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Those who spend the summer in the wild should expect a tick bite – and the possibility of an infection. Lyme disease is the most widespread tick-borne disease in Germany. However, a bite is not a cause for panic: the risk of contracting Lyme disease is low, the treatment is generally not a problem.
However, it is sometimes difficult to detect the infection. Untreated, Borrelia can cause serious and prolonged problems.
A quick withdrawal can prevent the infection
An estimated 60,000 to 200,000 people in Germany contract Lyme disease every year through a tick bite. Pathogens can affect, among other things, the nervous system, joints and skin, and very rarely the heart.
The disease is caused by various types of Borrelia bacteria that can appear in the tick gut. If the tick begins to suck blood, Borrelia migrate into their salivary glands and can be transferred to bite with saliva. However, it will take several hours for this to happen. Therefore, rapid withdrawal of the tick can prevent infection.
It is also important to know that only a small portion of ticks contain Borrelia, which depends on the stage of development of the animal and is regionally different. "With larvae, it's about one percent, with nymphs, there are ten and with adult animals, with 20%," says Volker Fingerle of the national reference center for Borrelia in Oberschleissheim. Nymphs are called young ticks.
Transmission not yet well documented
In addition, pathogens are not transmitted to humans for every bite of an infected tick. And not all pathogens make the bitten sick. According to the Robert Koch Institute, a clinically detectable disease may occur later in 0.3 to 1.4% of tick bites. In most cases, an infection occurs without symptoms of the disease, the body eliminates pathogens.
Until now, it is unclear why Borrelia bacteria is not always transmitted to humans and does not cause disease – and if so, if any. Factors that influence the risk of infection include:
- What kind of Borrelia sleeps in a tick,
- the immune system of the host and
- his current defense.
"Biologically, all of this is a very complex process that has so far been misunderstood," Fingerle said.
Redness, myalgia, paralysis
When it is an infection, it manifests itself in about 80 to 90% of cases on the skin: Around the bite site occurs a few days or weeks after the passage of the skin. 39, ring redness. This is also known as the whitening red because it spreads slowly to the outside.
Sometimes flu-like symptoms such as muscle and joint pain or fever appear. Anyone who experiences such symptoms after a tick bite should consult their doctor, who can then clarify the infection and treat it with antibiotics.
In about ten percent of infections, it is nerve infestation. The experts then speak of early neuroborreliosis. "This can lead to facial paralysis due to inflammation of the facial nerves," says Sebastian Rauer of the University Hospital of Freiburg.
Often the spinal nerves of the spinal cord are also affected. This causes violent, burning, painful pains that run in the shape of a belt. According to Rauer, they occur mostly at night and do not respond to painkillers. Subsequently, it can happen to paralysis of the legs and arms.
"This form of the disease is also well treated with antibiotic treatment for two to three weeks," said Rauer. "It is a rapid relief of symptoms, the disease heals in most cases without consequences."
Difficult diagnosis
If the infection is neglected for a long time, it can result in late neuroborreliosis. The bacterium infests the spinal cord and the brain, causing paralysis and bladder problems. This stage of the disease is also treated with antibiotics. "In this case, it means that you can at least stop the disease and prevent further progression," says Rauer, but at this point the symptoms persisted.
The diagnosis of the disease is sometimes difficult, "although this is only possible because of the symptoms," says Rauer. However, it may happen that the patient or doctor first think of other diseases because of the symptoms. Back pain could indicate a pinched nerve then an orthopedic treatment – and ineffective in this case -.
Conversely, Lyme disease often has to be used to diagnose other diseases, says Volker Fingerle of the Borrelia Reference Center. "Many people have misinterpreted their symptoms." Clear diagnosis can be tricky in individual cases, it is extremely difficult to evaluate cases. "But they are rare," says Fingerle.
Other tick-borne diseases are much less common in Germany. These include tick-borne encephalitis (TBE) and human granulocytic anaplasmosis.
To bite or sting? Editor's note
We often talk about whether ticks bite or bite. Since they open the skin with their mouthpiece and hang on it, then absorb the blood with a kind of horn, both terms are conceivable. We decided to bite after talking with tick researchers, but the RKI prefers to talk about tick bites.
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