UK Lyme Disease Resources
 

• The Royal College of GPs (RCGP) runs a Lyme Disease Spotlight Project with lots of resources. (please search via their homepage)
   

• RCGP have created a very useful Lyme Disease Toolkit for GPs.

   

• The RCGP and Lyme Disease Action Lyme disease e-Learning module is endorsed by the NICE Quality Standard for Lyme disease and free to all registered clinicians.
   

• The NICE Guidelines for Lyme disease state:

  • "Diagnose and treat Lyme disease without laboratory testing in people with erythema migrans".

  • Adults with an erythema migrans rash should be treated with "oral doxycycline: 100 mg twice per day or 200 mg once per day for 21 days". More details on treatment for other symptoms is given in their Management Recommendations section.

  • "Do not rule out diagnosis if tests are negative but there is high clinical suspicion of Lyme disease".

  • "Consider starting treatment with antibiotics while waiting for the results if there is a high clinical suspicion".

  • "Consider a second course of antibiotics for people with ongoing symptoms if treatment may have failed".
     

• The NICE Quality Standard states: "People with Lyme disease have initial antibiotic treatment, with the antibiotic, dosage and duration determined by their symptoms."
   

• The RCGP says (from NICE-publishes-quality-standard-for-lyme-disease from August 2019) "Development of a Lyme-aware practice team, utilising the resources listed above, will ensure consistent advice and improved diagnostic skills, thereby increasing the likelihood of patients receiving early and effective treatment of this potentially devastating disease".
   

• The Medical Defence Union say (from guidance and advice section) "An alleged failure to diagnose the disease is the most common reason for complaints and claims about Lyme disease reported to the MDU". One reason is the lack of reliability of standard two-tier testing, as used in the NHS. Lyme Disease can be fatal and a fatal outcome because of over-reliance on such tests has resulted in legal action.
   

• It is now accepted that mother-to-child transmission is possible.

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Scottish Lyme Disease Resources
 

• Health Protection Scotland general advice on Lyme disease, including surveillance data.
   

• Health Protection Scotland printable information sheet and poster.
   

• NHS Education for Scotland practitioner education resources. (please search via their homepage)
   

• The Scottish Lyme Disease and Tick-borne Infections Reference Laboratory User Manual.
   

• The Lyme disease test request form. (please search via their homepage)

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Lyme Disease Incidence
 

Lyme disease exists all over Scotland. A BMJ paper reported that Scotland has a high incidence of Lyme disease with over 1/4 of the 8000 UK cases per year.