Lyme disease can be diagnosed by rash alone, new advice to the NHS says.
People with circular rash on the bulls eye do not need a blood test and should be treated immediately to avoid complications, says the National Institute for Health and Care Excellence.
Waiting for laboratory results is unnecessary and can cause delays in patients prescribed the antibiotics they need.
Lyme disease is spread by begging bites and can be debilitating.
A blood test may check for it, but may not produce a positive result until eight weeks after the patient is bitten.
Prof Gillian Leng, Deputy Director and Director of Health and Social Care at the National Institute for Health and Care Excellence (NICE), told most people with the Lyme disease that an antibiotic treatment would be an effective treatment "so it is important we diagnose and treat people as soon as possible ".
"A person with Lyme disease can present themselves with a variety of symptoms, so we have clear advice for professionals on the use of laboratory tests for diagnosis and the most appropriate antibiotic treatments," she said.
"If a distinctive bull disease is present, healthcare professionals should feel confident in diagnosing the Lyme disease."
Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions, and there is not always an obvious rash. Rashes can also be displayed in a variety of ways, as these images from the NICE guide show.
Symptoms may also include:
- a high temperature or feel warm and appalling
- muscle and joint pain
- loss of energy
However, if there is a delay in treatment, more severe symptoms may develop months or years later, including:
- pain and swelling of the joints
- nerve problems – such as pain or numbness
- heart problems
- loss of memory or concentration
- Ticks that can cause Lyme disease are found throughout the UK
- High-risk areas include grassy and wooded areas in southern England and the Highlands
- To reduce the risk of being bitten, cover your skin, take your pants in your socks, use insect repellents and stick to paths
- If you are bitten, remove the junction with fine-tipped tweezers or a cross-removal tool found in pharmacists
- Clean bites with antiseptic or soap and water
- The risk of getting sick is low, as only a small number of ticks are infected with the bacteria that cause Lyme disease
- You don't have to do anything else unless you become uncomfortable
- You must go to your doctor if you have been bitten by a tick or visited an area in the last month where infected ticks are found and you get flu-like symptoms or a circular red rash
- These symptoms may include warmth and tremors, headaches, muscle pain or disease
Source: NHS Elections
An increasing number of high-profile people have talked about their experience with the problems of living with the Lyme disease due to delayed diagnosis.
American model Bella Hadid has talked about the challenges of continuing to work with the disease because she is often exhausted and needs regular medication. Her mother, starring in The Real Housewives of Beverly Hills, and Bella's brother also have the disease.
The singer Avril Lavigne said it had taken months for her to be diagnosed with the disease, which had left her bed for two years. She got the first symptoms of the tour when she was nervous, tired and unable to get out of bed. She said she had felt so bad at a time that she had "accepted that I was dying".
Former England rugby player Matt Dawson got the disease after being bitten by a cross in a park in London in 2015. It caused a bacterial infection to spread through his body and left him to have heart surgery.
Phones 4U founder John Caudwell finances a charity Caudwell LymeCo that fund research he hopes "will lead to a truly reliable test and cure via the NHS for each Lyme disease patient". He and 14 other members of his family have the disease.
Veronica Hughes, CEO of Caudwell LymeCo, said she hoped that the new NICE draft guide would increase the number of doctors who felt confident in diagnosing a Lyme disease rash on the eye.
"Caudwell LymeCo Charity regularly hears from people whose doctors have diagnosed erythema migrans, but decides to check with a blood sample, without realizing that the rash is more reliable from the two," she said.
"Waiting for blood test results always delays treatment. When a patient has a rash, this delay is unnecessary and reduces the likelihood of total cure."