Lyme disease is one of the risks that needs to be considered by nature photographers and during location shoots with models, potentially affecting anyone involved in the shoot. Also known as Lyme Borreliosis, Lyme disease was first identified in the town of Lyme, New London County, Connecticut, in the United States. If left untreated, it can cause serious disease, but it is easily preventable, with some care and awareness. Awareness is still low, not just by the general public, but also amongst healthcare professionals, although awareness has improved considerably in recent years. Incidence of disease is also increasing and it is possible that more ticks are being infected, although no studies are available to confirm this.

The Risks for Contracting Lyme Disease and How to Prevent it

This article is not designed to offer clinical advice and if you suspect you have been infected, you should see a doctor immediately, stating your suspicion and why. Include information such as areas you have visited (see below for more information) and any symptoms. The main aim of this article is to raise awareness and to give information on how where you may encounter ticks and how you can minimise risk.

What is Lyme Disease?

Lyme disease is a blood-borne disease caused by the spirochaete bacteria Borrelia burgdorferi senso lato (a group of closely related species, once thought to be a single species – B. burgdorferi). The B. burgdorferi bacteria infect Ixodes (hard-bodied) ticks. The ticks can then bite humans or animals and transmit the bacteria. Tick bites in themselves cause irritation and reddening of the local area, due to the local immune response and the chemicals present in the saliva of the tick, injected to prevent clotting. The reaction from infected bites may be more severe and classically it produces a characteristic bulls-eye appearance, but this is not always present.

What are the Symptoms?

Acute Stage

The classic sign of Lyme Disease is the bulls-eye rash at the bite site, known medically as erythema migrans (literally migrating redness). Other acute stage symptoms include general fatigue, headache, fever, chills, muscle and joint ache and swollen lymph nodes (“glands”); so general flu-like symptoms. Some or all of these symptoms may be present and they may be more common than the rash.

These signs and symptoms may take 3-30 days to appear. More recent studies indicate that incidence of the characteristic rash may only be present in as little as 30% of cases, but precise rates vary according to different studies and may also vary on different continents.

Disseminated Disease

Later stage symptoms can occur several months or even years later and are much more serious. They occur as a result of the bacteria disseminating or spreading throughout the body. They can spread to joints quite early in the disease process. Symptoms include severe headaches and neck stiffness, additional rashes, facial palsy (due to muscle droop, because of the loss of muscle tone), arthritis with severe joint pain, intermittent pain in tendons, muscles, joints and bones, heart palpitations, dizziness or shortness of breath, inflammation of the central nervous system, nerve pain and shooting pains or numbness in the hands or feet.

Treatment

Treatment involves the use of antibiotics to kill the bacteria. Only some antibiotics work however and there is evidence of increasing resistance to antibiotics. In addition, there may not be complete resolution or resolution may be delayed by several months (possibly up to 30 months), even with prolonged treatment (maybe up to four weeks).

Where might I get bitten?

The Borrelia bacteria are primarily carried by several species of ticks from the Ixodes genus (hard-bodied ticks). Ixodes ticks are usually associated with deer, but will also bite other wild and domesticated animals. Deer usually inhabit woodland areas or areas of long grass adjacent to woodlands. Ticks will “quest” when hungry, looking for passing animals. Their source of food is blood. When questing, they will often climb vegetation (grass is common) and will attach to any passing host as they brush against the vegetation.

A bit more about the ticks

Three stages in the life cycle of the ticks are important. Adult ticks are relatively easy to see and measure 3-4 mm. Because of the greater visibility, risk of infection from adults is lower, although they are potentially infected themselves. The earliest stage is the larval stage, which is very small at 0.8 mm. It is unlikely that you will detect the larval stage, but luckily, risk of infection is low. To be infected, they would have had to either bite and not complete the feed or have transmitted it from an adult. Larval ticks usually only feed once before dropping off to develop into the next stage. The nymphal ticks are also quite small at 1.4 mm. The nymphal forms exhibit the greatest risk, as they already have the potential to have fed on an infected host and become infected. Also, their small size makes them hard to detect and for that reason, they are the greatest source of infection in humans.

The nymphal forms are most prevalent between May and July, but they may also be around as early as late March and as late as October. By autumn, adults are the greatest risk of catching Lyme disease and they are present all year.

Generally speaking, the feeding process takes around 24 hours, so if the ticks are removed early, the risk of infection is greatly reduced.

Prevention is better than cure

Lyme disease can lead to significant complications and because of the difficulties in detection and treatment, the best protection is not to be bitten in the first place.

1. Avoid woodland and long grass. This may not be desirable, as woods are the places where many of us like to go for walks, take photos and organise shoots. When in woodland areas, you are better off keeping to paths and avoiding long grass and overhanging vegetation.
2. Wear long trousers and boots. If walking in long grass in particular, wear a thick pair of walking socks, If you tuck your trousers into your socks, ticks are unlikely to bite, as they find it difficult to penetrate and it is harder for them to detect a heat source (although they may just try their luck sometimes and attach accidentally as you walk past).
3. Don’t shoot in areas likely to contain ticks (i.e. don’t locate the shoot amongst long grass in a woodland), be sensible where the shoot is located. Clearings offer much safer areas.
4. Insecticide sprays can help in prevention, but not all are tolerated very well by some people.
5. Carry a tick remover when going out into the countryside. I use Tom O’ Tick removers, which are easy to use, but other removers are also available and if you’re careful, fine-tipped tweezers work well. It is important to remove the head and not to damage the tick though.
6. DO NOT use any chemicals, such as alcohol, Vaseline etc and DO NOT use a naked flame, such as a lighter. These can all cause the ticks to regurgitate their stomach contents, increasing the infection risk.
7. When returning home, perform a tick search and remove them as soon as possible. Ticks often migrate to nice warm and moist areas, so search crevasses and sweaty areas, such as armpits, groin and the backs of your knees.

Finally

After all that doom and gloom, most people explore the outdoors without getting infected. It isn’t known what proportion of ticks are infected, but some areas seem to have higher rates. If you’re careful, are aware of the risks, take appropriate precautions and remove any ticks quickly and correctly, you can pretty much eliminate the risk of becoming infected. Also be aware that Lyme Disease isn’t the only tick-borne disease. There are now vaccinations for Lyme Disease (although not widely available in the NHS due to cost) and Tick-Borne Encephalitis.

Additional Information

Ixodes Ticks

https://influentialpoints.com/Gallery/Ixodid_Ticks_Ixodes.htm

Lyme Disease and other Tick-Borne Diseases

https://flåttsenteret.no/in-english/

https://www.fhi.no/en/archive/artikler/smitte/borreliose/

Acknowledgements

Thanks to Huw for providing the links and to rimфsky° for starting the thread that prompted me to write this article. The thread below contains some images of what to look for.

https://purpleport.com/group/general-chat/155721/lyme-disease--we-are-all-at-risk/page/1/