Ticks & Diseases Info

Lyme disease andearly summer meningoencephalitis (TBE) are the most common tick-borne diseases in Austria. Rarely,anaplasmosis,tick-borne relapsing fever-Borreliosis throughBorrelia miyamotoi,neoehrlichiosis,rickettsiosis,babesiosis, andalpha-gal syndrome.Tularemiais usually a contact infection but is very rarely also transmitted by ticks in certain areas.Crimean-Congo hemorrhagic fever has not yet been observed in Austria.

Lyme-Borreliose

Lyme borreliosis is an infectious disease caused by spirochetes, which are bacteria of the genus Borrelia. More than 30 percent of Ixodes ricinus ticks (common wood tick; most common tick species in central and northern Europe) are infected with Borrelia. These bacteria reside in the tick's gut and can be transmitted to the host animal/human after an approximately 12-hour (6-48-hour) blood meal from an attached tick.

Lyme disease is the most common infectious disease transmitted by Ixodes ricinus ticks in the Northern Hemisphere. It is particularly common in Central Europe and Scandinavian countries. Due to climate warming, the distribution area of infected ticks is continuously expanding northward. From about seven degrees Celsius ground temperature, Ixodes ricinus becomes active. A study from Austria showed that the risk of getting a Borrelia infection after a tick bite is 5%. 3% of the individuals developed erythema migrans (see below). The number of Lyme disease infections in Austria is estimated at 25,000 to 70,000 per year.

Symptoms of Lyme borreliosis are seen in the skin, nervous system, joints, heart and eyes.

Symptoms of Lyme disease

Erythema migrans (wandering redness) is the most common disease symptom of Lyme borreliosis (> 80 percent of all cases). Erythema migrans develops at the earliest 3-6 days up to several weeks after the tick bite around the tick bite site as an enlarging red or blue-red spot with or without later central lightening. The outer edge is clearly separated, often more intensely colored and not noticeably raised. If the diameter is at least five centimeters, the diagnosis is made clinically by an experienced physician. If the diameter is smaller, the diagnosis requires a confirmed tick bite, a delay of at least two days in the appearance of the erythema after the tick bite, and increasing erythema at the tick bite site.

Accompanying symptoms such as local itching/burning, fatigue, headache, joint pain can occur with erythema migrans with a frequency of 40%.

Borrelia lymphocytoma is a painless, blue-red nodule or spot, usually on the earlobe, auricle margin, nipple, or scrotum. It is more common in children (especially on the ear) than in adults.

Acrodermatitis chronica atrophicans (ACA) is a chronic progressive skin disease caused by Lyme borrelia that does not heal spontaneously. ACA begins with a red or blue-red change in the skin, usually on the extensor sides of the arms or legs, which may persist for a long time. Later, there is a disappearance of all skin layers (skin atrophy), the skin becomes thin "like cigarette paper" and easily vulnerable. Neuropathies (damage to nerves) may occur in the affected skin area. With long-standing ACA, the joints in the affected skin area are also affected. Skin thickening and slowly growing, painless, fibroid nodules (benign tumors) may develop over bony prominences.

Lyme neuroborreliosis occurs in adults mainly as meningitis and as very painful nerve root inflammation (Garin-Bujadoux-Bannwarth syndrome). Rarely, brain inflammation (encephalitis), spinal cord inflammation (myelitis), and very rarely inflammation of the brain vessels (cerebral vasculitis) are observed.

In children, Lyme neuroborreliosis mainly manifests as facial paralysis or mild meningitis.

Lyme arthritis is characterized by recurrent attacks or persistent, objective joint swelling in one major joint or in a few major joints. Almost always, the knee joint is affected. Exclusion of other causes is necessary.

Lyme carditis occurs rarely and is characterized by conduction disorders and cardiac arrhythmia; occasionally, myocarditis and inflammation of all layers of the heart wall (pancarditis) have been observed. Exclusion of other causes is necessary.

Eye inflammations caused by pathogens of Lyme borreliosis are observed very rarely. They can affect the conjunctiva (conjunctivitis), iris (uveitis), sclera (episcleritis) and cornea (keratitis), as well as the optic nerve head (papillitis).

