Lyme disease in people is defined as a multi-system infection with the bacterium Borrelia burgdorferi, when, following a tick bite, infection is confirmed on the basis of either obvious clinical symptoms, such as a pink or red raised rash spreading from the site of the tick bite, or through laboratory diagnostic tests that conform to the internationally agreed testing criteria and that have the appropriate specificity and sensitivity to accurately identify the presence of Borrelia burgdorferi.
The term chronic Lyme disease is not defined as there is no convincing evidence for the existence of symptomatic chronic Borrelia burgdorferi infection among patients after receipt of recommended treatment regimens for Lyme disease.
Post-Lyme syndrome refers to a spectrum of non-specific symptoms, similar to those of chronic or post-viral fatigue syndrome, that are reported by a small percentage of patients despite apparently adequate treatment and lack of objective evidence of continued Borrelia burgdorferi infection activity.
There are no plans to make Lyme disease notifiable because there is already in place a robust surveillance system based upon laboratory reporting of all confirmed cases of Borrelia burgdorferi infection.
However, we are proposing to include meningitis associated with Borrelia infection as a notifiable infection in the proposed new regulations to be made under the Public Health (Control of Disease) Act 1984, as amended by the Health and Social Care Act 2008, on which we will be consulting shortly.