Ticks can transmit dangerous diseases. Recently, more people have been infected with Lyme disease. The number of infections rose sharply, especially in the first year of the pandemic. Detected in time, Lyme disease can be treated well. Tips on how to avoid and how to deal with stings.
The sun lures you outside, even in the evening it is often still nice and warm: In the summertime, many people spend their free time at lakes or in allotment gardens, hiking or barbecuing in the park. However, ticks also feel comfortable in tall grass and bushes. The little bloodsuckers are not only annoying, but can also transmit diseases. In addition to tick-borne encephalitis (TBE), against which there is an effective vaccination, Lyme disease (pronounced: Laim’s disease) also stands out.
“Lyme disease has been occurring all over Germany from Flensburg to Garmisch-Partenkirchen for decades,” explains Hendrik Wilking from the Robert Koch Institute. Many infections go unnoticed, in 90 percent of the others a ring-shaped so-called reddening of the skin becomes noticeable a few days to a few weeks after the bite. It is usually paler in the center than at the edge and slowly spreads outward over days. A few percent of those infected develop nerve and joint diseases or cardiac arrhythmia
What all forms have in common is that they can be easily treated with antibiotics. However, it does not make sense to go to the doctor for every tick bite. ” The occurrence of Borrelia in ticks is so small that a two-digit percentage of ticks can be infected on one side of a field, but only a fraction of them can be found on the other side of the field,” explains Wilking. very variable.”
Nevertheless, there are Lyme disease strongholds in Germany. The panel doctors diagnosed one Lyme disease per 100,000 insured persons in 2020
So that’s a lot of infections, according to figures from the Central Institute for Statutory Health Insurance Physician Care in Germany (Zi). According to this, the number of Lyme disease infections in Germany increased by around eight percent in the first year of corona compared to 2019.
This could possibly be a result of increased leisure activities in the countryside due to the restrictions imposed by the Corona measures, explained Zi CEO Dominik von Stillfried. In addition, there was ideal, i.e. warm and dry tick weather in many regions.
Previously, the numbers had fallen slightly since 2010. According to the most recent data from 2020, a total of almost 360,000 Lyme diseases were diagnosed by the panel doctors nationwide. That’s an average of 465 people per 100,000 insured, down from 429 in 2019.
“It wasn’t until 1981 that it was discovered that a connection with this bacterium plays a role in various diseases that were described more than 100 years ago and that also affect various organ systems,” explains Lyme disease specialist Helmut Eiffert from the MVZ wagnerstibbe for medical microbiology in Goettingen. The ticks suck blood from rodents that carry one of six Borrelia species and store them in their intestines.
If the ticks then dock with a person, transmission does not occur immediately. “The Borrelia must first migrate to the salivary gland,” explains Eiffert. So there is a certain time window in which the tick can be removed without further consequences. It is best to grab them with a special tick card or tweezers very close to the skin or wrap them with a thread – “and then quickly and straight out with it,” as Wilking explains.
If you don’t have any tools to hand – which is particularly common in nature – you shouldn’t wait, according to Wilking, but remove the tick with your fingernail if necessary. “The teething tools can stay in and catch fire, like a kind of pimple, but they don’t pose a health risk.” Under no circumstances should you wait until a doctor or a drugstore has reopened, because by then the ticks would probably have been with you delivery of the Borrelia started.
“When the tick bites, there is an average transmission in three percent and clinical symptoms in one percent,” reports Eiffert. “Most of the time, this disappears completely. However, it is possible that these bacteria are activated again years later , and then those are the severe cases. But we hardly ever see that anymore, because antibiotics are used at an early stage.”
Eiffert, who has treated many affected children in the past, points out that the offspring in particular are bitten particularly often on the head – with the risk that the typical reddening under the hair remains undetected and more severe symptoms can develop as a result. In addition to covering clothing, thorough searching after being outdoors is the best protection against Lyme disease. If a tick is actually found, you should keep a close eye on the area around the bite site – for six weeks. If redness occurs, you should go to the doctor immediately.
In order to completely avoid being bitten by a tick at all, anyone who spends a lot of time outdoors should observe the following tips:
“Our native ticks like to stay in tall grass, bushes, loose leaves and in forests that are not too dry,” says family doctor and emergency doctor Michaela Geiger from Neckarsulm.