Prevention

A vaccine is not currently available.

Treatment

Lyme borreliosis is treated with suitable antibiotics to be administered orally or intravenously over a period of 10 to 14 days, in individual cases over four weeks.

Occurrence in Austria

In Austria, 25,000 to 70,000 people contract Lyme borreliosis each year.

Early summer meningoencephalitis (TBE)

Early summer meningoencephalitis (TBE), also called tick-borne encephalitis, is caused by the TBE virus found in the saliva of some ticks. The tick transmits the viruses immediately after being bitten. The TBE virus multiplies in human nerve cells. The disease is notifiable and typically progresses in two phases.

Symptoms

In the first phase, flu-like symptoms such as headache, fever, fatigue or joint complaints occur about seven days to two weeks after the tick bite. These symptoms (signs of illness) disappear after a few days, and a connection with a tick bite is rarely thought of. For most patients, this means the disease is over and they are probably immune to TBE viruses for life.

In about five to 15 percent of patients, after a symptom-free interval, there is a second phase of illness involving the central nervous system. The symptoms of this meningitis or brain inflammation are severe headaches, photophobia, dizziness, concentration disorders, speech disorders, and walking disorders. These signs of illness can last for weeks to months. In severe courses, paralysis of the arms, legs or facial nerves can occur and lead to permanent disabilities. About one percent of patients with neurological symptoms die from TBE. In children, the disease is mild in most cases, that is, without severe or permanent damage.

Prevention

A vaccination protects against infection with TBE. There is no specific therapy against the disease, the treatment aims at alleviating the symptoms.

Occurrence in Austria

Austria is one of the areas most affected by TBE in Europe. Ticks contaminated with TBE viruses occur in all federal provinces. Cases of the disease are reported annually from all federal provinces.

Year Number
2000 12
2001 23
2002 36
2003 52
2004 32
2005 62
2006 53
2007 33
2008 65
2009 60
2010 67
2011 103
2012 49
2013 100
2014 81
2015 79
2016 95
2017 123
2018 171
2019 106
2020 250
2021 (as of 20/05/2022) 135

Source: BMSGPK Annual statistics of notifiable infectious diseases

Anaplasmose

Anaplasmas(Anaplasma phagocytophilum) are small, gram-negative (possess a protective capsule that protects them from infection-fighting white blood cells) pleomorphic (can take on a variety of appearances) rod-shaped bacteria that multiply primarily in host cells, i.e. are obligately intracellular. In the infected cells in the blood, the white blood cells (granulocytes), anaplasmas are present as small mulberry-like inclusions called morulae. In humans, they can occasionally cause a very febrile disease called human granulocytic anaplasmosis.

The pathogen has been known in veterinary medicine since 1932, and the first human infection was reported in the 1990s. Transmission to humans occurs through tick bites. The most common vector in Europe is the common wood tick(Ixodes ricinus).

Symptoms

Up to 75 percent of anaplasma infections proceed without recognizable signs of illness (symptoms). After an incubation period of about 5 to 30 days, flu-like symptoms (high fever, headache, aching limbs, muscles and joints) may occur. Rarely, abdominal pain, nausea, vomiting and diarrhea (diarrhea) occur. Severe complications such as multiple organ failure, meningitis, and acute respiratory distress syndrome may occur in people with compromised immune systems. The mortality of untreated anaplasmosis is reported to be 2 to 3 percent.

Prevention

A vaccine is not currently available.

Occurrence in Austria

Anaplasma phagocytophilum DNA was first detected in the common wood tick(Ixodes ricinus) and red deer in 2002. The occurrence of Anaplasma in ticks and red deer has been repeatedly confirmed since then. Human diseases with source of infection in Austria are very rare but severe courses have been documented.

Neoehrlichiosis

This disease is caused by the obligate intracellular bacterium Neoehrlichia mikurensis and it was first described in 2010. Infections have subsequently also been detected in individuals from Sweden, Germany, the Czech Republic, Austria, and China.

