Dr Dawn has experienced over 30 years in the NHS, in hospital medicine and General Practice. She is a member of the Royal College of Physicians and holds the Diploma of Child Health.

While a picnic in the country or a walk through fields seems an idyllic way to spend an afternoon, there could be danger lurking in the glades. We’re not talking this summer’s surge in snakes (although do be vigilant), but innocent-seeming tick bites that are linked to Lyme disease.

You may have read about Phones 4u founder John Caudwell, who discovered that he and several members of his family had been infected. It’s a risk we all need to take seriously. Now, when I take a summer walk with my dogs through the fields, I cover up my legs to minimise the risk of being bitten by a tick, and advise my patients to do the same.

Why are ticks dangerous?
They carry the bacteria that causes Lyme (borrelia burgdorferi), so if you get a bite you can become infected. Most (but not all) of the 2,000 to 3,000 cases of Lyme every year in the UK occur in the warmer areas where people spend a lot of time outdoors. The risk shouldn’t be exaggerated, as ticks can’t jump or fly. But they can climb on to our skin from long grass, which is why keeping legs covered when in meadows, woodland or heath areas is a good precaution to take.

What if I’m bitten?
You won’t automatically go on to develop Lyme disease. But act quickly to remove the tick, as it takes about 24–48 hours for the bacteria to pass from an infected tick into a human. To do this, gently grip the tick as close to your skin as you can with a pair of tweezers. Pull it away from the skin without twisting or crushing it. If you think you’ve had a tick bite and develop a rash or a high temperature, see your GP straightaway.

Know the symptoms
If the bacteria infect you, they multiply and cause the disease. There are usually three stages.

Stage 1: Anything from three to 36 days after being bitten, you may see a rash that looks like a bullseye (see below), although it won’t usually be itchy or sore. Don’t ignore it – it should fade after about four weeks, but you may still be infected. About 30% of people also develop a mild flu-like illness. If the rash does appear, the diagnosis is straightforward, and you’ll be treated with antibiotics.

Stage 2: The infection may not go any further, even without treatment. But in some cases, weeks or even months after the initial bite, more serious symptoms may start to appear. Joint pain (especially in the knee) is a common one, and some people develop nerve damage, particularly in the face, so the facial muscles will weaken – or a form of meningitis or encephalitis may develop. The heart can also be affected, leading to heart rhythm problems or chest pain. The rash may reappear in other parts of the body and, rarely, the kidneys, eyes or liver may be infected.

Stage 3: Sometimes called ‘late Lyme disease’, this can develop months or even years after the original bite. Those affected may suffer from arthritis, balance difficulties, nerve damage and skin changes as well as confusion, poor memory, personality changes and sometimes even a schizophrenia-like illness. Antibiotics may still be effective at this stage.

How to avoid it
The symptoms – especially in later stages – certainly sound scary, but it’s important to remember the earlier Lyme is diagnosed and antibiotics started, the more likely you are to make a full recovery. I advise everyone to protect themselves this summer like this:

  • Cover up arms and legs anywhere you’re likely to brush against long grass.
  • Check your skin (and clothing) for ticks.
  • If you’re bitten by a tick, remove it as soon as you can.
  • If you see the rash or develop a fever after being bitten, see your GP as soon as possible.
  • Check your pet’s fur for ticks to prevent any being brought into your home.
  • Find out if your area or a place you’re visiting is a low, medium or high-risk area using this Tick Threat Map.