With the warmer weather and more time spent outdoors, we are more susceptible to insect bites. In general, bugs in Ireland are pretty harmless with most just causing an itchy rash or an unsightly blemish. However, there is a more sinister creature lurking amongst the foliage and is largely unseen and unheard until it latches onto your skin and begins burrowing its way inside.
‘m talking of course, about the lowly tick – which can either be harmless or the bearer of a nasty bacteria which causes Lyme disease and can have long-lasting side-effects.
Figures are not available for the number of cases of Lyme disease in Ireland, but it is estimated that around 200 people have a positive blood test for it each year.
However, Brian O’Briain is well aware of the debilitating symptoms of this condition and counts himself lucky that he was diagnosed and treated successfully – but he still shudders at the memory and does his utmost to make others aware of how life-changing the disease can be.
“My husband, Alan, and I have been living in the Burren since 2012 and towards the end of 2016, we launched our coffee roasting business, Anam Coffee,” he says. “During the summer of 2017, we were incredibly busy over the bank holiday weekend and I began feeling really tired – but I put it down to the exhaustion of running a business during the hectic holiday.
“But after a few days I noticed a strange swelling on the back of my knee, which 24 hours later grew into a nasty bruise with a very obvious bullseye shape. Living where we do, we spend a lot of time outside and I knew immediately what was wrong, particularly as I had been bitten in the same place by a tick a couple of weeks previously.”
Without realising how serious Lyme disease could be, the 46-year-old went to his GP who confirmed his suspicion and prescribed a dose of antibiotic. This was followed up by blood tests and while waiting for the results, Brian began his own research into the reality of being bitten by a tiny tick with the means to cause such damage.
“I was quite ignorant and didn’t really understand the consequences, but my blood was taken and sent off, first to the hospital in Limerick and also to Northern Ireland for a more thorough test, and both came back positive,” he says. “I started looking online and of course, because there is so little research into Lyme disease, the internet is full of conspiracy theories and scaremongering – and I also don’t really think that GPs fully understand the disease, either.
“After being prescribed the antibiotics as per the HSE protocol, I discovered that it is not strong enough to get rid of Lyme, so I joined Tick Talk Ireland, a Facebook support group of people affected by the disease. I was incredibly lucky to find this group and this prompted me to get in touch with Professor John Lambert, an expert in Lyme disease, who agreed to see me and immediately put me on a very strong dose of antibiotics as he was quick to diagnose the particular strain of bacteria I had been infected by.”
A combination of a swift diagnosis and the right medicine meant that Brian was able to make a full recovery, but it took a long six months.
“I experienced symptoms all the while I was on the medication and these included an overwhelming tiredness which I will never forget,” he says. “There was also neurological damage and I found it very difficult to concentrate. I remember one day going out in the car to do a delivery and I had to pull over as I had completely forgotten where I was going.
“I also had an aversion to light – a bit like a vampire – and had to wear sunglasses regardless of the weather. And I struggled very badly with conversation. I like to talk but I found it very difficult to follow what people were talking about or formulate sentences and by the time I had caught up, they would have moved on to another topic. I also lost 12kg in eight weeks from the combination of the medication and a very specific diet where I cut out gluten, dairy and sugar, on the advice of Tick Talk Ireland, to allow the antibiotics to do their job properly.”
Living in the countryside, Brian and Alan are still very vulnerable to tick bites, but they take every precaution to ensure they minimise their risk.
“We are always so careful when we are out and about, but we have five acres of land so are surrounded by ticks and our dog Charlie loves to run in the long grass,” says Brian. “We make sure to brush her from head to toe when we come inside and there is a medicine for animals, which can prevent the disease from being transmitted.
“Unfortunately this can’t be used on humans so we make sure to wear our trousers tucked into our socks, never wear shorts or T-shirts when out walking and when we come back in, we strip off in the utility and make sure to check each other for bites. I’ve only had one tick bite since 2017 and I am really careful about making sure I don’t get any more.”
But he thinks ‘a lot more’ needs to be done to make people aware of the danger of Lyme disease.
“In other countries, there are signs on parklands to warn people about tick bites and give advice on how to remove them,” he says. “We need to do something like that here and make GPs and pharmacists more aware of how to deal with the disease effectively – I couldn’t even buy a tick-removal tool locally and had to get it online.
“So I am incredibly lucky that I had an early diagnosis and was treated very quickly. I owe my recovery to Professor Lambert and to Alan, who was an incredible support throughout and took the reins when I had nothing left.
“I am an example of why people need to take it more seriously.”
Anecdotally, tick bites seem to be very prolific this year but there are no official figures for how many people get bitten and indeed how many go on to develop Lyme disease.
Dr Suzanne Cotter, Specialist in Public Health Medicine with the HPSC, says not every tick will be infected and even if they are, not everyone will go on to develop Lyme disease. But the longer a tick is left on the skin, the higher the risk.
“Studies that tested large groups of people (such as blood donors) from areas with high levels of ticks, showed that around one in five people have a blood test result showing they were infected with the Lyme bacterium at some stage of their life, without remembering a tick bite or having symptoms of Lyme,” she says.
“In general, the longer the tick has been attached to the skin, the greater the chance is of being infected. All the evidence suggests that ticks need to be attached and feeding for quite some time (as long as 24 hours) before there is a risk of becoming infected. And all the evidence suggests that if a tick is removed as soon as it bites, the risk of infection is very low.”
But while there are many theories about the best way to remove a tick, the expert says it is best to avoid certain methods.
“Bathe or shower as soon as possible after being outdoors and check all over your body for ticks,” she advises. “If you find one attached, remove it by gently gripping it as close to the skin as possible using a pair of fine-tipped tweezers or tick-removal tool. Pull steadily away from the skin without twisting or crushing the tick. Wash your skin with warm water and soap afterwards and apply an antiseptic cream to the skin around the bite.
“Do not use a lit cigarette end, a match head or substances such as alcohol or petroleum jelly to force the tick out.
“And in order to reduce your chances of being bitten, cover exposed skin, wear closed-toe footwear, use repellent that contains at least 20pc DEET or picaridin or IR3535 on exposed skin and also use repellent on any tent or camping equipment. If using sunscreen, tick-repellent should be applied afterwards and inspect your skin and clothes every three to four hours while in areas where ticks are found.”
Lyme disease is an infection caused by bacteria Borrelia which is carried by infected ticks which feed on blood when they bite. The tick injects the bacteria into the blood while feeding.
⬤ It can affect anyone but is most common among people who spend a lot of time outdoors.
⬤ Some people will have no symptoms.
⬤ The illness has three stages — Early Localised Disease (with the bullseye rash), Early Disseminated Disease which may result in severe flu-like symptoms, multiple rashes, facial nerve weakness and meningitis. And the third stage is Chronic Disseminated Disease which is uncommon but may occur in patients who did not receive enough treatment at an earlier stage and mostly affects joints, particularly the knee.
If anyone is worried about Lyme disease, they should seek medical advice immediately. hpsc.ie/a-z/vectorborne/lymedisease/ or visit ticktalkireland.org