Lyme disease is monitored in England and Wales through routine surveillance. The UK Health Security Agency’s Rare and Imported Pathogens Laboratory provides Lyme disease laboratory testing services for England and Wales and data is published in the quarterly Health Protection Reports, available at the following link:

https://www.gov.uk/government/collections/health-protection-report-current-issue-and-latest-surveillance-reports#zoonoses

Data is not collected at constituency level.

The incidence of Lyme disease in Somerset sits higher than the average in England, as in Somerset per 100,000 of the population it is approximately two to four times higher than the average incidence in England.

There has not been an increase in laboratory confirmed cases in Somerset or England over the past seven years, with overall cases remaining stable. There is a fluctuation every year as expected, with more cases some years and less other years, but there has not been a sustained increase.

Yearly fluctuations are expected and driven by several factors including the weather which impacts how people interact with the outdoors. Trends do not show a significant change in laboratory confirmed cases in England since 2018 and cases have remained stable.

Direct impacts of gamebird releases on Lyme disease risk are difficult to quantify due to the complex transmission cycle that occurs between Borrelia and a wide range of British wildlife. The lack of clarity on where humans are exposed to infected ticks, as well as levels of engagement in protective behaviours that reduce disease risk further complicates matters.

A recent study by the University of Exeter and the UK Health Security Agency in southwest England compared woodlands with and without pheasant release and provided evidence that woodlands with pheasants have a higher percentage of ticks infected with the bacteria that can cause Lyme disease. The study, however, did not link this directly with human case data and thus cannot be used to infer Lyme disease risk.

In England, Wales, and Northern Ireland there are approximately 1,000 to 1,500 laboratory confirmed cases every year, and in Scotland there are approximately 500 laboratory diagnosed cases.

Previous studies have shown that there are approximately 2,000 additional cases of Lyme disease per year that are not laboratory confirmed in England and Wales. Lyme disease is more common in Scotland, and Southeast and Southwest England, compared to other parts of the United Kingdom such as Northern Ireland, and cases peak in the spring and summer months.

Lyme disease is not a notifiable disease in the UK so the exact number in the community is unclear, as many patients are diagnosed with Lyme disease clinically, without sending samples for testing. Further details on Lyme disease are available at the following link:

https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis

The Department funds research through the National Institute of Health and Care Research (NIHR). The NIHR is not currently funding any research on early diagnostic tests for Lyme disease. The NIHR welcomes research proposals on Lyme disease and diagnostics.

The Department commissioned four reviews on Lyme disease, published by the Evidence for Policy and Practice Information group in December 2017. These reviews were undertaken alongside reviews conducted by the National Institute for Health and Care Excellence, who developed definitive advice on the treatment, testing, and diagnosis of Lyme disease in April 2018.

If recognised promptly and treated with a full course of appropriate antibiotics, acute Lyme disease will usually resolve without further complications. Further information on the diagnosis and treatment of Lyme disease is available on the GOV.UK website.

I refer the hon. Member to the answer I gave to the hon. Member for South Cambridgeshire on 12 November 2024 to Question 13156.

DSIT funds medical research through UK Research and Innovation (UKRI) and the Department of Health and Social Care funds research through the National Institute for Health and Care Research (NIHR).

UKRI’s Medical Research Council (MRC) supports the best scientific research to improve human health, with work ranging from molecular level science to public health medicine. MRC plays a key role in funding underpinning research which may not be attributable to a specific disease but will benefit medical research more generally. As part of this, UKRI funds research on immunology which is relevant to all of these diseases and will not be categorised per disease.

Details of UKRI and NIHR funding on specific areas is provided in the table below:

There are several studies and projects being undertaken in the United Kingdom looking at the prevalence and distribution of Lyme disease. Examples include two studies undertaken in association with National Institute of Health Research. One is focussing on studying the evolution of the disease in patients, and the second is examining the evidence of exposure to the Lyme disease bacteria in the English population.

Clinical advice for general practitioners (GPs) and hospital physicians on Lyme disease is available from the National Health Service. Most cases are diagnosed based on clinical signs by GPs, and laboratory testing is widely available for more complicated cases.

The UK Health Security Agency (UKHSA) provides Lyme disease laboratory testing services for England and Wales and issues detailed advice on sample testing.

