Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales

Emma L. Gillingham; Jessica L. Hall; Richard J. Birtles; Kevin J. Bown; Jolyon Medlock; Robert Smith; Kayleigh Hansford; Jenny C. Warner; Matthew Dryden; Maaike E. Pietzsch

doi:10.1111/zph.12694

Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales

Emma L. Gillingham^*, Jessica L. Hall, Richard J. Birtles, Kevin J. Bown, Jolyon Medlock, Robert Smith, Kayleigh Hansford, Jenny C. Warner, Matthew Dryden, Maaike E. Pietzsch

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Lyme borreliosis (LB) is a tick-borne disease caused by Borrelia burgdorferi sensu lato complex. In Europe, it is predominately transmitted by the sheep tick, Ixodes ricinus. Compared with other European countries, the United Kingdom (UK) is considered to have a low incidence of LB, although this varies regionally. To determine whether an association exists between tick bite consultations and LB incidence in the UK, retrospective questionnaires were sent to general practitioners (GPs) in high (Wiltshire), medium (Cumbria) and low (Wales) incidence areas. During 2011, the greatest incidence of consultations for tick bites was reported by GPs in Cumbria (204 consultations per 100,000 inhabitants), followed by Wiltshire (160 per 100,000 population) and Wales (54 per 100,000 population). In Wiltshire and Cumbria, GPs predominantly provided advice on tick removal, whilst Welsh GPs mostly advised patients on tick bite prevention. Focusing on Cumbria during 2011–2013, 72.5% of GPs removed ticks from patients (incidence of 101 consultations per 100,000 population), and more GPs diagnosed LB based on clinical features than laboratory-confirmed diagnoses. To date, this is the first study to investigate the incidence of tick bite consultations and LB in England and Wales.

Original language	English
Pages (from-to)	591-599
Number of pages	9
Journal	Zoonoses and Public Health
Volume	67
Issue number	5
DOIs	https://doi.org/10.1111/zph.12694
Publication status	Published - 1 Aug 2020

Bibliographical note

Funding Information:
We thank the GPs from Wiltshire, Cumbria and Wales who responded to questionnaires, as well as Francis Senyah in the GIS team at Public Health England for assistance in accessing GP population data. We also thank Ben Cull, Amanda Semper and Steve Leach for comments on a previous version of the manuscript. JLH was funded by a scholarship from Merial. JMM is partly funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections at the University of Liverpool in partnership with PHE and Liverpool School of Tropical Medicine. JMM is based at PHE. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or Public Health England.

Publisher Copyright:
© 2020 Crown copyright. Zoonoses Public Health © 2020 Blackwell Verlag GmbH

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

Borrelia burgdorferi sensu lato
GP
Ixodes ricinus
UK
incidence
tick-borne infection

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/zph.12694

Cite this

Gillingham, E. L., Hall, J. L., Birtles, R. J., Bown, K. J., Medlock, J., Smith, R., Hansford, K., Warner, J. C., Dryden, M., & Pietzsch, M. E. (2020). Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales. Zoonoses and Public Health, 67(5), 591-599. https://doi.org/10.1111/zph.12694

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title = "Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales",

abstract = "Lyme borreliosis (LB) is a tick-borne disease caused by Borrelia burgdorferi sensu lato complex. In Europe, it is predominately transmitted by the sheep tick, Ixodes ricinus. Compared with other European countries, the United Kingdom (UK) is considered to have a low incidence of LB, although this varies regionally. To determine whether an association exists between tick bite consultations and LB incidence in the UK, retrospective questionnaires were sent to general practitioners (GPs) in high (Wiltshire), medium (Cumbria) and low (Wales) incidence areas. During 2011, the greatest incidence of consultations for tick bites was reported by GPs in Cumbria (204 consultations per 100,000 inhabitants), followed by Wiltshire (160 per 100,000 population) and Wales (54 per 100,000 population). In Wiltshire and Cumbria, GPs predominantly provided advice on tick removal, whilst Welsh GPs mostly advised patients on tick bite prevention. Focusing on Cumbria during 2011–2013, 72.5% of GPs removed ticks from patients (incidence of 101 consultations per 100,000 population), and more GPs diagnosed LB based on clinical features than laboratory-confirmed diagnoses. To date, this is the first study to investigate the incidence of tick bite consultations and LB in England and Wales.",

