{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:39:50Z","timestamp":1775727590792,"version":"3.50.1"},"reference-count":152,"publisher":"Oxford University Press (OUP)","issue":"1059","license":[{"start":{"date-parts":[[2013,11,6]],"date-time":"2013-11-06T00:00:00Z","timestamp":1383696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Lyme disease, while still an uncommon disease in the UK, is on the increase. Case numbers have increased by 3.6-fold since 2001, with over 950 cases reported by the Health Protection Agency (HPA) in 2011, compared with less than 500 cases annually pre-2004. HPA indications of the true incidence are suggested to be closer to 3000 cases\/year, of which around 82% of cases are indigenously acquired. Three genospecies, Borrelia burgdorferi sensu stricto, Borrelia afzelli and Borrelia garinii, represent the predominant pathogenic variants in the UK. Erythema migrans is the commonest manifestation, occurring in 60%\u201391% of cases. In the UK, neuroborelliosis is the most common complication, while myocarditis is unusual, and death from either conduction disease or carditis is extremely rare. The role of Borrelia infection in chronic dilated cardiomyopathy in the UK remains unproven. Controversy over the existence of either \u2018chronic Lyme disease\u2019 and\/or \u2018post-Lyme disease syndrome\u2019 continues unabated. National medical societies, patient advocacy groups, insurance companies, lawyers, doctors, the private health medical sector and scientific journals have all become embroiled in this bitter controversy. New developments include diagnostic tests able to detect Lyme disease at an earlier stage, shorter durations of antibiotic therapy and potential advances in vaccines against Borrelia.<\/jats:p>","DOI":"10.1136\/postgradmedj-2012-131522","type":"journal-article","created":{"date-parts":[[2013,11,7]],"date-time":"2013-11-07T03:46:56Z","timestamp":1383796016000},"page":"33-42","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Lyme disease in the United Kingdom"],"prefix":"10.1093","volume":"90","author":[{"given":"Simon W","family":"Dubrey","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Hillingdon Hospital , Uxbridge , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The Hillingdon Hospital , Uxbridge , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Woodham","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The Hillingdon Hospital , Uxbridge , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojtek","family":"Rakowicz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Charing Cross Hospital , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2013,11,6]]},"reference":[{"key":"2023041905540781800_R1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3201\/eid0604.000416","article-title":"Lyme disease surveillance in England and Wales, 1986 1998","volume":"6","author":"Smith","year":"2000","journal-title":"Emerg Infect Dis"},{"key":"2023041905540781800_R2","first-page":"260262","article-title":"Emerging pattern of Lyme disease in the United Kingdom and Irish Republic","volume":"1","author":"Muhlemann","year":"1987","journal-title":"Lancet"},{"key":"2023041905540781800_R3","article-title":"Lyme Borreliosis in England and Wales","author":"Health Protection Agency","year":"2011"},{"key":"2023041905540781800_R4","author":"Health protection Agency"},{"key":"2023041905540781800_R5","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1073\/pnas.91.7.2378","article-title":"Lyme disease: a growing threat to urban populations","volume":"91","author":"Steere","year":"1994","journal-title":"Proc Natl Acad Sci USA"},{"key":"2023041905540781800_R6","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0140-6736(11)60103-7","article-title":"Lyme borreliosis","volume":"379","author":"Stanek","year":"2012","journal-title":"Lancet"},{"key":"2023041905540781800_R7","first-page":"119","article-title":"Iceman unfrozen","volume":"220","author":"Hall","year":"2011","journal-title":"Nat Geographic"},{"key":"2023041905540781800_R8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/art.1780200102","article-title":"Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three connecticut communities","volume":"20","author":"Steere","year":"1977","journal-title":"Arth Rheum"},{"key":"2023041905540781800_R9","article-title":"Lyme disease: \u2018I knew whatever was troubling me was\u2019nt a sports injury.","year":"2010"},{"key":"2023041905540781800_R10","article-title":"An insect bite on holiday put Sarah in a wheelchair. 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