Lyme disease is treatable with a course of antibiotics in accordance with national guidelines. However, if left untreated, the infection can spread to affect the nervous system, joints, or the heart. More information on the diagnosis and treatment of Lyme disease is available at the following link:

https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis#laboratory-diagnosis

The UKHSA’s Be Tick Aware toolkit provides information resources to enable local stakeholders to deliver public health information on ticks and tick-borne disease prevention directly to their population and visitors. The toolkit is available at the following link:

https://assets.publishing.service.gov.uk/media/642e966bfbe620000f17ddbe/Be_tick_aware_toolkit.pdf

The UK Health Security Agency (UKHSA) has an active programme to promote awareness of tick-borne diseases among local authorities, health professionals and the public by 2025 in line with the Third National Adaptation Programme. This includes Lyme disease and tick-borne encephalitis. UKHSA has worked to develop a toolkit for local authorities and key stakeholders to raise awareness of the potential risks created by ticks and tick-borne disease, a copy of which is attached. UKHSA also publishes Lyme disease data on Fingertips, which is an open access public health data platform which allows the public, health professionals, and local authorities to view trends, compare indicators and understand the incidence of Lyme disease in their area.

Clinicians are also engaged via teaching sessions for General Practitioners, seminars for infection specialists, and briefing notes to notify clinicians of the possibility of tick-borne diseases, with detail of compatible signs and symptoms. Disease messaging is shared through media, social, and stakeholder channels at a national and regional level, such as the #BeTickAware campaign which aims to raise awareness in the population, including those at risk of exposure through work or leisure.

The National Institute for Health and Care Excellence’s (NICE) Clinical Knowledge Summaries (CKS) are specifically aimed at general practices (GPs), and cover the availability of testing services. The entomology group in the UK Health Security Agency (UKHSA) also has a tick awareness scheme, which sends out information on avoiding tick bites in a spring campaign, and supports local authorities in areas with a high prevalence of Lyme disease. Further information on Lyme disease, access to testing, and the NICE’s CKS’ is available respectively at the links below:

https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis

https://www.nice.org.uk/guidance/ng95

https://cks.nice.org.uk/topics/lyme-disease/management/management/

All confirmatory testing in England is performed by the Rare and Imported Pathogens Laboratory (RIPL). Delays may occur in the referring laboratory when submitting the sample, during testing at the RIPL, or when accessing the results, which are sent back electronically, before being passed onto GPs. Only the RIPL is within the UKHSA’s control, and the RIPL is planning to introduce new technology to speed up tests for neuroborreliosis.

National data analysis is released through the Fingertips system, which is regularly updated. The annual number of cases of Lyme disease varies from year to year, depending on weather conditions in the Lyme season, the effects of weather and human activities on animals that harbor the disease, and the tick population. Further information on the Fingertips system is available at the following link:

https://fingertips.phe.org.uk/profile/health-protection/data

The Government has not conducted an assessment of the adequacy of National Health Service capability and capacity to diagnose Lyme disease or a comparative assessment of best practice in the diagnosis and treatment of this disease in the United Kingdom, the United States, and Germany.

Diagnosis of Lyme disease in England and Wales is conducted by the Rare and Imported Pathogens Laboratory (RIPL). RIPL provides Lyme polymerase chain reaction PCR testing and a comprehensive serological panel which has been fully validated to UK Accreditation Service standards.

Services for the treatment of Lyme disease are commissioned locally. These services are the responsibility of integrated care board and general practitioners use their professional judgement in diagnosing and treating this condition.

The Government has not conducted an assessment of the adequacy of National Health Service capability and capacity to diagnose Lyme disease or a comparative assessment of best practice in the diagnosis and treatment of this disease in the United Kingdom, the United States and Germany. Diagnosis of Lyme disease in England and Wales is conducted by the Rare and Imported Pathogens Laboratory (RIPL). RIPL provides Lyme polymerase chain reaction PCR testing and a comprehensive serological panel which has been fully validated to UK Accreditation Service standards.

Published research, for example the VICTORY study in Lancet ID, indicates that cellular tests for Lyme borreliosis used by many private laboratories in Europe have a high false positive rate. A copy of the VICTORY study in Lancet ID, is available at the following link: https://doi.org/10.1016/S1473-3099(22)00205-5.)

