Doctors have been warned to look out for a tick disease which is thought to be on the increase in Britain.
Infected ticks harbour the disease-causing bacterium
The Medical Defence Union (MDU), a doctors' insurance body, has told its members to remain vigilant for possible cases of Lyme disease.
Recently it has dealt with a number of complaints alleging a delay in diagnosis of the condition.
Lyme disease can be hard to spot as it has a variety of symptoms, and can easily be mistaken for something else.
It is caused by the bacterium Borrelia burgdorferi and is transmitted to humans by the bite of infected ticks.
The most common symptom is a slowly expanding rash which spreads out from a tick bite, usually after about five to 14 days.
Typical symptoms also include fever, headache, fatigue, and a characteristic skin rash called erythema migrans.
Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics.
But if left untreated, infection can spread to joints, the heart, and the nervous system.
Rise in cases
In England and Wales 684 cases were reported last year, and Scotland has seen a tenfold increase in numbers over the last decade, with 177 cases reported last year.
Dr Claire Wratten, MDU senior medical claims handler, said: "While a delay or failure in diagnosis is not necessarily negligent, if the condition remains untreated, patients may develop serious symptoms affecting mainly the neurological, cardiac and musculo-skeletal systems, many months to years after the initial infection.
"Doctors may see increasing numbers of cases of Lyme disease in the future as recent news reports have indicated a rise in the tick population."
Despite the fact the number of cases of Lyme disease is increasing, the MDU said it was likely that an individual doctor will only rarely see a case.
However, it has issued guidance for doctors advising them to:
- Tell patients to take precautions against tick bites if they are visiting woods, heathland and parklands in high risk areas
- Make themselves aware of the various clinical manifestations of the disease
- Consider the diagnosis in patients with possible symptoms who have walked in areas where the disease is prevalent
- Remember that only about 20% of patients are likely to recall being bitten by a tick
Sue O Connell, of the Health Protection Agency, said the MDU was right to highlight the issue, especially now when people were going off on holiday and spending more time outside.
She said: "Areas where infection has been acquired in the UK include popular holiday destinations such as Exmoor, the New Forest, the South Downs, parts of Wiltshire and Berkshire, Thetford Forest , the Lake District, the Yorkshire moors and the Scottish Highlands, but the infection can occur in other areas where ticks are present."