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NICE Guideline

LDA broadly welcomes the NICE Guideline. It is not the ā€˜game changerā€™ some may have been hoping for but there are some positive points.
NICE Guidelines set standards for treatment. This Guideline is a gain. It increases duration of treatment. This is a gain. It also makes clear that doctors are free to use their clinical judgement to depart from such guidance. This is a gain.

However, few doctors are sufficiently aware of, or experienced in, Lyme disease to do so. Still fewer have the knowledge to understand the nuanced results of diagnostic tests, which themselves have inherent limitations. We are worried that under-pressure doctors will simply look up the table of recommended treatment options without realising that the evidence underpinning that treatment is recognised by NICE to be of poor quality or even missing.

The Guideline also stops short in key areas. Particularly frustrating is the absence of any strong recommendation for development of specialist service provision, where long-term and late diagnosed disease can be treated and UK clinicians can gain in experience.

The Guideline recommends referring ā€˜difficultā€™ cases to ā€œspecialistsā€. The elephant in the NICE room is that there are NO Lyme disease specialists in the NHS to whom GPs can refer.

For 15 years we have consistently argued for better medical care and treatment and for research and science in fighting this debilitating, and occasionally fatal, disease. We will continue to do that because, despite the undoubted gains in this NICE Guideline, there is much more to do.
Read our full comment here

The Lyme rash

The rash is red, roughly circular and spreading outwards.

It is called erythema migrans (EM):Ā erythemaĀ for red andĀ migransĀ for spreading.

It may clear in the middle as it gets bigger. It is not normally itchy, hot or scaly.

See ourĀ rashes pageĀ for other images.

To help your doctor to take the possibility of Lyme disease seriously, see our page

Resources / For the public.

This has information expelling some myths and also links to official documents that will help.

What we do

We are a charity dealing with Lyme disease throughout the UK. We provide accredited information that you can trust; for the public, patients and health professionals. Find out the facts here on

We raise awareness, provide free leaflets and lobby for improved services. See what we have been doing recently. We hold an annual conference. See the LDA conferences page for details of our next conference in Devon in September 2018.