Symptoms

The symptoms (signs of illness) of neoehrlichiosis are nonspecific: after an incubation period of approximately 7 to 14 days, malaise, muscle and joint pain, high fever up to 40 °C, and weight loss occur. Other symptoms described in the literature include headache, cough, nausea, and vomiting. The duration of the fever is reported to be up to eight months. Laboratory diagnostics reveal anemia (anemia of the blood).

Prevention

A vaccine is currently not available.

Occurrence in Austria

About four percent of ticks are infected with the bacterium Neoehrlichia mikurensis. In Vienna and Tyrol, ticks are most frequently affected with just over eight percent. Human diseases with a source of infection in Austria have been documented repeatedly, but almost exclusively in patients with an impaired immune system, such as those with leukemia, rheumatism or after organ transplantation. A study from Austria, conducted at the Medical University of Vienna, showed that the pathogen was detectable in 2.5% of healthy individuals after a tick bite without causing disease.

Rickettsialpox

Rickettsiae are obligate intracellular bacteria (multiply primarily in host cells) that are distributed worldwide and can multiply exclusively in living cells. They are found in ticks as well as in mites, fleas and lice. Only a few species of rickettsiae are pathogens of humans.

The tick-borne rickettsiae are grouped together as the tick-borne fever group.

It includes Rocky Mountain spotted fever, native to America, caused by Rickettsia rickettsii, and rickettsiosis caused by R. parkeri. Dermacentor variabilis, D. andersonii, and Amblyomma maculatum act as vectors there.

The Rickettsia conorii complex includes Mediterranean tick-bite fever, transmitted by the brown dog tick (Rhipicephalus sanguineus). In addition, in 2002, the University of Marseille reported the case of a 36-year-old patient who developed a febrile infection with a generalized rash caused by Rickettsia aeschlimannii following a tick bite by Hyalomma marginatum in Morocco. Other rickettsial species in Europe include R. helvetica, R. monacensis, R. raoultii, and R. slovaca. The latter two cause a disease called TIBOLA (tick-borne lymphadenopathy) or SENLAT (schalp eschar and neck lymphadenopathy after tick bite), which occurs mainly after bites from Dermacentor ticks.

Louse spotted fever is a notifiable infectious disease caused by Rickettsia prowazekii. It is a typical disease of the uncultivated, occurring in times of war and hardship, and is transmitted primarily by the clothes louse.

Symptoms

In Rocky Mountain spotted fever, the incubation period is a few days to two weeks. Symptoms include a sudden onset of fever, headache, nausea with vomiting, muscle aches, and rash on the wrists, ankles, and forearms. The rash is seen in only about one in two patients.

Mediterranean tick-bite fever is a severe illness with high fever, severe muscle and joint pain, fatigue, and exhaustion. Patients with underlying diseases are at much higher risk.

In TIBOLA / SENLAT, a skin lesion develops at the tick bite site that resembles a cigarette butt burn and is called an eschar. It often occurs on the scalp. Enlargement of lymph nodes in the neck and throat area is also found. Accompanying symptoms include fever, fatigue, and skin rashes. However, SENLAT can also be triggered by other pathogens. In Austria, for example, SENLAT was detected for the first time after a Borrelia infection.

In louse spotted fever, after an incubation period of 10 to 14 days, chills, increasingly high fever, headache, pain in the limbs and clouding of consciousness (if the brain is also affected) occur. A blue- to red-spotted skin rash is typical.

Prevention

A vaccine is currently not available.

Occurrence in Austria

About 17 percent of Ixodes ricinus ticks are infected with rickettsiae (R. helvetica, R. raoultii, R. monacensis, R.slovaca). In the Vienna area, about every second tick was infected with rickettsiae, followed by Carinthia (23.8 percent positive) and Lower Austria (18.8 percent positive). Human diseases with an infectious source in Austria have not been documented in recent decades.

Louse spotted fever was still of great importance in Austria until the post-war years.

