Why Lyme disease could be coming to a park near you ...Middle East

If you know one thing about Lyme disease, the infection spread by tick bites, it is probably that the biggest risk comes from time spent outdoors in the countryside.

What you may not know is that the bacteria that cause this disease, which can be deadly if left untreated, are also lurking in some parks within towns and cities.

“Ticks can be more common in some of our cities’ urban green spaces than people perhaps realise,” said Dr Sara Gandy, a researcher at the University of Glasgow.

“When you’re just going to walk your dog in your local park by your house, you might not think about ticks. But it’s still good to check.”

The bacteria that cause Lyme disease are carried by ticks, deer and many small mammals.

If someone gets bitten by a tick and doesn’t spot the creature embedded in their skin, the first sign of the disease might be an expanding “bulls-eye” red rash, although this doesn’t always appear.

It can cause flu-like symptoms, followed by joint pains and fatigue. In the long-term, it can lead to brain and heart problems.

The condition was only discovered in the 1970s, in the US town of Lyme, near the East Coast, and the bacteria have been spreading west through America ever since.

In the UK, the condition is still relatively rare, with just a few thousand estimated cases a year. In theory you could be bitten by an infected tick anywhere, but certain areas are higher risk, including parts of southern England, Norfolk, the Lake District, the North York Moors and the Scottish Highlands.

Even in these regions, people are generally thought to be at risk only if they are walking in wooded areas or places with long grass. That needs a rethink, said Dr Gandy.

Her team found ticks infected with Lyme in parks in five of the 16 cities that they investigated (Inverness, Perth, Falkirk, Dunfermline and Scarborough). Previous studies have shown they are present in Bath, Salisbury, Southampton and London.

They also found that the presence of Lyme in city parks was more likely if there was more woodland directly surrounding the cities. The study was published in the journal, Nature Cities.

Flu that never ended

Julia Knight, who works for the patient charity Lyme Disease UK, was bitten by a tick 15 years ago, when she was staying at holiday park in a forest. “After about a month, I started feeling really unwell – sort of fluey but I couldn’t put my finger on it.”

At first, her doctor suspected a brain tumour. Knight ended up being diagnosed with chronic fatigue syndrome and quit her job.

At the time, British doctors were less aware of Lyme disease. It was not until years later that a US doctor recommended she get tested for Lyme, which gave a positive result.

A three-week course of antibiotics led to gradual improvement in her health. She is now almost back to normal, but there is still slight neurological impairment that affects her concentration.

Risk from grey squirrels

Another assumption that may be wrong is whether large numbers of deer need to be in an area for Lyme disease to be present. We may have been overlooking the risk from grey squirrels, said Professor Steven Belmain, an ecologist at the University of Greenwich.

Deer do contribute to high levels of the bacteria, because they are so large that they can support lots of ticks feeding on them. But deer are also immune to Lyme disease. So, a person can only catch Lyme if they are bitten by a tick that has just fed on a small mammal like a squirrel. “It’s the small mammals and birds that are responsible for Lyme disease transmission,” said Professor Belmain.

His team has found that after deer, squirrels are the second biggest food source for ticks. They are carrying out a study to see if the levels of Lyme bacteria in an area can be reduced by giving grey squirrels bait laced with oral contraception.

Squirrels may also be contributing to the spread of Lyme from a city’s surrounding woodlands and grasslands into its parks, he said. “Some of these cities highlighted in that paper, there could be more of a risk of those animals from the rural areas coming into the city with Lyme disease, and spreading that to the urban grey squirrels,” he said.

There has been much speculation about whether the risk from Lyme disease may rise in the future because climate change is making our winters warmer, which helps ticks survive.

In England, there is not yet an upward trend in confirmed cases. They have been hovering at about 1,500 a year for several years, although there are thought to be many more cases that do not get reported. GPs are advised to offer antibiotics to anyone with a bulls-eye rash without requiring a Lyme disease test.

Rewilding campaigns could boost Lyme

Other factors could boost tick numbers, though, including the increasing trend for wilder green spaces, such as the “No Mow May” campaign, and councils creating wildflower meadows where once there would have been mown grass.

This is visible in urban parks, said Professor Richard Birtles, a microbiologist at the University of Salford, who worked on the new study. “I did the surveys in and around Inverness and a lot of the urban green spaces there were quite wild,” he said.

“If you’re in parks where the grass is very tidy, mown, and there are neat borders then it’s less likely the ticks are there because they can’t survive in that kind of habitat. But with this agenda of rewilding, allowing even parkland to revert back to a wild state, then you’d expect that to be the habitat for ticks.

“Rewilding is a fantastic thing, but we need awareness out there that that’s the environment that ticks all love,” said Julia Knight, of the patient charity Lyme Disease UK. “If people are going to be walking through long grass and overgrown shrubbery, that can’t do anything but up the risk.”

The charity advises that wherever you live, if you are spending time outdoors, use insect repellent, tuck trousers into socks and avoid long grass if possible. Then, check your body for ticks when you get home.

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