Public health organizations continue to grow more concerned as tickborne diseases increasingly threaten the health of thousands.
But, for many regular citizens, illnesses like tickborne encephalitis and Lyme disease may appear to be the same thing. So, what’s the difference between the two diseases?
Let’s find out.
How are the Two Diseases Transmitted?
Lyme disease is caused by bacterium while a virus causes tickborne encephalitis.
Both tickborne encephalitis and Lyme disease are transmitted principally by ticks. It is also possible for each to be passed on from an infected mother to her baby. Additionally, tickborne encephalitis can spread through the consumption of raw milk from infected cows, goats or sheep.
The bacterium responsible for Lyme disease is Borrelia burgdorferi. This is spread by the blacklegged tick (a.k.a. the deer tick or Ixodes scapularis) and the western blacklegged tick (Ixodes pacificus) in the United States. The disease is most commonly transmitted by tiny young ticks, called nymphs, during the cooler months of the year. These nymphs must generally be attached to a human for 36-48 hours before the Lyme disease bacterium can spread.
Tickborne encephalitis virus (TBEV) is from the Flaviviridae family and is spread by hard ticks of the family Ixodidae. The tickborne encephalitis virus has three subtypes: European, Siberian and Far Eastern. The ECDC shares that TBEV transmission to humans occurs most commonly in rural, forested areas. Travelers to endemic regions are most at risk in the period between April and November.
The United Kingdom’s Louping ill virus, which primarily affects sheep, is related to the TBEV.
What Symptoms Can These Diseases Cause? How Severe are They?
Tickborne encephalitis and Lyme disease can each cause very serious, potentially lifelong symptoms. It is possible for patients of either disease to die as a result of infection, though fatalities are rare.
The hallmark Lyme disease sign is a classic EM (erythema migrans) rash, which will appear in roughly 70-80% of infected persons. Other more generic symptoms like fever, chills, headaches, and muscle/joint aches will show 3-30 days after the tick bite.
Later signs and symptoms can be more severe and occur days to months after the bite. These symptoms include:
- Neck stiffness
- Additional EM rashes
- Facial palsy
- Heart palpitations or irregular heartbeat
- Nerve pain
- Inflammation of the brain and spinal cord
- Intermittent pain in tendons, muscles, joints and bones and shooting pains
- Numbness or tingling in the hands or feet
- Some patients develop post-treatment Lyme disease syndrome
Tickborne encephalitis patients will be asymptomatic during the incubation period (approximately 7-14 days after infection). Two-thirds of patients infected with the European TBEV will experience only an early viremic phase. They will have nonspecific symptoms such as fever, muscle aches, headaches, nausea, vomiting and malaise.
In 20-30% of cases, a new clinical illness begins after eight days of remission. This involves the central nervous system and brings the onset of meningitis, encephalitis or meningoencephalitis. Signs include:
- Headache and a stiff neck
- Sensory disturbances
What is Treatment Like for Each Disease?
After laboratory testing to confirm a diagnosis, antibiotics are used to treat Lyme disease while tickborne encephalitis has no specific initial treatment.
Patients who receive medication in the early stages of Lyme disease infection typically recover rapidly and totally. Those who are treated later will also likely respond well, but some may have suffered long-term joint or nervous system damage. Lingering symptoms generally improve on their own over time.
Common choices for the oral treatment of Lyme disease include antibiotics such as doxycycline, amoxicillin or cefuroxime axetil.
There isn’t any specific treatment for tickborne encephalitis.
If meningitis, encephalitis or meningoencephalitis develop, patients will require hospitalization. Supportive care, such as anti-inflammatory drugs, could be used based on severity of the symptoms. Intubation and ventilator support may be used to assist patients.
Are Tickborne Encephalitis and Lyme Disease Common?
Unfortunately, statistics of the prevalence of both Lyme disease and tickborne encephalitis are likely significantly lower than their actual totals, making it difficult to know exactly how many cases there are.
The CDC considers Lyme disease the most commonly occurring vector-borne disease. Lyme disease is also the sixth-most commonly reported notifiable infectious disease.
Lyme disease causes more than 300,000 illnesses each year in the US and has reportedly been found in more than 80 countries. Global Lyme Alliance shares that approximately 230,000 new cases of Lyme disease are reported in Western Europe each year. Lyme cases cause approximately 1 billion euros of financial burden.
Tickborne encephalitis is described by the WHO as “an important cause of viral infections of the central nervous system” in eastern, central and northern European countries, and in Mongolia, Northern China and the Russian Federation. There are at least 10,000-12,000 clinical cases of tickborne encephalitis annually around the world. European’s human cases increased by almost 400% in the last 30 years.
What Can be Done to Prevent Infections?
A vaccine is available to protect against tickborne encephalitis transmission. There is currently no such preventative measure for Lyme disease.
To lower your chances of getting either illness on your travels to endemic regions, avoid exposure to ticks. Consider wearing light, covering clothing and sticking to paths whenever possible. The use of insect repellents containing DEET can also prevent tick bites. Remember that ticks can attach to any part of the human body, but are often found in hard-to-see areas.
If you’re concerned that you may have been bitten by a tick, read more about the signs of a dangerous bug bite in our guide.
Reducing exposure to ticks is considered the best defense against Lyme disease. There is still no vaccination or medication to prevent transmission.
Vaccines can help people successfully prevent tickborne-encephalitis transmission. The NHS shares that two injections of a vaccine can protect you for about a year. A third injection can increase protection to about three years.
Because tickborne encephalitis can spread through animal milks, avoid drinking or eating unpasteurized diary products in risk areas.
Did you realize Lyme disease and tickborne encephalitis were so different? Have you or someone you know had to deal with these diseases? Let us know in the comments below, or via Facebook and Twitter.
Written for Passport Health by Katherine Meikle. Katherine is a research writer and proud first-generation British-American living in Florida, where she was born and raised. She has a passion for travel and a love of writing, which go hand-in-hand.