Relapsing fever Lyme disease

Borrelia miyamotoi-Borreliose

Borrelia miyamotoi was discovered in Ixodes persulcatus ticks in Hokkaido, Japan, in 1995. The unique feature of this was that a new relapsing fever Borrelia species was discovered in tick ticks. Vectors of all other tick-borne relapsing fever borrelia are leather ticks. As recently as 2011, cases of disease caused by B. miyamotoi were reported from Russia and subsequently from the United States, Europe, and Japan. The disease presents with flu-like symptoms including fever, fatigue, headache, and chills. Meningoencephalitis due to B. miyamotoi was reported in a severely immunocompromised patient. The name shield tick relapsing fever-Borreliosis has been suggested. However, there are as yet no clear case definitions for disease induced by B. miyamotoi.

Prevention A vaccine is currently not available

Occurrence in Austria In Austria, the occurrence of Borrelia miyamotoi in ticks was first documented in 2015. A case of disease has only been documented once in Austria to date.

Tick and lice relapsing fever

Tick-borne relapsing fever occurs primarily in Africa, Asia, the Americas (North, Central, and South), the Middle East, southern Russia, and sporadically in the Mediterranean region (Spain, Portugal). Leather ticks of the genus Ornithodorus are reservoirs and vectors of relapsing fever borrelia - with the exception of B. duttonii, for which humans themselves are the reservoir.

Louse relapsing fever is a notifiable infectious disease caused by Borrelia recurrentis. It is a typical disease of the uncultured, occurring in times of war and hardship, and is transmitted primarily by the clothes louse, only rarely by ticks.

Symptoms

After an incubation period of 1-14 days (often about five days), the disease begins with sudden high fever, joint, head, chest, and limb pain, nausea, and sometimes shortness of breath. Cough and a small-spotted exanthema (skin rash) may occur. Increased bleeding tendency with nosebleeds and bleeding into the skin are also not uncommon, as well as clouding of consciousness and yellowing of the skin (icterus). The first episode of fever lasts about 5-7 days, followed by a fever- and symptom-free interval of 1-21 days (often 5-7 days). Subsequent febrile episodes usually decrease in duration and intensity. In addition, the central nervous system may also be affected in the form of meningitis. Relapsing fever Lyme disease can be treated with antibiotics; untreated, mortality is about 20 percent.

Prevention

A vaccine is not currently available.

Occurrence in Austria

In Austria acquired (autochthonous) cases are not known. Tick-borne and louse-borne relapsing fever cases detected in our country in recent years were without exception imported diseases.

Tularemia

Tularaemia (rabbit plague) is a notifiable infectious disease caused byFrancisella tularensis, a gram-negative (possess a protective capsule that protects them from infection-fighting white blood cells) bacterium that is endemic (localized) throughout Austria, especially in the Austrian-Slovak borderlands along the Morava River. Various small mammals such as rodents and hares act as reservoirs. In mice from these areas, mixed infections with different Borrelia species and withFrancisella tularensis can be detected. Francisella tularensis is found in bothdermacentor andIxodes ricinus ticks. Routes of infection usually include skin or mucosal contact with infectious animal material, consumption of inadequately heated contaminated meat or other food, and ingestion of contaminated water or inhalation of contaminated dust.

Symptoms

In tick-bite transmission, a punched-out ulcer (Eschar-like) develops around the bite site, followed by regional lymphadenitis (lymphadenitis) and occasionally fever (ulceroglandular form). Aerogenous transmission may result in high-fever pneumonia. Microbiological diagnosis is necessary, especially because of the differentiation from rickettsial infections and the implementation of appropriate therapy.

Prevention

A vaccine is currently not available.

Occurrence in Austria

Of the 418 cases of tularemia observed in western Slovakia between 1985 and 1998, 45 were transmitted by tick bite. In Austria, a total of 42 human cases of tularemia were reported between 01/01/2009 and 31/03/2018; the exact route of transmission is unknown in most cases. Tick-borne transmission was recently documented in a child from Salzburg.

Babesiosis

Babesia are unicellular parasites that infect the red blood cells of vertebrates. Transmission to humans occurs through tick bites. The most common vector in Europe is the common wood tick(Ixodes ricinus). The wood tick(Dermacentor reticulatus) is a vector of Babesia canis canis, the causative agent of canine babesiosis ("canine malaria").

