Lyme disease is a bacterial infection carried by ticks and spread to humans through tick bites. It is the most common tick-borne disease in the northern hemisphere, although only a small number of ticks carry the disease. If an infected tick is not removed quickly enough, the person bitten can develop long-lasting chronic fatigue-type symptoms. It is thought there are up to 3000 new cases of Lyme disease in the UK every year.
What are the signs and symptoms of Lyme disease?
Lyme disease is most often identified by a red, bulls-eye-looking rash around a tick bite, although a rash may not appear in all cases. Other symptoms include:
- Limb stiffness, particularly in the morning after waking up
- Extreme fatigue
- Memory and attention difficulties
- Fever and high temperature
- Joint pain and swelling
- Heart problems and numbness (if left untreated for a long period)
How is Lyme disease diagnosed and treated?
It is recommended that people who have spent time in grassy or wooded areas check for ticks upon returning home as it may not be obvious from pain in the area of the bite alone.
A tick can be removed with tweezers and the area bitten disinfected with antiseptic following the removal. If done quickly, the person bitten will not develop a rash or other symptoms.
A GP will ask about travel to wooded areas if a patient presents with a circular red rash and flu-like symptoms. However, Lyme disease is difficult to diagnose because there is no conclusive test and symptoms are similar to those of other conditions such as chronic fatigue syndrome or seasonal flu.
Blood tests can still be carried out, but there may be a certain amount of inaccuracy in results in the early stages of the disease.
A doctor can prescribe antibiotics to treat suspected Lyme disease, which can last up to 28 days. Symptoms may last for much longer but they should improve eventually.
There is no standard procedure of treatment for people who experience the long-term side effects of Lyme disease such as chronic fatigue and muscle aches, but a GP can help advise on how to manage the condition in conjunction with work or school and other daily activities.
There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with Lyme disease:
An employee may not disclose their Lyme disease upfront, but if they do, questions regarding the nature of an employee’s Lyme disease and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, avoiding certain types of manual tasks which might exacerbate their fatigue or muscle ache symptoms.
- Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs and empowering them, in spite of their Lyme disease.
- Even if the employee does not wish to disclose their Lyme disease – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
What reasonable adjustments are possible for employees with Lyme disease?
Employers have a legal duty to make reasonable adjustments for employees with Lyme disease if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has Lyme disease. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of Lyme disease:
- Flexible working hours to accommodate medical appointments and periods of increased absence or decreased productivity following a flare-up in fatigue or pain symptoms.
- Additional breaks if the person’s pain medication causes their concentration to lapse or makes them drowsy shortly following taking it.
- Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. This may also be dependent on when they take their medication if they are required to operate machinery, for example.
- Raising awareness so that colleagues understand the employee’s Lyme disease and can help ensure the employee feels comfortable at work, for example, when taking additional breaks. This is also important in the case of Lyme disease as many cases go undetected (ticks embedded in the skin are simply not noticed by the person who has been bitten).
- Ergonomic equipment to reduce pressure on the back, joints and other susceptible parts of the body while sitting at a desk.
Lyme disease Signposting
Lyme disease UK – charity founded by people with Lyme disease to help raise awareness of the condition among the public and among health professionals and legislators. The charity has a dedicated Facebook group which allows people with Lyme disease to provide mutual support and advice.
Lyme Disease Action – organisation working with Public Health England and various medical journals to combat misinformation on the subject of Lyme disease and to raise awareness of symptoms and how they differ from Covid-19.