The risk of a tick bite in Germany is highest between March and November,
in forests, meadows, parks and gardens
particularly in the grass, the edges of paths, bushes or undergrowth.
Apart from a red rash, usually itchy,
that tick bites cause on the skin around the bite,
ticks can also pass on diseases.
The ticks absorbed the pathogens responsible along with blood
from animals, wild animals in particular, from previous bites.
The main diseases transmitted by ticks
are Lyme disease and tick-borne encephalitis.
Tick-borne encephalitis (TBE) is caused by the TBE virus
sometimes found in tick saliva.
This means the TBE virus can be passed on directly by a bite
and infection cannot be prevented by quickly removing the tick
as with Lyme disease.
This is because the Lyme disease pathogens live in the tick’s bowel
and have further to travel to the bite,
so it takes longer for them to be passed on.
However tick-borne encephalitis infections are very rare.
There were just 445 cases reported for the whole of Germany in 2019,
most of them in Bavaria and Baden-Württemberg.
There are maps of Germany for risk assessment purposes
showing areas at a high risk of tick-borne encephalitis,
as cases are recorded throughout the country.
Symptoms of mild tick-borne encephalitis mostly take 1 to 2 weeks to appear
and are similar to those of flu
such as high temperature, headaches, vomiting and feeling faint.
They clear up on their own after a week,
but a second phase may occur after about a week
with more severe symptoms.
During this phase meningitis or even encephalitis may develop,
or in rare cases myelitis.
Symptoms are again high temperature as well as severe fatigue and headaches.
Impaired consciousness, coordination problems
or paralysis may also occur,
affecting the face, arms or legs.
People may also have swallowing problems, impaired vision and slurred speech.
Paralysis is mostly temporary
but in rare cases may also persist for months or even become permanent.
However, around 70 - 95 out of every 100 infections
are asymptomatic or do not enter the second phase.
In children in particular,
the infection often goes unnoticed or is very mild.
Deaths due to tick-borne encephalitis are very rare.
Out of every hundred people
with the severe form of tick-borne encephalitis
less than one dies from it.
There are no drugs for the tick-borne encephalitis virus.
The disease is treated symptomatically,
i.e. with drugs for relieving pain and reducing fever.
However there is a vaccine
that is recommended for specific at-risk groups
such as residents in or visitors to high-risk areas
who spend a lot of time outdoors.
The best thing of course is to avoid tick bites entirely.
This means, for example, taking special care in high-risk areas,
or generally wearing suitable clothing when hiking in forests and meadows
such as robust footwear, long trousers and socks pulled up over trouser legs.
There are also tick-specific repellents
that can be applied to exposed areas of skin.
However the level and duration of protection they provide varies
and they are not 100% effective.
In short:
In southern Germany in particular,
ticks may be carrying tick-borne encephalitis viruses
that can be passed on via a bite
and cause tick-borne encephalitis.
However the disease is very rare.
Most cases of tick-borne encephalitis are asymptomatic
or involve mild symptoms only.
Typically, flu-like symptoms appear 1 - 2 few weeks after the bite
in people who catch the disease
and last for about a week.
The disease sometimes progresses to a more severe second phase.
Meningitis, encephalitis or even myelitis may then develop a week later.
There is no drug treatment for the tick-borne encephalitis virus
but there is a vaccine recommended for at-risk groups.
Apart from vaccination
the best way to protect against tick-borne encephalitis is to avoid tick bites.