The existing National Institute for Health and Care Excellence (NICE) guidance supports primary care doctors in managing Lyme disease but to further strengthen the evidence base we have commissioned NICE to develop guidelines for the recognition and treatment of Lyme disease; this is expected in June 2018.
Public Health England (PHE) provides information on Lyme disease and tick awareness to the medical profession and the public, holds regular medical training days, and works with Lyme Disease Action to support the needs and interests of patients.
NHS Choices also publishes information on its website to raise awareness of Lyme disease and encourage timely medical consultation because early diagnosis and treatment of Lyme disease is the best way of limiting complications from infection.
The number of human cases can be reduced by raising public awareness of how to avoid tick bites, and by environmental measures in public places to reduce the long grass and scrub which harbor ticks. PHE works with interested local authorities to raise tick awareness, and has produced joint public information with local authorities in areas such as the New Forest with a significant incidence of Lyme disease.
The number of laboratory confirmed cases of Lyme disease in England and Wales varies annually, in 2013 there were 878 and in 2014 there were 730, but the majority of diagnoses are made clinically by general practitioners and those figures are not recorded.
Patients with late or complicated Lyme disease may be diagnosed in a variety of specialist clinics, and the numbers are not recorded. Based on the clinical information supplied with the laboratory request, only a small proportion of the annual number of cases fall into this category.
There is no clear definition for chronic Lyme disease, and no general acceptance of what the term means, so no data is available.