Results from an enhanced surveillance study of laboratory-confirmed acute Lyme disease cases in England between 1 April 2023 and 31 March 2024.

In England, Lyme disease (LD) surveillance is based on laboratory-confirmed cases. However, clinical and epidemiological characteristics of these cases are limited; therefore, we conducted an enhanced surveillance study of acute LD in England. Enhanced data were collected through an online questionnaire sent to all laboratory-confirmed acute cases of LD resident in England, with specimen dates between 1 April 2023 and 31 March 2024. The analysis included data from 511/1086 cases. Respondents were representative of age, sex, and region of national LD trends. A total of 57.3% of the respondents reported that they did not realize that they had been bitten by a tick. Among those who remembered a tick bite, 66.1% reported bites close to their home and only 10.6% happened abroad, and 28.5% reported that the tick bite could have occurred in a garden. Most respondents were residents of areas of higher socioeconomic status. Erythema migrans was noted by 70.5% of the respondents. It is important to raise awareness among both patients and clinicians that ticks can be found in urban and suburban parks and gardens, as well as ensuring that wildlife initiatives to increase biodiversity include information on tick prevention and tick checks.