Clare Marsh, a runner from near Wrexham, was visiting the Lake District and found a tick on her ankle which she realised she must have picked up on a run. Although carefully removing it as per the correct advice, after around six weeks she began to feel ill. The medical problems continued for months on end as she struggled to get a diagnosis.
After enduring what turned out to be Lyme disease, she feels she has recovered, but said: “I’m still traumatised by it now. I wouldn’t wish it on anyone. There were two nights when I thought, ‘God, I’m going to die from this.’ It’s just horrific.”
Clare wants other runners to be more aware about ticks and the illness, which appears to be not that well understood, even by GPs. Her initial symptoms were a constant headache, extreme tiredness and flu-like symptoms. After a number of other complications, the following June she tested positive for pneumonia and after five more courses of antibiotics showed no improvement.
Among other things, she had cold shivers, swollen stomach, dizziness, funny voice, breathlessness, all-over aching, loss of appetite, nausea, stiff neck, swollen lymph nodes in the neck and brain fog.
Runner and cyclist Ian Palmer was also in the Lakes, clocking up Wainwrights, when he was bitten by a tick in October 2019. Some time after being rushed into hospital with a suspected heart attack, it emerged that it wasn’t a cardio problem at all but probably Lyme disease. Describing his condition, he said: “I couldn’t remember friends’ names even though I’d known them for years, and conversations would leave me completely drained and needing sleep. I pretty much couldn’t do a thing but sleep. It was so bad that at one point, I couldn’t even manage to walk to the surgery – 300 metres away.” By June 2020 he was still recovering but not out of the woods.
The telltale ‘ring’
Lake District B&B owner Sarah Moir reckons it was when she was running through bracken near Derwentwater in 2017 that she was bitten, although she didn’t find the tick afterwards. She fell ill, later noticing the trademark ‘ring’ of Lyme disease.
She was underprescribed doxycycline and it got worse. By February 2020 the problems were still ongoing. “I couldn’t remember things,” she said. “I was really easily confused, to the point where one day I got in the car and couldn’t remember which was the clutch or how to drive. I can’t explain how bad it was. I’ve never felt like that before.”
Although the above cases all happened to be in the Lake District, Trail Running has heard from many affected runners from different parts of the country.
The British Medical Journal estimated there could be as many as 8000 cases a year, 27% of them in Scotland. A study of GP records showed the number of cases increased tenfold from 2001 to 2012. The ticks can be found anywhere, most commonly in woodland or heathland areas, but are more frequent in the south of England or highlands of Scotland.
Know the signs
Lyme disease is rare and we don’t want to cause alarm. However, it is important for all trail runners to know the symptoms, take precautions in affected areas and – most crucially – know how to remove a tick correctly (see below). If you don’t do so appropriately, part of the tick or its fluids can be left behind in the skin, possibly leading to more complications.
Sarah Morton, a trail runner and former sufferer from Scotland, has completed academic research into the subject. “The main outcome from my research was that, regardless of what preventative measures one takes, there is always a chance of getting a tick,” she said. “So the crucial action to take after being in the outdoors is to check for ticks following potential exposure.”
Symptoms can last months or even years and can be worse if treatment is delayed, so it is important to get an early diagnosis, which can often be a problem.
Sophie Kellaway is among many who found it difficult to gain a diagnosis for Lyme disease. A sufferer 10 years ago before she became a trail runner, she founded the charity LymeAid UK to raise awareness. A negative test from the NHS does not rule out Lyme disease and some may wish to obtain a private test from overseas. LymeAid UK can help out such individuals with grants.
Getting a diagnosis
Lorraine Murray was suffering with the symptoms for more than a year before realising it could be Lyme disease – which, if caught early, can be treated with antibiotics – but that was far from the end of her problems. She eventually resorted to private treatment.
“My symptoms weren’t investigated, and were ignored by the NHS infectious disease department – the very people I thought could help me,” said Lorraine, who recalls seeing the tick while bathing back in 2014. “Treatment was all hinging on a positive NHS test, regardless of the fact I already had several positive tests from two separate accredited labs.”
We all want to make the most of the trails, but whether in the wilderness or in urban environments, the experiences of so many show that runners need to be aware of ticks and Lyme disease. Don’t let the threat stop your enjoyment, but check yourself afterwards and know how to remove any ticks you find.
How to remove a tick
Our list of dos and don’ts when it comes to avoiding and dealing with them...
1 Routinely check your skin after running on the trails.
2 Use fine-tipped tweezers or a tick-removal tool as available from some pharmacies, vets and pet shops. Blunt-nosed tweezers, such as those used to pluck eyebrows, are not ideal.
3 Grasp the tick as close to your skin as possible.
4 Slowly pull upwards, taking care not to squeeze or crush the tick. Dispose of it without touching it with your hands when you have removed it.
5 Clean the bite with antiseptic or soap and water.
6 You do not need to see a GP if you have been bitten unless you develop symptoms or develop the circular rash. You should also seek medical assistance if either of the latter two apply, but you have merely been to an area affected.
7 To help prevent a tick bite, you can use insect-repellents, especially those containing DEET. Wearing light-coloured clothing will make them easier to spot. And avoid running through long grass.
Possible Lyme disease symptoms
■ Circular red rash, which can occur up to three months after the bite or not at all. It can have a ‘bullseye’ appearance or be more irregular. It is not usually raised, painful or itchy
■ A high temperature, or feeling hot and shivery
■ Muscle and joint pain
■ Tiredness and loss of energy
■ Neck stiffness
■ Digestive issues
■ Later, more severe symptoms can include loss of cognitive function, joint swelling and vertigo.
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