Lyme disease is the most common vector-borne human infection in England and Wales. As elsewhere in northern Europe, the spirochaetes (Borrelia burgdorferi) are transmitted by the hard bodied tick, Ixodes ricinus, commonly known as deer or sheep ticks.

Image/Robert Herriman
Image/Robert Herriman

Lyme disease is monitored in England and Wales through routine surveillance.

Cases of Lyme disease are not statutorily notifiable by medical practitioners in England, Wales and Northern Ireland. However, since October 2010 under the Health Protection (Notification) Regulations 2010, every microbiology laboratory (including those in the private sector) in England is required to notify all laboratory diagnoses of Lyme disease to Public Health England.

The data reported refer to laboratory-confirmed cases of Lyme disease in England and Wales, and do not include cases diagnosed and treated on the basis of clinical features such as erythema migrans (the early rash of Lyme disease) without laboratory tests. It has been estimated that there are between 1,000 and 2,000 additional cases of Lyme disease each year in England and Wales that are not laboratory diagnosed.

Cases of Lyme disease have climbed steadily since the turn of the century with 1,579 total laboratory confirmed cases in 2017 and a mean annual rate per 100,000 population of 2.7.

Based on laboratory-confirmed Lyme disease, cases occur in people of all ages, with peaks in those aged between 45 and 64 years, followed by those aged from 24 to 44 years.