If you are bitten by an infected tick, there is a risk that you will become infected with tick-borne encephalitis (TBE) or Lyme disease bacteria. Here you can find out what the typical symptoms of both diseases are and what to do if you experience symptoms.
The good news first: The fact that a tick has landed on your body does not automatically mean that it leaves you with an illness. In order to become infected, the tick must first carry the bacteria or viruses that cause the disease – and pass them on.
Diseases that can be transmitted by ticks include Lyme disease (also called Lyme borreliosis or Lyme disease) and tick-borne encephalitis (TBE). Lyme disease is a bacterial infection that, according to the Robert Koch Institute (RKI), can affect various organ systems. TBE is transmitted via viruses – it is an inflammation of the brain or meninges. Lyme disease is more common than TBE.
According to the German Brain Foundation, around three percent of tick bites result in Lyme disease. TBE viruses occur mainly in southern Germany. For this purpose, the RKI publishes a map of the main endemic areas every year. On average, in TBE risk areas, 0.1 percent to 5 percent of ticks carry TBE viruses, explains the Robert Koch Institute (RKI).
It is important to know how the diseases manifest themselves – and how to protect yourself from them.
What symptoms does tick-borne encephalitis cause?
TBE initially manifests itself through fever, headaches and body aches, i.e. a general feeling of illness. The symptoms are similar to those of the flu and are often misinterpreted. When the symptoms subside, many people are over the disease – but not for everyone.
In some of those infected, the meninges, brain or spinal cord become inflamed in a second phase of the disease about a week later. This can be accompanied by fever, headache and nausea. “Sick people are also often sensitive to light,” says Kristina Huber, a doctor in the outpatient clinic of the Department of Infectious and Tropical Medicine at the LMU Clinic in Munich.
If the course is severe, seizures, symptoms of paralysis – for example in the arms and legs – and also difficulty swallowing and speaking are possible. Consequential damage, such as permanent impairment of fine or gross motor skills, cannot be ruled out. By the way, anyone who has TBE is not contagious.
By the way: Immediately after a tick bite, the affected area often becomes itchy and red – this is normal. It usually disappears within a few days. What if a red, spreading spot appears several days after the tick bite? Then this is a sign of Lyme disease, not TBE. It makes sense to go to the doctor about it.
According to the Robert Koch Institute, 475 TBE diseases were reported in Germany in 2023. Almost all of the sick people were not vaccinated or were only insufficiently vaccinated.
Lyme disease: What are the signs?
In addition to TBE, Lyme disease is the second disease that can be transmitted by ticks. Lyme disease can take very different courses. This is because the disease affects different – and often multiple – organ systems. This could be the skin, the nerves, the joints or the heart, as the German Brain Foundation explains.
The infection can also go unnoticed. However, if it causes symptoms, erythema migrans is typical.
Recognize typical wandering redness
This is how you recognize erythema migrans: A circular redness with a diameter of at least five centimeters forms around the puncture site. This can happen as early as three days after the tick bite, but it can also only appear after around 30 days. The redness continues to spread and can reach a diameter of up to 20 centimeters.
However, not every Lyme disease is accompanied by erythema. According to the German Brain Foundation, this symptom only occurs in three out of four people who show symptoms.
Other signs of Lyme disease include fever, chills and/or fatigue. Muscle and joint pain may also occur in the days or weeks after the sting. If Lyme disease affects the nervous system, it can cause nerve irritation, numbness, visual or hearing impairments or symptoms of paralysis.
Important to know: Lyme disease can have a second phase of the disease, which sometimes only begins months after the tick encounter. This can lead to meningitis, which is noticeable, among other things, through paralysis on one or both sides of the face.
I think I’m affected. And now?
Anyone who suspects they have Lyme disease should see their family doctor. The good news: The disease can be easily controlled with antibiotics, which can also protect against severe progression.
Precisely because it can take so long for Lyme disease to show itself, the German Brain Foundation advises: Keep in mind that you were bitten by a tick – it’s best to write down the date.
How can I prevent Lyme disease?
Good to know: It takes a few hours for the Borrelia (ie the pathogens of Lyme disease) to enter the body when a tick bites, explains the German Brain Foundation. “Up to 12 hours after the bite, the likelihood of Borrelia being transmitted is still very low. So if you discover the tick bite during this period and completely remove the tick, you usually don’t have to worry about Lyme disease.”
It is therefore important to search the body thoroughly immediately after excursions and to remove ticks quickly – for example with a tick card or tick pliers or even tweezers.
Of course, it’s best if the tick doesn’t even have the opportunity to bite. Therefore, you should wear long trousers when going out into the countryside – ideally long sleeves too. Anti-tick lotions and sprays can also help keep the animals away. By the way: Unlike TBE, there is no vaccination against Lyme disease.
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