A bite from a tick, like this deer tick, started Matt Dawson’s problems. (Centers for Disease Control and Prevention via AP)

The bite was minuscule, so tiny that Matt Dawson, England’s former international rugby star, didn’t really think much about it until he began feeling awful. But that tick bite led to Lyme disease and 18 months of cascading health issues that resulted in heart surgeries.

Dawson, 44, is recovering, but he tells a nightmarish story of how he contracted the disease, which is more typically associated with rural and undeveloped areas, during an ordinary stroll in a west London park. “It was a really scary time for me and my family,” he said (via the Telegraph), “and I was shocked to find out that a tick bite in Chiswick, such a tiny creature, caused me to end up needing heart surgery.”

The disease, which is passed on by ticks who pick it up from deer and other animals, can lead to heart failure, meningitis, paralysis and memory problems. Dawson knew something was wrong when he felt poorly for a couple of days. Although the Centers for Disease Control and Prevention says that in cases of Lyme carditis, which are rare, bacteria enters heart tissue and “can interfere with the normal movement of electrical signals from the heart’s upper to lower chambers, a process that coordinates the beating of the heart. The result is something physicians call ‘heart block,’ which can be mild, moderate, or severe. Heart block from Lyme carditis can progress rapidly.” Patients are treated with antibiotics and can require a temporary pacemaker. Dawson did not detail exactly what occurred in his case, but noted that the initial symptoms seemed not to be serious.

“I had two days where I felt awful, very feverish on the sofa, crashed out,” said Dawson, who was a World Cup winner in 2003 and played 77 times for England (making seven appearances for the British and Irish Lions). “I’d heard of Lyme disease before. It was something I’d always associated with places abroad, on the continent, in America, wherever there were deer. There’s no way that I would’ve walked through a wood or a forest with my kids and gone back home and thought, ‘Right, I’ll just check for some ticks just to make sure everything is fine.’

“I just wouldn’t have thought of that.”

But warm, wet winters, coupled with a growing deer population and development that encroaches on animals’ and rodents’ habitats, has led to an increase in cases. The Big Tick Project, for which Dawson has been raising awareness, reports that “the distribution of ticks is estimated to have expanded by 17 percent in the last 10 years.” In a recent study, the project found that almost one-third of 14,000 dogs studied carried the parasite.

Dawson is free of the disease now, but he has not fully recovered. “I’m still on medication and its going to take a lot of time for the heart to fully recover. This is not something that should be looked at like, ‘Oh, it’s only a tick. A tick is a bit like a flea. It’s fine,'” he said (via the BBC). “These ticks carry some really quite potent, serious bacteria and they can cause you a lot of problems. Raising awareness of them is imperative.”

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