Lyme Disease: Tick-Borne Encephalitides and Complications


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Adult Deer Tick, Ixodes scapularis, Photo Scott Bauer, US Dept of Agriculture

Lyme disease is the world’s fastest-growing tick-borne infection. Victims can have either mild or severe symptoms, depending on the state of their immune system and the extent of co-infections in the body such as bartonella, anaplasmosis and babesia or other health issues. When do Lyme Disease symptoms show up, and what makes them worse?

Lyme disease (Borreliosis) Symptom Onset

Some who contract Lyme Disease may have no symptoms at first; they can appear months after the initial infection. You can catch European Lyme disease in forested regions throughout Europe and northern Asia; it’s more common in eastern and central Europe. In North America, several species of Borrelia burgdorferi cause Lyme disease, all over the continent. Infection by American ticks results in similar symptoms, although U.S. tests cannot detect European Lyme disease.

Lyme Disease and Co-Infections

The bacterium Borrelia burgdorferi causes Lyme Disease, which we get when we’re bitten by infected ticks. If left untreated, infection can spread to joints, the heart, and the nervous system. Doctors diagnose Lyme disease based on symptoms and exposure to infected ticks, and lab testing. Once you’ve received a diagnosis, your doctor will treat you with antibiotics.

There are a variety of co-infections that can make Lyme Disease even worse. If you’ve got any of these infections, and add an infected tick to the mix, you could become very ill.

  • Bartonella bacteria cause cat scratch disease, trench fever and Carrión’s disease.
  • The bacterium Anaplasma phagocytophilium, carried by the black-legged tick (Ixodes scapularis) causes Anaplasmosis.
  • Microscopic Babesia parasites cause Babesiosis, which infects red blood cells and is also spread by ticks.

Potentially Fatal Tick-Borne Encephalitides

Flaviviruses transmitted by ticks cause encephalitis. The Central European form of encephalitis has two phases, the first phase beginning with a fever which lasts for 7 days, followed by an asymptomatic period of 8 to 15 days. The second phase manifests with the signs and symptoms of meningo-encephalitis, including fever, headache, nausea and vomiting; body temperature may rise rapidly. Most patients recover completely, but a lack of treatment can be very dangerous.

A small, almost invisible tick bite could prove fatal to you, for example, if you’ve had your spleen removed. A 2008 case in the Journal of American Board of Family Medicine highlights an incident in which a traveler did not reveal a visit to a sector of the United States where tick borne encephalitis is endemic – his trip could have proved fatal.

Lyme disease ticks may also transmit other dangerous tick-borne diseases:

  • Imported tick-borne spotted fevers (rickettsial infections) cause infection in returning travelers. In the U.S., Rickettsia africae (the agent of African spotted fever) causes the most frequently-diagnosed infection due international travel.
  • Tick-borne encephalitis is present in many parts of Europe, the former Soviet Union, and Asia. Three virus sub-types include: European or Western tick-borne encephalitis virus, Siberian tick-borne encephalitis virus, and Russian Far Eastern tick-borne encephalitis virus.

Tick-Bite Season is Here: Lyme Disease

Another traveler, an orienteer who competed in Central Europe, returned home with Central European meningo-encephalitis which was diagnosed and treated- fortunately without complications. He told me, ‘A bull’s eye, spreading rash with the tick bite clearly visible coupled with a rise in body temperature ensured a visit to my GP with a seven day course of antibiotics clearing the rash and infection.’

Red Deer, coming from the Czech Republic, have helped spread tick-borne encephalitis throughout Western Europe. Alarmingly, tick-borne encephalitis is on the increase, so this traveler may not be the last to experience the bull’s-eye rash of Lyme Disease.


US CDC. Lyme Disease Centre. (2013). Accessed June 2, 2013. 

Abrams, Y. Complications of Babesia and Lyme Disease. (2008). Journal of American Board of Family Medicine. Accessed June 2, 2013. 

National Science Foundation. Lyme Disease on the Rise. Accessed June 2, 2013.

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