Most of the time you brush them off in passing. “In this respect, the protective rules are: wear sturdy shoes, put long trousers in your socks and thoroughly check your whole body after spending time in nature.”
Children should also wear a hat. Because: Ticks can climb up to a certain height in the bushes.
It is also advisable to find out whether you are traveling in a TBE risk area. According to the Robert Koch Institute, there are currently 175 districts, most of them in Bavaria and Baden-Württemberg.
Mosquito or tick sprays are only useful to a limited extent, says tropical medicine specialist Kristina Huber from the LMU Klinikum in Munich. “They are good against mosquitoes – but it has not been proven that they are just as effective against ticks.”
A combination of different measures ensures the best possible protection: a vaccination against TBE, long clothing, a tick spray with the active ingredient permethrin – sprayed on the skin and fabric.
Just as important as the preparation is the follow-up – i.e. the thorough examination of the body. Important: “Since you can’t see the back and the back of your knees so well, it helps to support each other when searching,” says emergency doctor Geiger.
You should also not forget the body folds in the genital area as well as the areas behind the ears and under the armpits.
“A tick, which is usually dark, is easier to spot on light-colored clothing,” says family doctor Geiger.
By the way, if you dress in bright colors in nature, you can also keep mosquitoes that are active during the day at bay. According to Huber, a specialist in tropical medicine, they tend to respond to dark colors.
What if you were bitten by a tick? The advice of emergency doctor Michaela Geiger: “As a rule, you have enough time to remove the tick.”
In the case of Lyme disease, the tick has to suck on the skin for a certain amount of time before it releases Borrelia to the human organism. “If you remove the tick in less than twelve hours, you usually have nothing to worry about,” says Geiger.
It looks a little different with TBE. The disease is transmitted much faster by a tick bite. But it is also much rarer: According to the RKI, only 0.1 to 5 percent of ticks in risk areas carry TBE viruses.
As a rule, however, there is time to go to the pharmacy to buy tools to remove the tick. Advantage of tick hooks, cards or pliers: Thanks to them, the tick can be removed slowly and in a controlled manner. It is best to disinfect the wound afterwards.
Sometimes you don’t have any special tools at hand – and there is no pharmacy nearby either. It is better to stay away from home remedies.
Kristina Huber gives an example: “It used to be said that you should rub oil or butter on the tick so that it couldn’t breathe anymore and had to let go.”
According to the infectiologist, this is true, but there is a risk that the tick – if it brings TBE viruses or Borrelia with it – will spit out the pathogens through the friction. “Therefore, this method is strongly discouraged,” says Huber.
In an emergency, the tick can also be removed with your fingers. “It is important not to squeeze or twist the tick, otherwise it is more likely to release pathogens into the human organism,” says Geiger, who is also the chairwoman of the German Central Association of Homeopathic Doctors (DZVhÄ).
“Many are afraid that they have removed the body of the tick, but its head or stinging device is still in the skin,” says the doctor. The same applies here: no reason to panic. Because the transmission of Borrelia via the head alone does not work – these are in the intestine of the tick.
If you are not sure that you have removed the entire tick, you can consult your family doctor to be on the safe side.
“If you have been bitten by a tick, it is fundamentally important to observe the area for four to six weeks,” says Michaela Geiger. You can note the date of the sting and mark the puncture site.
In this way, the local movement of the inflammation can be easily tracked. “Sometimes you get stung and the skin turns a little red at the site, which is perfectly normal,” says Geiger. The redness often disappears after a few days without an infection having occurred.
By the way: Lyme disease and TBE symptoms can be easily distinguished from each other. In the case of Lyme disease, the so-called reddening occurs as the first sign.
“The puncture mark in the center is fading. An expanding red halo is created around it,” describes Geiger. The edge-accentuated circle can increase up to a diameter of 10 to 20 centimeters. Lyme disease can be treated well with antibiotics.
According to Huber, a TBE infection usually begins with non-specific symptoms such as headaches and body aches or fever. There is often a symptom-free interval of almost a week before meningitis, brain or nerve inflammation sets in.