Emergence of Lyme Disease on Treeless Islands, Scotland, United Kingdom

Lyme disease is usually associated with forested habitats but has recently emerged on treeless islands in the Western Isles of Scotland. The environmental and human components of Lyme disease risk in open habitats remain unknown. We quantified the environmental hazard and risk factors for human tick bite exposure among treeless islands with low and high Lyme disease incidence in the Western Isles. We found a higher prevalence of Borrelia burgdorferi sensu lato-infected ticks on high-incidence than on low-incidence islands (6.4% vs. 0.7%); we also found that residents of high-incidence islands reported increased tick bite exposure. Most tick bites (72.7%) occurred <= 1 km from the home, including many in home gardens. Residents of high Lyme disease incidence islands reported increasing problems with ticks; many suggested changing deer distribution as a potential driver. We highlight the benefits of an integrated approach in understanding the factors that contribute to Lyme disease emergence.

Automated summary

A study in the Western Isles of Scotland found that residents of treeless islands with higher Lyme disease incidence were more likely to be infected by Borrelia burgdorferi sensu lato-infected ticks. Some residents suggested changing deer distribution as a potential driver of Lyme disease emergence. This highlights the importance of an integrated approach in understanding factors contributing to Lyme disease.