease to their host during the feeding process.
The increasing popularity of outdoor pursuits in Scotland’s great outdoors is exposing a growing percentage of the Scottish population to tick bites and Lyme disease. The current strategy for dealing with Lyme disease in Scotland is focused on raising public awareness of the danger of tick bites and providing information about precautions to prevent being bitten and how to remove ticks safely. But the results of Xeroshield’s public survey suggest many people at high risk of being bitten are not accessing public information and are generally unaware of the dangers.
Despite the huge rise in confirmed cases, responding to recent questions tabled in the Scottish Parliament, the Scottish Government has confirmed it currently has no plans to commit additional resources towards tackling Lyme disease.
In response to a series of Parliamentary questions tabled by West Scotland MSP Margaret McDougall, the Scottish Government also confirms that there is currently no data available to indicate what percentage of the tick population in Scotland is infected with Lyme disease. Xeroshield believes that the laboratory testing service it is seeking to develop could provide a suitable sample to be able to predict accurately the prevalence of Lyme disease in Scotland’s tick population in the future.
Margaret McDougall MSP commented:
“I find the significant rise in Lyme disease concerning, and Xeroshield’s public survey confirms that the public generally don’t know how to access information on the dangers of Lyme disease and many are unaware how to safely remove a tick. There is a surprising lack of high quality data available on this issue and I am concerned that a full picture of the distribution of ticks that carry Lyme disease in Scotland is unknown.
“I welcome Health Protection Scotland’s review into the latest trends in confirmed cases, which recommended more effective reporting and better quality data to be produced.
“But more needs to be done to make sure the public is properly informed about the dangers of Lyme disease and how to remove ticks safely, particularly when we are encouraging more people to exercise outdoors. The work Xeroshield is doing to highlight this issue and to develop technologies for even safer tick removal is to be commended.”
Xeroshield Managing Director Dr. Bruce Alexander said:
“The preliminary results of our public survey demonstrate that people are generally dissatisfied with the amount of public information currently available about the danger of tick bites and Lyme disease. They also show that a large number of people have inadequate or inaccurate information about how to deal safely with a tick once they’ve been bitten – and even the best devices currently available for removing ticks are far from 100% effective. These factors are combining to put many thousands of Scots’ health at risk and there’s clearly much more work for the Scottish Government to do to educate the public about the dangers.
“It’s even more shocking to realise that we don’t know what percentage of the tick population is actually carrying Lyme borreliosis. What is also clear from the latest research is that the total number of people affected by Lyme disease is being significantly and consistently underestimated.”
Dr. Alexander concluded:
”Xeroshield is now seeking funding to help us progress our proposed tick removal device and laboratory testing service to the next stage of development. With modest funding, we are confident we can develop a device which is significantly more effective than the best tick removers currently on the market. As well as helping to ensure rapid and accurate diagnosis and treatment of people affected by Lyme disease, our proposed testing service would also be able to offer a potentially valuable public service in collating accurate data about the percentage of ticks infected with the Lyme borreliosis organism.
“We believe that information is vital to enable the Scottish Government and Health Protection Scotland to develop an effective strategy for tackling this disease in the future.”
Anyone interested in contributing to Xeroshield’s study can still access the online survey by visiting www.xerolyme.wordpress.com.
ENDS
Notes to Editors1. The Annual Report of the Chief Medical Officer 2010, published by the Scottish Government on the 14th December 2011, provides data from Health Protection Scotland which shows there were 308 reported cases of Lyme disease in Scotland in 2010, an elevenfold increase on the 28 cases of the disease reported in 2001: http://www.scotland.gov.uk/Publications/2011/12/14120931/0
2. The number of cases of Lyme disease reported annually in countries around Europe ranges from less than 20 in Central Italy to as many as 24,000 in Austria.
3. The Annual Report states: “One concerning trend in zoonoses, i.e. diseases that can be transmitted from animals to humans, is that shown by the increase in Lyme disease, a tickborne disorder. The rise cannot be accounted for purely by changes in laboratory protocols or in the number or demographics of patients tested. Variations in climatic conditions and alterations in clinical presentations may have contributed to this continuing rise year on year. This is also likely to be impacted by improved recognition and clinical suspicion”.
4. Commenting on the Annual Report, Chief Medical Officer Sir Harry Burns said: ““the rise in the number of new cases of tuberculosis, HIV, hepatitis C, campylobacter infection, gonorrhoea, Chlamydia and Lyme disease demonstrates the continuing need for action on the underlying reasons as to why people are falling ill with these conditions, our management responses to such threats and on the prevention of onward transmission of infection from them”.