UK Health Security Agency published accompanying guidance documents on Lyme disease in July 2018, which describe the clinical signs and symptoms and are consistent with the National Institute for Health and Care Excellence guidance. The guidance is available at the following link: https://www.gov.uk/guidance/lyme-disease-management-and-prevention

Services for the treatment of Lyme disease are commissioned locally. These services are the responsibility of integrated care board and general practitioners use their professional judgement in diagnosing and treating this condition.

The Government has not conducted an assessment of the adequacy of National Health Service capability and capacity to diagnose Lyme disease or a comparative assessment of best practice in the diagnosis and treatment of this disease in the United Kingdom, the United States and Germany.

Diagnosis of Lyme disease in England and Wales is conducted by the Rare and Imported Pathogens Laboratory (RIPL). RIPL provides Lyme polymerase chain reaction PCR testing and a comprehensive serological panel which has been fully validated to UK Accreditation Service standards.

Published research, for example the VICTORY study in Lancet ID, indicates that cellular tests for Lyme borreliosis used by many private laboratories in Europe have a high false positive rate. A copy of the VICTORY study in Lancet ID, is available at the following link:

https://doi.org/10.1016/S1473-3099(22)00205-5.)

UK Health Security Agency published accompanying guidance documents on Lyme disease in July 2018, which describe the clinical signs and symptoms and are consistent with the National Institute for Health and Care Excellence guidance. The guidance is available at the following link:

https://www.gov.uk/guidance/lyme-disease-management-and-prevention

Services for the treatment of Lyme disease are commissioned locally. These services are the responsibility of integrated care board and general practitioners use their professional judgement in diagnosing and treating this condition.

Two studies on Lyme disease are being undertaken in association with National Institute of Health Research (NIHR) Emerging and Zoonotic Infections Health Protection Research Unit. One is focussing on studying the evolution of disease in patients, and the second is examining the evidence of exposure to the Lyme disease bacteria in the English population by region, using blood samples from the NHS Blood Transfusion & Transplant Service.

Lyme disease is treated with antibiotics and patients typically recover quickly and fully. Guidance accords with best practice used in the US and across Europe and is based upon the available evidence. A number of private clinics offer expensive and complex treatment regimens, caution should be exercised when accessing these services as treatments may not be supported by scientific evidence.

UK Health Security Agency (UKHSA) share Lyme disease messaging through theirour social, media and stakeholder channels at a national and regional level, most recently publishing the Tick awareness leaflet in March 2023.

The ‘Tick awareness’ leaflet informs the public about the risks associated with ticks including Lyme Disease and tick-bite prevention behaviours. A copy is attached.

UKHSA, along with local authority partners, have also developed a Tick awareness toolkit which includes resources and materials that can be used by local authorities and other organisations to deliver tick awareness campaigns. A copy is attached.

The Department commissioned four reviews on Lyme disease published by the Evidence for Policy and Practice Information group in December 2017. This was followed by definitive advice on treatment, testing and diagnosis of Lyme disease developed by National Institute for Health and Care Excellence in April 2018. Most cases are diagnosed on clinical signs by general practitioners, but laboratory testing is widely available through the National Health Service for more complicated cases. NHS testing follows the international best practice on Lyme disease tests and accords with European and US best practice. Some private clinics and laboratories offer their own tests which are not recognised by national health authorities, and for which little literature exists to support their veracity.

Research shows that the vast majority of patients with Lyme disease will experience a full recovery. A minority of patients may experience more protracted symptoms, known as Post-treatment Lyme disease Syndrome (PTLDS). Why some patients experience PTLDS and others do not is unclear. There is no current proven treatment for PTLDS, however research is looking at the best way to manage patients.

Specific training for general practitioners (GPs) and infection specialists on Lyme disease is held regularly. Lyme Disease Action has an e-learning module for GPs, recommended by the Royal College of General Practitioners. Guidelines for Healthcare professionals and providers, and people with Lyme disease, their families and carers, are published by National Institute for Health and Care Excellence.

The data is not available in the format requested. The UK Health Security Agency’s Emerging Infections and Zoonoses team has a remit to publish zoonoses surveillance data for England and Wales, including diagnoses of Lyme disease. The number of laboratory-confirmed cases of Lyme disease reported in England and Wales was 1,639 in 2019, 1,262 in 2020 and 1,156 in 2021.