title: Lyme disease in the United Kingdom.
abstract: Lyme disease, while still an uncommon disease in the UK, is on the increase. Case numbers have increased by 3.6-fold since 2001, with over 950 cases reported by the Health Protection Agency (HPA) in 2011, compared with less than 500 cases annually pre-2004. HPA indications of the true incidence are suggested to be closer to 3000 cases/year, of which around 82% of cases are indigenously acquired. Three genospecies, Borrelia burgdorferi sensu stricto, Borrelia afzelli and Borrelia garinii, represent the predominant pathogenic variants in the UK. Erythema migrans is the commonest manifestation, occurring in 60%-91% of cases. In the UK, neuroborelliosis is the most common complication, while myocarditis is unusual, and death from either conduction disease or carditis is extremely rare. The role of Borrelia infection in chronic dilated cardiomyopathy in the UK remains unproven. Controversy over the existence of either 'chronic Lyme disease' and/or 'post-Lyme disease syndrome' continues unabated. National medical societies, patient advocacy groups, insurance companies, lawyers, doctors, the private health medical sector and scientific journals have all become embroiled in this bitter controversy. New developments include diagnostic tests able to detect Lyme disease at an earlier stage, shorter durations of antibiotic therapy and potential advances in vaccines against Borrelia.
authors.affiliation: Department of Cardiology, The Hillingdon Hospital, , Uxbridge, UK.
authors.forename: Simon W
authors.initials: SW
authors.lastname: Dubrey
authors.forename: Ajay
authors.initials: A
authors.lastname: Bhatia
authors.forename: Sarah
authors.initials: S
authors.lastname: Woodham
authors.forename: Wojtek
authors.initials: W
authors.lastname: Rakowicz
mesh_terms: D000818:Animals; D001428:Bacterial Vaccines; D025065:Borrelia burgdorferi / Q000302:isolation & purification; D015748:Borrelia burgdorferi Group / Q000302:isolation & purification; D015787:Erythema Chronicum Migrans / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D020852:Lyme Neuroborreliosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D011933:Reagent Kits, Diagnostic; D012867:Skin / Q000382:microbiology* / Q000473:pathology; D064927:Tick Bites / Q000382:microbiology*; D017282:Tick-Borne Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001428:Bacterial Vaccines; D011933:Reagent Kits, Diagnostic
keywords: Cardiology; Infectious Diseases; Neurology