Recorded cases of Lyme disease spiked last year at the highest level since 2013, according to NHS statistics.
Laboratory tests confirmed more than 200 cases of the tick-borne condition in 2018 in Scotland.
Health Protection Scotland (HPS) says this is likely to be an underestimate of the total number because not every case is established by testing.
Instead doctors diagnose and treat the disease based on symptoms, according to HPS, which released the figures this week.
The number of cases rose to 238 in 2018, an increase of 70 on 2017.
HPS experts say some of the rise could be down to a new national testing lab at Raigmore established in 2018, which provides specialist diagnostic and confirmatory services for all of Scotland.
Lyme is caused by infected ticks that live in woodland and grassy areas attaching themselves to people walking by.
Around two in three people with the disease develop a distinctive bullseye-shaped rash around the bite.
If untreated it can lead to heart problems, swelling of the joints and damage the nervous system.