And flog mcfall. A bit cooler in scotland, we could see some surface a bit cooler in scotland, we could see some surface water a bit cooler in scotland, we could see some surface water flooding from persistent rain. The odd thunderstorm could break outjust about anywhere on monday but most leases will stay dry. The best of the sunshine in england and wales, often larger bits of cloud however. Temperatures are widely meant to low 20s across part of england and wales in particular. Some high impact sums working their way across parts of central and Eastern England into tuesday. This is bbc news. The headlines at 9. 00pm. Theres focus on Boris Johnsons private life after police were called to his partners flat after a row meanwhile his opponent for the conservative leadership says he should be answering questions about his brexit plans. The United States reportedly launched a cyber attack on iranian Weapons Systems on thursday as President Trump pulled out of air strikes on the country. The opposition has won a re run of the election for mayor of turkeys biggest city, istanbul. Five people are arrested over alleged accounting fraud at the bakery chain, patisserie valerie. Andy murray and Feliciano Lopez when the queens doubles title, and england beat cameroon 3 0 in the womens world cup. Now, on bbc news, fiona stoker investigates the spread of lyme disease. One tiny take under the skin can cause chronic illness, but gps are often slowed to diagnose and give treatment. More and more of us are catching lyme disease. 0ne tiny tick under the skin can cause debilitating illness. Nine years on from having started treatment, my life is still completely dominated by this disease. Are some gps too slow to diagnose and to give treatment that can stop it in his tracks . I went to the doctor and she said, no, you havent got lyme disease. None of that around here. And are doctors in denial about how patients can suffer long term . Basically told, why are you making up your illness . So i think even worse than being sick, being told you are not sick. There will be a tendency to not believe the patient and tell them it is in their head. As the Climate Changes and more of us are at risk, we reveal the truth about lyme disease. Callum culbert is 18. He lives with his parents and younger brothers in this beautiful part of the aberdeenshire countryside. He has grown up loving the outdoors and two years ago, he went on a hill walk that would change his life. Like any country boy, he was well used to insect and tick bites. He never imagined being bitten by something so small could be so dangerous. I sort of got tick bites throughout my life. Always been very outdoorsy and camping and going up hills. Callums mum has always been very aware of ticks. He had gone off and came back, we always do a tick check, we knew he had been bitten but when we did the tick check, i took 19 20 of them off of him. But there was no marking. He didnt exhibit too many ill conditions or anything. He seemed ok, for a few weeks. Then he started getting ill. I was in bed all the time and couldnt get up or move. I was losing weight ridiculously quick. I just couldnt carry on with normal life. Three months after he fell ill, callum was tested for lyme disease. It came back positive. He was actually another on another duke of edinburgh award. I met him and said you have lyme disease. I couldnt do anything. My life came to a standstill basically. Callums lyme disease took a while to diagnose. That is not unusual. Around 200 people a year in scotland are recorded with the disease. The true number is thought to be much higher. I was one of the lucky ones. I love the outdoors. Im always outside with the dog or outdoors with the children. But about 12 years ago, i tested positive for lyme disease. I noticed a bulls eye type rash on the back of my calf. I went to my gp and my gp said he wouldnt take any chances and gave me antibiotics. A few weeks later, that test came back again negative. The treatment i received for my gp was quick and successful. But i have been reading about a rise in lyme cases in the uk in instances where sufferers say they have struggled to get help. Lyme disease was only recorded for the first time in the 1970s by doctors in the usa. It is on the rise here and the highlands have been identified as a hotspot for infections. This is lochaber, one of the hotspots, and a good place then to speak to a gp who regularly sees patients with the disease. Lyme disease is an illness caused by a bacteria a barilla bacteria that is transmitted by ticks. That bacteria can be transmitted to the humans and cause a whole variety of different diseases. So around about the focus of the tick bite, over about a week after the original tick bite, a rash develops. That is the first and obvious sign that somebody has picked up an infected tick. And if the bacteria goes deeper into the body, it can cause really quite significant illness and affect primarily the nervous system, so can start causing paralysis, it can affect the joints. When it gets to this stage, again, antibiotics certainly can get rid of the bacteria, but in a percentage of people, theyre left with debilitating symptoms for quite some time. It is hard to believe that a tiny tick can cause such Serious Health problems. And it turns out there are far more of them around us than we might think. Along loch lomonds east banks, i met doctor lucy gilbert. She brought a blanket along. We were not going for a picnic. I will take this little square of blanket material. Im going to walk through the vegetation for ten metres slowly. At the end of that i will turn the blanket over and see whether any ticks have attached. We