Individuals living in areas where ticks are prevalent know the risk of Lyme disease. Although Lyme is the most commonly reported vector-borne disease in the U.S., several other tick-borne diseases pose a threat to humans, including tick-borne encephalitis (TBE).
Understanding the differences between these diseases, including how they spread and the differences between their respective symptoms, can help spread awareness and inspire precautions against transmission and long-term complications.
Tick-borne encephalitis vs. Lyme disease
Is tick-borne encephalitis the same as Lyme disease? Although tick-borne encephalitis and Lyme disease are both infectious diseases caused by tick bites, they are distinct illnesses with different symptoms and modes of transmission.
Transmission
One of the chief differences between tick-borne encephalitis and Lyme disease is how they’re transmitted. While both are generally transmitted by tick bites, Lyme disease is caused by bacteria, and a virus causes TBE.
Lyme disease
In the United States, Lyme disease is generally spread by the blacklegged tick (Ixodes scapularis), also known as the deer tick. These types of ticks can carry a bacteria called Borrelia burgdorferi, which, when transmitted to humans, can cause a Lyme infection. Lyme is most commonly transmitted during cooler months by young ticks known as nymphs.
There are approximately 476,000 cases of Lyme disease in the U.S. and over 200,000 cases in Europe each year.
Lyme is usually transmitted after a tick has been attached to its host for several hours.
Tick-borne encephalitis
Tick-borne encephalitis, caused by a virus belonging to the genus Flavivirus, is most often transmitted by tick bites, but can occasionally be spread by ingesting raw milk or cheese from infected sheep, cows, or goats. TBE virus is prevalent in western and northern Europe and northern and eastern Asia and is more commonly spread during warmer months. Tick-borne encephalitis has been reported in over 34 countries.
Although the TBE virus is not commonly reported in the U.S., people who travel to areas where it’s found may be at risk of infection. The risk is even higher for people who do outdoor activities in or near forests.
The World Health Organization, WHO, described TBE as “an important cause of viral infections in the central nervous system.” There are approximately 10,000-12,000 reported cases of TBE each year.
As opposed to Lyme disease, tick-borne encephalitis can be passed from the tick to the host in a matter of minutes upon feeding.
Symptoms of tick-borne encephalitis vs. Lyme disease
In Europe, Lyme disease and TBE are spread by Ixodes ricinus, also known as the sheep tick, deer tick, or wood tick. Coinfection can occur in patients bit by a tick carrying Lyme-causing bacteria and the TBE virus simultaneously.
Awareness of the symptoms of both these illnesses can aid in early identification and diagnosis, thus leading to proper treatment.
Symptoms of Lyme
Lyme disease is often called the “great imitator” as its symptoms can mimic those of fibromyalgia, chronic fatigue syndrome, and Multiple Sclerosis (MS). Lyme disease symptoms typically manifest within 3 to 30 days following a tick bite.
The most common symptoms of Lyme disease include:
- Fever
- Headache
- Fatigue
- Swollen lymph nodes
- Chills
- Joint and muscle aches
- Erythema migrans, “bull’s eye rash,” that starts at the site of the tick bite and gradually expands over several days
People with late-stage Lyme or chronic Lyme disease may experience these symptoms months or years after an initial infection:
- Severe headaches
- Shooting pains, tingling, or numbness in the feet or hands
- Arthritis, especially in large joints like the knees, typically occurring on only one side of the body
- Dizziness
- Lyme carditis which can cause irregular heartbeat and heart palpitations
- Effects on the central nervous system
Symptoms of TBE
People who contract tick-borne encephalitis typically display symptoms within 7 to 14 days after being bit, though it can take as long as 28 days. Roughly two-thirds of patients infected with the virus do not experience symptoms.
Initial symptoms of TBE may include:
- Fever
- Headache
- Vomiting
- Weakness
In severe cases, a patient may develop swelling of the brain (encephalitis) and the membranes around the spinal cord (meningitis). For some patients, initial symptoms may resolve after a few days before more severe symptoms develop a week later. This is referred to as a “biphasic illness.”
Approximately 50% of people who contract TBE develop severe symptoms. TBE has a 1% fatality rate.
Treating tick-borne encephalitis vs. Lyme disease
As Lyme and TBE are distinct illnesses, they require different treatment approaches.
Lyme disease
The first step in adequately treating Lyme disease is receiving a diagnosis. Innovations in Lyme disease testing, like those by iGeneX, have allowed for more accurate and reliable results at any stage of the disease.
Most cases of Lyme are treated with antibiotics, such as doxycycline or amoxicillin, when caught early on. Those who are never treated or who develop Post-Treatment Lyme Disease Syndrome (PTLDS) may require additional support to manage symptoms.
Chronic Lyme and PTLDS treatment may include:
- Medications for fatigue or fibromyalgia symptoms
- Antidepressants for treatment of pain, sleep, and mental health
- Long treatment using antibiotics
- Natural remedies such as supplements, acupuncture, and bee products
- Dietary and lifestyle changes
Tick-borne encephalitis
Because TBE is a viral rather than a bacterial infection, it can not be treated using antibiotics. At this time, there are no bespoke treatments for tick-borne encephalitis. Symptoms may be managed with rest, fluids, and over-the-counter pain medications.
People who develop more severe symptoms, including meningoencephalitis, encephalitis, or meningitis, may require hospitalization and intensive care. In-patient treatment may entail intubation, ventilator support, and anti-inflammatory medications.
Preventing tick-borne diseases
A vaccine is available for tick-borne encephalitis, though it is only approved for use in some countries. Where available, inoculation is recommended for individuals residing in high-risk areas, as well as those who are frequently outdoors. Those looking to travel into regions where the virus is prevalent are encouraged to inquire about vaccination against tick-borne encephalitis with their insurance and healthcare provider.
The most effective way to prevent both Lyme disease and TBE is to take steps to avoid tick bites first. Remember these tips when in areas where ticks are prevalent:
- Be mindful when trekking in areas of brush or tall grass
- Restrict travel to paths and trails
- Utilize insect repellent containing DEET (N,N-diethyl-meta-toluamide) or lemon eucalyptus oil
- Wear long hair tied up
- Cover arms and legs
- Thoroughly check oneself, children, and pets when returning from the outdoors
Remaining diligent about preventing tick bites is vital. If you suspect you may have contracted a tick-borne disease, seek out testing as soon as possible.
Treatment starts with testing
As stated above, Lyme is often misdiagnosed as other ailments with which it shares some symptoms. If you’ve been bit by a tick and have the specimen available, send it in for testing as soon as possible to catch tick-borne diseases, even before symptoms are present.
Without the tick, it is still crucial that patients get tested for tick-borne diseases as soon as they identify a bite. IGeneX uses carefully developed cePCR™ (Culture Enhanced PCR) testing tick-borne illnesses, including Lyme.