5. On the 25th January 2012, the School of Biological Sciences at the University of Bristol published the findings of a survey of pet dogs in Scotland, England and Wales, which showed that, at 0.5% or 481 infected ticks per 100,000 dogs, the prevalence of ticks infected with Lyme disease in the dog population may be much higher than previously thought. Consequently, it was concluded that the percentage of ticks in the UK infected with Lyme borreliosis and the corresponding risk to humans is also likely to be much higher than previously believed: http://bristol.ac.uk/news/2012/8176.html
6. Margaret McDougall MSP tabled a series of Parliamentary Questions to the Scottish Government on the subject of ticks and Lyme disease, answers to which were published on the 25th July 2012:
Health and Social Care
Margaret McDougall (West Scotland) (Scottish Labour): To ask the Scottish Executive what information it has made publicly available regarding Lyme disease; how this guidance is issued, and whether it includes details about (a) tick bites and (b) how to remove ticks from the skin.
(S4W-08300)
Michael Matheson: Information about Lyme disease is available on the Health Protection Scotland (HPS) website – http://www.hps.scot.nhs.uk/giz/lymedisease.aspx?subjectid=100.
Also available on the website is a factsheet titled What Do I Need To Know About Ticks and Tick Borne Diseases?. This factsheet includes information on ticks, what diseases they carry, how to prevent being infected and what you should do if you are bitten.
Margaret McDougall (West Scotland) (Scottish Labour): To ask the Scottish Executive what percentage of ticks in Scotland carries Lyme disease and what information it has about the rest of the UK.
(S4W-08301)
Michael Matheson: The percentage of ticks in Scotland which carry Lyme disease is not known. There have been, and continue to be, research studies conducted in Scotland that have investigated aspects of tick ecology and Lyme disease epidemiology. However, in part because of the difficulty in defining and ascertaining precisely where an infectious tick bite occurred, a comprehensive picture of the distribution of ticks in Scotland which carry lyme disease remains largely unknown and unquantified. The Scottish Government does not hold information relating to the rest of the UK.
Margaret McDougall (West Scotland) (Scottish Labour): To ask the Scottish Executive what strategy it put in place regarding the rise in identified cases of Lyme disease that was recorded in the Annual Report of the Chief Medical Officer 2010 and what additional resources it will commit toward the (a) prevention, (b) diagnosis and (c) treatment of cases.
(S4W-08302)
Michael Matheson: In order to contribute to the reduction of Lyme disease in Scotland, Health Protection Scotland (HPS) recently reviewed the latest trends in respect of confirmed cases. This review identified recommendations for further action, including the need for effective reporting and high quality data, upon which informed decisions and future services and intervention planning for Scotland can be based. HPS is currently considering the conclusions of the review.
As there is no immunisation against Lyme disease, prevention depends upon key messages to the public who frequent rural areas. These key messages are issued via Health Protection Scotland’s Tick Fact Sheet and the Health Protection Agency’s seasonal Tick Awareness Week alert, which highlight the importance of preventative measures against tick bites, for those visiting rural areas.
While no additional resource has currently been committed towards Lyme disease, this is subject to review on an ongoing basis.
Margaret McDougall (West Scotland) (Scottish Labour): To ask the Scottish Executive what information it has regarding the annual number of cases of Lyme disease that are misdiagnosed or unreported.
(S4W-08303)
Michael Matheson: Surveillance of Lyme disease in Scotland is based on laboratory identification of Borrelia burgdorferi reported to Health Protection Scotland. As clinical notifications are not included, it is not possible to estimate the number of cases of Lyme disease which are misdiagnosed or unreported.
About Xeroshield
6. Xeroshield is an Edinburgh-based life sciences company dedicated to the development of products and services using innovative technologies for insect control.
7. Originally from Edinburgh, Managing Director Bruce Alexander is an entomologist who has spent many years in Latin America studying the effects of a range of insect-borne diseases and their transmission to humans.
8. Together with his wife Cristina Ayala, a bacteriologist, Bruce established Xeroshield in 2005.
9. Xeroshield’s other projects include the development of a novel textile for use in mosquito nets, a new method to control the mosquito that transmits Dengue Fever and several other technologies for the control of a wide variety of domestic, agricultural and horticultural pests. They currently have links with a number of academic institutions including Heriot Watt and Leeds University in the UK and several others throughout the world.
10. Xeroshield has secured funding from the UK Technology Strategy Board to undertake a proof of market study for the development of an innovative non-mechanical device for the removal of ticks from humans, combined with a rapid turnaround, accurate and reasonably priced laboratory service for the detection of Borrelia spirochete (the bacteria responsible for Lyme disease) in ticks collected and immobilised using this device
[1] Zenner, L., E. Drevon-Gaillot & M.P. Callait-Cardinal (2006) Evaluation of four manual tick-removal devices for dogs and cats. The Veterinary Record, October 14, 2006.
