‘The tricky thing is knowing if you have been bitten by a tick. They are hard to find and can be very small when they first attach because they’re not full of blood,” says Professor James Logan, head of the department of disease control at the London School of Hygiene and Tropical Medicine. There are three sizes of tick, and they all feed on blood: the larvae are tiny, the nymphs are about the size of a poppy seed and are most likely to transmit Lyme disease, while the adults reach the size of a pea when they are full of blood. “If you are out somewhere where there are likely to be ticks – particularly moorland, but anywhere where there are deer – you need to be checking yourself and your kids every hour or so, and especially when you get home. Even Richmond Park in London has ticks with Lyme disease,” he advises. Organisations such as Lyme Disease Action and Public Health England have information on where there is a known prevalence of Lyme disease, such as Dartmoor, Exmoor, the Scottish Highlands and some national parks, but, warns Logan: “Technically it could happen anywhere.”

Once you find a tick, the key is to remove it as quickly as possible. Use specially made very fine tweezers – “Not the kind you pluck your eyebrows with, those are too big,” says Logan – or you can buy claw-shaped tick-removal tools in pharmacies, outdoor pursuit shops and online. If using tweezers, pull the tick directly upwards – do not twist it – and grab it as close to the skin as possible, to ensure you remove the head and mouth. “When the tick bites you, it injects saliva and a kind of cement into your skin, which means it clings on very tightly – if you pull the body, the head will snap off, stay in the skin and you could become infected,” warns Logan. If you use the claw-shaped tool, twisting helps to remove the tick. “I carry a tick-removal tool whenever I go on a walk in the countryside,” he says.

The next step is to keep an eye on the bite. “In the majority of people, it will disappear, and there will be no consequences,” says Logan. But half of those who do get Lyme disease go on to develop what’s known as erythema migrans, a bull’s eye-shaped rash that looks like a red spot surrounded by normal skin, then a red circle that starts to expand. “If you have that after a tick bite, you probably have Lyme disease,” he says – but if you don’t see the mark, it doesn’t mean you don’t have Lyme. It could take a few days, weeks or months to show, and you might also develop flu-like symptoms: feeling tired with achy joints. “If any of those things occur after the bite, then it’s worth going to see your GP. The key is to tell them about the tick and where you’ve been, so they can make their assessment as to whether it’s likely to be Lyme disease,” says Logan. If it is, they’ll prescribe a course of antibiotics, which should clear up the infection. “The consensus is it’s not a good idea to take antibiotics ‘just in case’ – there has to be some evidence that you’re ill or have a very high chance of having contracted Lyme disease,” he explains.

Some people with Lyme disease describe getting short shrift from their GP, so what should you do if you don’t feel you’ve been taken seriously? Logan says: “Some GPs are very well informed – such as in the Scottish Highlands, where they regularly see people with tick bites – whereas a GP in a city centre is much less likely to see people with tick bites or Lyme disease very often.” If you want a second opinion, you can ask to be referred to another GP, and go to the Hospital for Tropical Diseases, where there are specialists. “What I don’t recommend is going online and finding a lab that offers to test for Lyme disease – you have no idea if that lab is accredited, and it could give you a fake result.” Lyme Disease Action also offers advice, and the website bug-off.org has information about how to protect yourself from ticks.