Symptoms

The disease is rarely diagnosed in humans. Infection is often clinically inconspicuous, i.e., without symptoms. If symptoms do occur, they resemble malaria in some respects. The incubation period is approximately one to three weeks. Fever, anemia and jaundice may occur. In acute cases, coffee-brown to red-colored urine is common.

Prevention

A vaccine is currently not available.

Occurrence in Austria

In Austria, Babesia divergens, Babesia venatorum and Babesia microti have been detected in ticks so far. Human diseases with source of infection in Austria have been described.

Crimean Congo Hemorrhagic Fever

This disease is caused by the Crimean-Congo fever virus (CCHFV). The virus is transmitted byHyalomma ticks, which are found in warmer regions of southeastern Europe (Bulgaria, Kosovo) and Asia (Turkey), among others. Over 30Hyalomma species have been identified as vectors. Domestic and wild animals, e.g. cows, sheep, camels or goats act as hosts to spread the pathogen. The virus was first isolated in Africa (Congo) in 1956 from the blood sample of a diseased person. The disease pattern "Crimean hemorrhagic fever" had already been known since 1944.

Transmission of the pathogen can also occur through direct contact with blood or meat from infected animals. Nosocomial infections (infections in hospitals) have also been repeatedly documented. In August 2016, a person died in Spain for the first time from Crimean-Congo fever, having been infected in Spain through a tick bite.

Symptoms

Signs of illness usually appear three to seven days after infection. The disease begins suddenly with high fever, headache, pain in the limbs, vomiting, and diarrhea. As the disease progresses, skin rashes and general bleeding may occur. The mortality rate ranges from 2 to 50 percent.

Prevention

A vaccine is not currently available. As a preventive measure, protection against tick bites is recommended in affected areas (insect repellent, closed light-colored clothing, regular self-examination for ticks).

Occurrence in Austria

Hyalomma ticks have been repeatedly detected in Germany since 2015. In October 2018, the University of Veterinary Medicine Vienna succeeded in detectingHyalomma marginatum in Austria for the first time. The tick proved to be free of Crimean-Congo fever virus (CCHFV). Human diseases with a source of infection in Austria have never been documented before.

Alpha-gal syndrome

This allergy to the sugar galactose-alpha-1,3-galactose (alpha-gal) is caused in some people by the bite of certain tick species. Alpha-gal syndrome was first described in the USA in 2009. Subsequently, this form of allergy has been detected in people on other continents, including Europe (Sweden, Norway, Germany, Switzerland, Italy, France, Austria).

Symptoms

Reactions occur 3 to 7 hours after consumption of mammalian products (red meat, gelatin, dairy products, etc.), beginning with severe itching, often over the entire body, sometimes accompanied by skin rashes (urticaria). Severe reactions may include abdominal pain, nausea, vomiting, diarrhea (diarrhea), swollen hands, and even respiratory distress, hypotension, and fainting (anaphylactic reactions).

Prevention

There is no specific therapy for this allergy. Patients are advised to avoid red meat (beef, pork, sheep, game, etc.) and gelatin. If dairy products also cause symptoms, these should also be avoided. Affected patients are usually prescribed an emergency kit with medication.

Occurrence in Austria

Cases acquired in Austria are known.

Sources

Blum S, Gattringer R, Haschke E, Walochnik J, Tschurtschenthaler G, Lang F, Oberbauer R., The case: hemolysis and acute renal failure. Babesiosis. Kidney Int. 2011 Sep;80(6):681-3. doi: 10.1038/ki.2011.184

Duscher G, Hodžić A, Hufnagl P, Wille-Piazzai W, Schötta A, Markowicz M, Estrada-Peña A, Stanek G, Allerberger F. Adult Hyalomma marginatum tick positive for Rickettsia aeschlimannii in Austria, October 2018. Euro Surveill. 2018;23(48):pii=1800595.

Hoepler W, Markowicz M, Schoetta AM, Zoufaly A, Stanek G, Wenisch C. Molecular diagnosis of autochthonous human anaplasmosis in Austria - an infectious diseases case report. BMC Infect Dis. 2020 Apr 19;20(1):288. Markowicz M, Schötta AM, Wijnveld M, Stanek G. Lyme Borreliosis with Scalp Eschar Mimicking Rickettsial Infection, Austria. Emerg Infect Dis. 2020 Sep;26(9):2193-2195.