have a few ticks on this. It is probably about 13 celsius today. Probably about 90 of the tick population are active today. Scottish ticks are quite hardcore and even when it is 6 degrees, about 20 of them are active. Whereas if you go to central france, if its 6 degrees, none of them are active because they are used to the heat. Lucys interested in how Climate Change can affect tick numbers. She and her team are also looking into how Land Management and deer numbers in scotland can influence how many ticks we find around us. There is one. So tiny. Only about one and a half millimetres long. These guys are. They are so difficult to spot unless you know what youre looking for. They really are. They can get through holes in socks and hide in little crevices, and your tummy button. You have these three little ones, hatched about a year ago. We call these nymphs. This is an adult female, the biggest type, and has a very red abdomen and this is the adult male who is a bit smaller than the female and he is a black rather than red. Which ones can be infected . These can all be infected. But the ones that are most responsible for lyme disease cases in humans are the nymphs and they might be infected. In scotland, the average infection rate of these is maybe three or 4 of these might be infected. But obviously, that will vary enormously depending on where you are. A lot of places, none of them will be infected. 0ccasional place in scotland where maybe 20 may be infected. Lucy told me about her own brush with lyme disease. Her expertise in ticks and the Health Threat they pose held little sway with her gp. I noticed a little classic bulls eye rash, only a little one, i went to the doctor, and she said no, you havent got lyme disease. None of that around here. I said oh, i do work on lyme disease and ticks and this is one of my study sites and i do know it is around here. She said, no, i will not treat you. And i got flu like symptoms, and joint aches. Strange sensations on my skin. Eventually i went back to the doctor and there was a nice young doctor and he said i have to refer you to the hospital. And they gave me a month of intravenous antibiotics and luckily that cleared it. I am fine now. It mustve been difficult to be told you didnt have it when you knew about it. It was really frustrating. I knew i had it. I found a tick on me and knew it was the right type, been on for at least 2a hours, from an area i knew people had got lyme disease previously. I got the bulls eye rash which is supposed to be diagnostic. So, it was frustrating. Getting a diagnosis of lyme disease can be a complicated business. Morven may maccallum fell ill suddenly when she was 14. She says it changed her life. I was hugely into mountain biking, horse riding, i was in training for climbing up the mountain at caithness. I was one of these really annoying people who never stopped. Ijust kept going and i bounced everywhere. All that changed when what started off feeling like the flu became more serious. I would come home and collapse on the couch in a heap and i would literally get up and collapsed in utter exhaustion each day. We got to the point where i had to leave school at 16 because by the time i got home from school, i was so weak i couldnt physically walk. Her doctors believed that she was suffering from Chronic Fatigue syndrome. Then a neighbour who had lyme disease intervened. They saw me struggling to walk. They said to my mother have you considered lyme disease . She really researched this and she presented that research to the doctors and to the specialist that i saw and they refused again to accept that it could be lyme disease. Because all my blood tests kept coming back as negative. How was it confirmed as lyme disease . I want to a private clinic down south. There is a lyme disease specialist. She clinically diagnosed me with lyme disease and then she ordered a blood test which went to germany and they came back positive for lyme disease and from that i started my treatment, which has been ongoing for about nine years now. How could tests for the same infection produce such variable results . This hospital in inverness is the home of scotlands specialist Testing Centre for tick borne diseases. They collect lyme tests and data from across the country. The head doctor is roger evans. Lyme Disease Testing is complex. The disease presents in different ways. If you present acutely with a rash, and we do a normal test, if that is positive, with the clinical indications of a rash or flu like illness after a tick bite, we will think it is lyme disease and we would treat it. The difficulty there of course is in an acute infection, the antibody response might respond very quickly. And so the test that we use may be negative, even though the person has the disease. So, what we get is a false negative result. And those false negative results can have serious consequences. I think for a person who has been bitten by a tick, within a week or two, they may have very vague symptoms or flu like illness, not feeling terribly unwell, not the classic rash. So, it is not immediately identified by the gp. If we do a test and it is negative the person might think i dont have lyme disease. But in fact they may do have it and what can happen then is they go on to develop delayed lyme disease or other symptoms and then it is more to difficult to diagnose possibly and get treatment for it. Janie experienced a long delay in getting a lyme diagnosis. She has been living with the disease since being bitten by a tick while walking 15 years ago. I was in bed virtually all the time. I had headaches that felt like somebody had stuck a kitchen knife in the side of my