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author = "Gillingham, {Emma L.} and Hall, {Jessica L.} and Birtles, {Richard J.} and Bown, {Kevin J.} and Jolyon Medlock and Robert Smith and Kayleigh Hansford and Warner, {Jenny C.} and Matthew Dryden and Pietzsch, {Maaike E.}",

note = "Funding Information: We thank the GPs from Wiltshire, Cumbria and Wales who responded to questionnaires, as well as Francis Senyah in the GIS team at Public Health England for assistance in accessing GP population data. We also thank Ben Cull, Amanda Semper and Steve Leach for comments on a previous version of the manuscript. JLH was funded by a scholarship from Merial. JMM is partly funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections at the University of Liverpool in partnership with PHE and Liverpool School of Tropical Medicine. JMM is based at PHE. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or Public Health England. Publisher Copyright: {\textcopyright} 2020 Crown copyright. Zoonoses Public Health {\textcopyright} 2020 Blackwell Verlag GmbH Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

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AU - Birtles, Richard J.

AU - Bown, Kevin J.

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AU - Warner, Jenny C.

AU - Dryden, Matthew

AU - Pietzsch, Maaike E.

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N2 - Lyme borreliosis (LB) is a tick-borne disease caused by Borrelia burgdorferi sensu lato complex. In Europe, it is predominately transmitted by the sheep tick, Ixodes ricinus. Compared with other European countries, the United Kingdom (UK) is considered to have a low incidence of LB, although this varies regionally. To determine whether an association exists between tick bite consultations and LB incidence in the UK, retrospective questionnaires were sent to general practitioners (GPs) in high (Wiltshire), medium (Cumbria) and low (Wales) incidence areas. During 2011, the greatest incidence of consultations for tick bites was reported by GPs in Cumbria (204 consultations per 100,000 inhabitants), followed by Wiltshire (160 per 100,000 population) and Wales (54 per 100,000 population). In Wiltshire and Cumbria, GPs predominantly provided advice on tick removal, whilst Welsh GPs mostly advised patients on tick bite prevention. Focusing on Cumbria during 2011–2013, 72.5% of GPs removed ticks from patients (incidence of 101 consultations per 100,000 population), and more GPs diagnosed LB based on clinical features than laboratory-confirmed diagnoses. To date, this is the first study to investigate the incidence of tick bite consultations and LB in England and Wales.

AB - Lyme borreliosis (LB) is a tick-borne disease caused by Borrelia burgdorferi sensu lato complex. In Europe, it is predominately transmitted by the sheep tick, Ixodes ricinus. Compared with other European countries, the United Kingdom (UK) is considered to have a low incidence of LB, although this varies regionally. To determine whether an association exists between tick bite consultations and LB incidence in the UK, retrospective questionnaires were sent to general practitioners (GPs) in high (Wiltshire), medium (Cumbria) and low (Wales) incidence areas. During 2011, the greatest incidence of consultations for tick bites was reported by GPs in Cumbria (204 consultations per 100,000 inhabitants), followed by Wiltshire (160 per 100,000 population) and Wales (54 per 100,000 population). In Wiltshire and Cumbria, GPs predominantly provided advice on tick removal, whilst Welsh GPs mostly advised patients on tick bite prevention. Focusing on Cumbria during 2011–2013, 72.5% of GPs removed ticks from patients (incidence of 101 consultations per 100,000 population), and more GPs diagnosed LB based on clinical features than laboratory-confirmed diagnoses. To date, this is the first study to investigate the incidence of tick bite consultations and LB in England and Wales.

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Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales

Abstract

Bibliographical note

Keywords

UN SDGs

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