Health and prevention

Tick bites: 11 questions and answers on Lyme disease and more

INFORMATION
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The best protection against ticks is to wear light-coloured clothing that covers as much of you as possible and use tick repellent. Source: iStock / Kerrick

Tick season is set to continue until October. This year, a significant number of patients have already had to visit their doctor because of a tick bite. The chances of contracting an infection from a tick bit are high – according to information on the TCS website, this will occur in roughly one in twenty people. Comparis answers the 11 most compelling questions surrounding tick bites, the transmission of infections to humans, first aid measures, vaccinations and costs.

Ticks don’t jump onto people, nor do they drop from trees. Rather, these tiny bloodsuckers tend to lie in wait for their victims on bushes and grass. At an opportune moment, they attach themselves to any living thing that brushes past them, ready to bite. This occurs imperceptibly and usually painlessly – a small bite that can have severe consequences, as ticks infected with viruses and bacteria transmit the pathogen into the skin. There are two serious diseases that they spread in this way: Lyme disease (borreliosis) and the tick-borne encephalitis (TBE) virus, which can lead to meningitis.

Why can tick bites be dangerous?

Ticks are carriers of diseases. If they carry the borreliosis bacteria, this can lead to infection. In Switzerland, some 10,000 people contract Lyme disease each year. As well as the site on the skin becoming inflamed, producing a rash called erythema migrans, often called the “bullseye” rash, the disease can also affect the nervous system, musculoskeletal system and the heart. If the illness is not treated with antibiotics in time, the person affected can be left with lifelong impairments such as arthrosis, skin atrophy and personality changes.

In addition, some ticks carry the virus that can cause tick-borne encephalitis (TBE). Within one or two weeks of being bitten, the victim may complain of flu-like symptoms such as headaches, fever, fatigue and joint pain. In approximately one in ten cases, encephalitis or meningitis may follow, leading to severe headaches, light sensitivity and dizziness, as well as problems with concentration, speech and walking. In rare cases, the virus can cause paralysis in the arms and legs and even death.

Are all ticks dangerous?

Depending on the region, between 5 and 30 per cent (sometimes even up to 50 per cent) of ticks carry the borreliosis bacteria. About one per cent of ticks carry the TBE virus. Two common types of tick are the sheep or castor bean tick and the ornate cow tick.

But scientists warn of another tick species that has started to appear in Switzerland: the Ixodes inopinatus from the Mediterranean. What is still unclear is whether this type can also transmit the TBE virus – or even introduce new diseases.

How can I guard against infections?

There is no vaccine against Lyme disease as yet, but there is an effective vaccine for TBE, which is administered in three doses. 

How soon is the TBE vaccine effective?

The first two doses of the TBE vaccine are administered within one month. After the second dose, the patient is protected for a limited time. The third dose is given five to twelve months after the second injection and provides long-term protection against TBE – usually around ten years. After that, a booster injection should be given.

Who should be vaccinated against TBE?

All adults and children from the age of six who live in or occasionally spend time in areas where the TBE vaccination is recommended should be immunized against TBE.

When is the TBE vaccine not recommended?

Since the TBE vaccine is grown on chicken cells, the doctor should inform those allergic to chicken egg protein of this fact. However, according to the Robert Koch Institute in Germany, the vaccination is safe even for those with this allergy. On the other hand, if the egg protein allergy is severe, safety precautions must be taken when the vaccine is administered and the patient monitored afterwards. 

Does health insurance cover the TBE vaccine?

TBE vaccines are covered for adults and children from six years of age, minus the deductible and coinsurance, provided they live in an area where the TBE vaccination is recommended. If you spend time in tick-infested areas for work reasons, your employer covers the costs.

Where are the risk areas in Switzerland?

Ticks are found across the whole of Switzerland up to a height of around 2,000 metres above sea level, although there are no known areas over 1,000 metres above sea level inhabited by ticks carrying the TBE virus. The Swiss Confederation website features an interactive map showing the risk areas for Lyme disease and the areas where the TBE vaccination is recommended.

How can walkers, hikers and runners protect themselves?

Light-coloured clothing, which makes ticks easier to spot, should be worn. To reduce skin exposure, long sleeves and trousers are recommended, with trousers tucked into socks. Special protective sprays and lotions are available that can be applied to the skin. Otherwise, areas of undergrowth should be avoided, since ticks are usually brushed off bushes onto clothing or skin. It's generally a good idea to inspect your body for ticks after spending time in the forest – ideally the same day.

How do you remove a tick? 

If you discover a tick on you, you should remove it as soon as possible, either by pulling it out in a single continuous movement with fine-tipped tweezers or using a special tick remover card. Never use oil, nail varnish, alcohol or glue as these substances can encourage the transmission of viruses. Always disinfect the site of the tick bite. If you notice any symptoms occurring within a few days or weeks of a tick bite, you should consult a doctor.

Typical symptoms are:

  • Fever, headaches and aching limbs
  • Light sensitivity
  • Dizziness

A typical sign of Lyme disease is the red bullseye rash. It is commonly called this because of the red ring that appears around the bite: 

Lyme disease is transmitted to humans by tick bites.
Lyme disease is transmitted to humans by ticks. Source: iStock / anakopa

How are TBE and Lyme disease treated?

It is very difficult to treat TBE. Treatment focuses on protecting the body from the virus, reducing pain and preventing long-term impairments.

Lyme disease is usually difficult to diagnose. The symptoms can vary significantly, sometimes taking years to appear after the infection. However, if the disease is identified at an early stage, it can be effectively treated with antibiotics. How long the antibiotic treatment lasts and how high the dose depends on how far the illness has advanced.