head. I couldnt move for about six hours each night because it just was so painful. What does it feel like mentally . Torture. Janie had never heard of lyme disease and it would be three years before a specialist diagnosed her as having it. That wasnt the end of her problems. I was put on antibiotics. They were long term high dose antibiotics. I was treated for over three years by the nhs for my lyme disease. The treatment only really began to be effective at five weeks in and i had a day when i had the most severe headache and just was in bed all day feeling awful and then woke up the next day it felt like somebody had switched a light bulb on in my head, it was a really dramatic sudden improvement. And then, about ten months in, i had an attempt to come off the antibiotics, and it took five days before i crashed completely. Janies experiences mirror those of a number of lyme disease sufferers. They say it becomes a long term illness, which only responds to long term antibiotic treatments. Janie pays for all of these medicines privately. They are prescribed by a doctor who lives and works here in dublin. Doctor jack lambert believes the effects of lyme disease can last far longer than current medical advice suggests. I see patients who are previously 100 well, high functioning, and, two years later, nobody can figure out what is going on with them. And basically they are told, it is put back on them, are you depressed . Why are you making up your illness . So, i think become even worse than being sick is being told youre not sick. Do you think lyme disease is a chronic long term illness . I think it is absolutely. And that is the debate in the medical community. Most medical texts describe lyme disease as a tick bite, you get an acute infection and that is the end of it. But i think it actually goes on to cause chronic persistent infection and it is well documented in medical literature, people ignore the fact that lyme can persist for years and years. If it is untreated. Even if you treat it, with short course antibiotics, you have persistent symptoms, and that is enough proof to me that yes, it can cause chronic persistent infections. It is reversible with antibiotics. This is a minority view among those treating lyme. Most doctors say that definitive evidence of chronic or long term lyme disease has not been established. I think there are a lot of uncertainties and scientific uncertainties and understanding about the disease and how different peoples immune systems respond to a bacteria. But also the way that peoples bodies respond to that infection is all about the immune response and how our body tries to fight off that infection, i think what is happening is the bacteria is no longer there but i think the immune system is still very active and that is where they are getting symptoms from because of the activity of the immune system, the body kind of fighting itself. Now research is under way to try and resolve this debate. The ideal would be to for us to devise a test that can detect active lyme disease. If we could devise that test we would be made for life because that will be a test, where we could try and identify that patient, you have lyme disease and need to be treated. You do not have lyme disease, you need to consider another diagnosis. And both aspects are very important because for those who have lyme disease, they need to be identified and be treated appropriately. For those who do not have it, another diagnosis needs to be sought because they need to be helped. They are very unwell and need to find out what is causing that. Until then, a patients best bet is finding a gp who knows about lyme disease. They work to uk wide guidelines set out by nice, the National Institute for clinical excellence. These tell gps that the standard treatment is a three week course of antibiotics. A second course of different antibiotics if the first is unsuccessful. If that doesnt work, referral to a specialist and telling them the symptoms may take months or even years to resolve. Even after treatments. The people i have spoken to believe gps need more support in tackling lyme disease. If somebody is coming to a doctor saying i have all the symptoms and they cant find anything wrong because they dont have the test to cover it, i can completely understand that it is difficult, and there will be a tendency to not believe the patient and tell them it is in their heads. But what we need to make doctors aware of is this is a real illness and its really serious. And patients need an enormous amount of support. Calum culberts mum believes doctors should be better at picking up clues which could lead to a lyme diagnosis. I would have thought one of the first conversations should have been on the lines of you are very outdoorsy and have a history of being bitten, lets give you a test. I cannot reiterate how lucky calum is to get a positive test compared to people we know who have been left for years. I want to meet scotlands chief medical officer. I wanted to know if the government is doing enough to combat this disease. We have some really good resources. Resources that are on the website for patients and professionals. We have developed some really good, new guidelines for professionals specifically. I as chief medical officer am writing to all of the doctors in scotland in particular to the gps to highlight these Educational Resources are available. They can look at those themselves and they can also point out to patients if there are symptoms or issues to look out for. Getting better Awareness Among doctors in the public is clearly going to be vital in tackling lyme disease. It is notjust those of us who love the countryside