How a tick bite ended Kirsty's dream

Climate change could combine with altered farming and wildlife management practices to produce an increase in a little-known but debilitating disease transmitted by ticks.

Climate change could combine with altered farming and wildlife management practices to produce an increase in a little-known but debilitating disease transmitted by ticks. And it's particularly common in parts of East Anglia.

WHEN athlete Kirsty Waterson developed a rash on her ankle soon after a race in Thetford Forest she did not pay it much attention.

But over the subsequent weeks and months it was followed by severe headaches, a pins and needles sensation in her limbs and extreme fatigue.

All the symptoms were made worse when Kirsty, then aged 21 and one of the UK's most promising young long-distance runners, trained.

She consulted a doctor and was referred to a skin specialist, who recognised the tell-tale 'bulls-eye rash' on her ankle as a sign of Lyme disease and sent her for a blood test.

It confirmed Kirsty, from Bury St Edmunds, did indeed have the illness, which is transmitted by ticks infected with the Borrelia bacteria.

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Although she received antibiotic treatment, four years on Kirsty is still not fully recovered.

The disease has shattered her hopes of being an international athlete and she no longer runs competitively.

The loss of her dreams still hurts but she has learned to live with her changed circumstances and has built a new life.

She is no longer Kirsty Waterson: she married last summer and is now Kirsty Taylor. She is expecting her first baby in the autumn and has almost completed her training as a beauty therapist.

But her professional life, at least, would have been so different if it were not for that fateful tick bite.

“I must have been bitten during that run in Thetford Forest,” she says, “but it was eight months before I got it seen to.

“Where I had been bitten on the bottom of my leg a rash appeared. It used to react to heat and it spread up the leg. Then I had headaches and flu-like symptoms. My running was going out the window. I had pins and needles in my hands.

It was emotionally draining.

“I had never heard of Lyme disease before they told me that was what I had. The doctors said I needed to go on antibiotics.

“I haven't been the same since and, as an athlete, I know my body very well.

“Since then I have spoken to people who have had Lyme disease and they have told me I should could have been given antibiotics intravenously in hospital rather than in tablet form.

“My immune system isn't as good as it used to be, although I am a lot stronger than I was.

“I am still running but not competitively; it is not the same since I became ill.

“When you live in Bury and were at such a high level competitively everyone knows you. The pressure of going back and not being able to run to your previous ability is too much.

“It is a huge disappointment to me. I had quite big ambitions and dreams. I had been running since I was 11, doing cross country, track and was going into road running and marathons.

“I was running for England at the top of my sport and hoped to make a career of competing internationally.”

Kirsty says Lyme disease is a bit like glandular fever in that it can come back at any time.

But what has surprised her most about the illness is how little sections of the medical profession actually know about it.

“I have consulted doctors who I have told that I have Lyme disease and they have had to look it up on the internet.

“I even saw a doctor who was implying I might have an eating disorder because I was so thin. This was after I had been diagnosed with Lyme disease.”

This apparent ignorance is perhaps alarming for us all, given that experts now predict there will be more incidence of Lyme disease in the future.

The Department of Health has recently published a document called Health Effects of Climate Change in the UK 2008, an updated version of a report originally written six years ago.

It says that it is now perhaps even clearer than it was in 2002 that the UK's climate is changing and predicts an increase of mean annual temperature of between 2.5 and 3 degrees centigrade by the end of the century.

Tick-borne diseases are likely to become more common in the UK, says the report, but this will be more likely to be due to

changes in land use and leisure activities than to climate change.

Oxford University's Professor Sarah Randolph, a specialist in tick-borne diseases, who contributed to the report and has almost concluded another study for the Department of Food and Rural Affairs, says that although the annual number of Lyme disease cases reported in the UK between 1986 to 1997 has increased since 1994, there is no significant correlation with mean summer temperatures in central England.

The major risk factors for all tick-borne infections are the distribution, abundance and pattern of seasonal activity of the insects. Any increase in tick-infested areas is more likely to be the effect of changing agricultural and wildlife management practices than of changes in climate alone, says Professor Randolph.

“There has been an increase in the number of deer and all types of deer feed the ticks,” she said. “Another thing that has changed is farming practices, especially up in the hills. Sheep are being put out on the grass less and those that are have not been drenched in insecticide.

“It is a very complex balance. There is no reason to say that climate change we are observing in the UK is having a universal negative impact on risk of tick-borne diseases, although something is happening in the environment affecting the behaviour and number of ticks.”

Professor Randolph believes the most important thing that the medical profession and public need to take on board is increased awareness. This, she says, will help people protect themselves in areas where ticks may be prevalent and encourage doctors to become more knowledgeable about the disease.

“Ticks have to have moisture in summer and this is mostly found in woodlands. That is also where the majority of deer hang out. Typically between 10 and 35% of ticks contain the bacteria that causes Lyme disease. If one bites you and you leave it on you for more than 12 to 24 hours and it is infected, there is a high chance you will be infected too.

“Raising awareness is what it is all about. If you think you may have been bitten and have symptoms, go to your GP. Persuade him or her to get you diagnosed and given treatment. We don't want to frighten people away from the countryside but equally it would be irresponsible not to make people aware,” said Professor Randolph.

Lyme disease

Lyme Disease was discovered following a cluster of cases in the 1970s among young people living in Old Lyme in Connecticut, USA.

The illness is caused by a bacteria carried by the tick which is transmitted when the tick begins to draw up the host's blood.

Typically a rash appears at the bite mark. Victims can also experience joint pains, fever and fatigue, and as the bacteria spreads around the body, a stiff neck, facial paralysis and tingling.

More severe symptoms can include severe headaches, painful arthritis and joint swelling, heart problems and even mental disorders such as short-term memory loss and difficulty concentrating.

Antibiotics are used to treat Lyme disease, but if the illness is not caught early it does not respond well to treatment.

It is suggested up to 2,000 people now get Lyme disease in the UK each year.

Most infections happen in forests, heathland or moorland where deer are common. Each year in Suffolk there are about half dozen diagnosed cases of Lyme disease. Some originate abroad but there are a few of more local origin. Thetford Forest is, for example, is a known reservoir of infected ticks, but most cases in the UK are in southern England around the New Forest

Ticks feed only once per life stage, as a larva, a nymph and an adult, between which they spend long developmental and host-seeking periods on the ground. Not all hungry ticks are infected. Nymphs are regarded as the most significant risk.

To protect yourself when out walking stay on established paths or bridleways; be vigilant if sitting in fields with long grass and vegetation; wear light-coloured clothing so ticks are easily seen; wear long sleeves and trousers, tuck trousers into socks; check for ticks after walking and remove immediately; inform your doctor of tick bites should you show signs of illness.

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