Help at hand in diagnosing Lyme disease

NEW NICE guidance aims to help doctors spot Lyme disease so that NHS treatment can be offered promptly.

The guideline provides advice for GPs and specialists on symptoms to look out for and tests to help confirm a diagnosis.

Lyme disease can cause a circular red rash – erythema migrans – in the days or weeks after a tick bite. If this occurs, doctors can diagnose Lyme disease immediately and give the person antibiotics.

The disease has symptoms in common with other conditions and lab tests can be useful to help confirm a diagnosis. Typical symptoms include combinations of headache, fever, joint pain or fatigue, as well as others that are more specific, such as problems with nerves or joints.

NICE recommends using a combination of tests to address uncertainty in the evidence. ELISA and immunoblot detect antibodies created by the body’s immune system to fight infection. Not everyone with Lyme disease will have a positive test and if clinicians strongly suspect someone has Lyme disease, antibiotic treatment should be started while waiting for test results.

Saul Faust, Professor of paediatric immunology and infectious diseases at the University of Southampton and chair of the NICE guideline committee, said: "We want people to be diagnosed early so they get the right treatment as soon as possible.

"This new guideline gives more clarity on how clinicians can spot Lyme disease and provide early treatment. It guides through when to use tests and what antibiotics to prescribe according to symptoms."