who need to take care. It is absolutely stunning here. It is like wild park land. But it is in the middle of a city. You have arthurs seat over there in holyrood park. You will have deer all around here that carry ticks, foxes, rabbits, birds, even the dogs that we walk up here, even we carry ticks. I think it is important to understand about lyme disease in scotland yes, there are hotspots, but it is not just a rural problem. We have come across cases of lyme disease that are in cities. If you live in a city, it is no guarantee that you wont be bitten by a tick, and if you are bitten, there is a chance you will get lyme disease. It is a problem we all need to be aware of. The Scottish Government is committed to raising awareness and more research. There is so much more we dont know. Including exactly why cases have risen so much over the past 20 years. Professor Dominic Miller heads up scotlands response to lyme and other tick borne diseases. I started working here in 2006 and even then we knew lyme disease was a problem. Between then and 2010, the numbers of cases being diagnosed took a big jump. It is difficult to know for sure whether that was because there were that many more cases, or whether part of that was because people were coming more aware. 0ur changing climate is one major area for future research. Climate change is an obvious thing. It is very difficult to predict what is going to happen. Probably some areas more common and some less, but for Climate Change, it affects not just the ticks but the habitat and the behaviour of the people. We put all that together and work out the tricky bits. Certainly, my first two or three decades in practise here i very rarely saw lyme disease. But certainly over the past five years, we have seen an increasing problem. That is reflected notjust here, but in the wider lochaber area and many parts of highland. Conversations with gps, colleagues, other colleagues within the hospital are seeing more patients in their own observations, there is a lot of ticks around now and it is beginning to warm up in more ways than one. Whether you live in the city or the country, there are practical steps we can all take to reduce our risk. We start with this one here. The twister type device. It looks a little bit like a claw hammer and has a bevelled edge. The idea is if i had a tick on the back of my hand, i would go along and underneath the tick, and twist and lift off the idea is that you are not squeezing the tick, this is the alternative method. The so called card device. Produced by the nhs in scotland. It has a little magnifying glass on it so if it is one of the tiny nymph ticks, you can see it more clearly by looking through the glass. If it is the big tick, you use a little bevelled edge to go underneath and just lift off and it flicks out. Similar to that. The slightly larger size. 0n the back is how to remove it. It would be so tempting to use tweezers. Yes. The trouble is everybody then uses eyebrow tweezers or domestic tweezers. Where some people say if you use fine point tweezers they are ok but i think that creates confusion in the public and i think the plastic removal devices are much better. I guess you would like to see more of these. Exactly. Everywhere. It is impossible not to be moved by the suffering ive heard about. Lyme disease changes lives. It is still a slow battle getting back to what i felt before i got seriously ill. Still getting ill a bit and struggling with getting my health back in shape. It has been a long battle. In reality, even nine years on from having started treatment, my life is still completely dominated by this disease. Not a single second in which i feel like it is not in control of me. And that it not monopolizing my body. The whole world is in its infancy dealing with lyme disease. There is so much complexity about it. And so much that the scientists do not know. I feel passionate that this is something which needs to change. And i will keep pushing for it as much as i can. As patients struggle on, sometimes for years, it is clear much more needs to be done to get under the skin of lyme disease. Good evening. Sunshine will be back more widely later only weak, but getting increasingly hot and humid. Quite muggy out there tonight, and increasing risk of thunderstorms of the next few days. Not everyone will feel them, but if you do, risk of lightning. Showers pushing across Northern England into southern scotland, maybe Northern Ireland too. Things will turn dry, where you see the rain through the day, a bit of mist and fog and low cloud, and sticky temperatures, in mid to teens. The north east could see some surface water flooding from persistent rain. Using a bit in the afternoon, but the odd thunderstorm could break outjust about afternoon, but the odd thunderstorm could break out just about anywhere during monday, and businesses will stay dry, otherwise. Best of sunshine in england and wales, large amounts of cloud, and temperatures in the mid to low 20s. Some high impact storms working the way across parts of central and Eastern England to tuesday. This is bbc world news today. Our top stories. Celebrations in the turkish city of istanbul as the opposition wins a re run of the mayoral election. Its a major setback for president erdogan. Ethiopias Prime Minister urges his people to unite against evil, after his military chief of staff is shot dead during an attempted coup. Thousands of people gather in the czech capital prague, to call for the resignation of the Prime Minister over fraud allegations. Thailand celebrates the anniversary of the cave rescue that captivated the world, with a charity race run by some of the trapped footballers