Markowicz M, Schötta AM, Höss D, Kundi M, Schray C, Stockinger H, Stanek G. Infections with Tickborne Pathogens after Tick Bite, Austria 2015-2018. Emerging Infectious Diseases 2021; 27(4):1048-56.

Markowicz M, Schötta AM, Penatzer F, Matscheko C, Stanek G, Stockinger H, Riedler J. Isolation of Francisella tularensis from Skin Ulcer after a Tick Bite, Austria, 2020. Microorganisms. 2021 Jun 29;9(7):1407.

Marques AR, Strle F, Wormser GP. Comparison of Lyme Disease in the United States and Europe. Emerg Infect Dis . 2021 Aug;27(8):2017-2024

Petrovec M, Schweiger R, Mikulasek S, Wüst G, Stünzner D, Strasek K, Avsic Zupanc T, Marth E, Sixl W, poster presentation P-5, International Conference on Rickettsiae and Rickettsial Diseases, Ljubljana, Slovenia, 2002.

Pisazka V, Duscher G, Hodžić A, Reider N, Allerberger F, Alpha-gal allergy after a tick bite in Austria, Wiener klinische Wochenschrift, 2019, 131 (15), 385–388. doi: 10.1007/s00508-019-1506-5.

Polin H, Hufnagl P, Haunschmid R, Gruber F, Ladurner G. Molecular Evidence of Anaplasma phagocytophilum in Ixodes ricinus Ticks and Wild Animals in Austria. J Clin Microbiol. 2004; 42: 2285–86.

Reiter M, Schötta AM, Müller A, Stockinger H, Stanek G. A newly established real-time PCR for detection of Borrelia miyamotoi in Ixodes ricinus ticks. Ticks Tick Borne Dis. 2015;6:303-8.

Schötta AM, Wijnveld M, Stockinger H, Stanek G. Approaches for Reverse Line Blot-Based Detection of Microbial Pathogens in Ixodes ricinus Ticks Collected in Austria and Impact of the Chosen Method. 2017, Applied and Environmental Microbiology 2017; 83:e00489-17.

Sixl W, Petrovec M, Schweiger R, Stünzner D, Wüst G, Marth E, Avsic Zupanc T, poster presentation P-2, International Conference on Rickettsiae and Rickettsial Diseases, Ljubljana, Slovenia, 20.

Sonnleitner ST, Fritz J, Bednarska M, Baumgartner R, Simeoni J, Zelger R, Schennach H, Lass-Flörl C, Edelhofer R, Pfister K, Milhakov A, Walder G. Risk assessment of transfusion-associated babesiosis in Tyrol: appraisal by seroepidemiology and polymerase chain reaction. Transfusion. 2014;54:1725-32.

Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A, Kristoferitsch W, O'Connell S, Ornstein K, Strle F, Gray J. Lyme borreliosis: clinical case definitions for diagnosis and management in Europe, Clin Microbiol Infect. 2011;17:69-79.

Stanek G, Strle F. Lyme borreliosis–from tick bite to diagnosis and treatment. FEMS Microbiol Rev. 2018;42:233-258. doi: 10.1093/femsre/fux047.

Tobudic S, Burgmann H, Stanek G, Winkler S, Schötta AM, Obermüller M, Markowicz M, Lagler H. Human Borrelia miyamotoi Infection, Austria. Emerg Infect Dis. 2020 Sep;26(9):2201-2204.

Prevention and removal

How to protect yourself from tick bites

There is no absolute protection against tick bites. If you are in tall grass, bushes or undergrowth, wearing closed clothing (sturdy shoes, long pants, long sleeves) offers some protection. This makes it more difficult for a tick to find a suitable skin site for a blood meal. In addition, if the pant legs are tucked into the socks, the tick is forced to walk up the clothing, making it easier to find. Pants and socks should be a light color to help detect dark ticks. Headgear is recommended for children.

If necessary, supplement the hiking or excursion first-aid kit with a pair of pointed, sturdy tweezers to remove attached ticks right away.

Avoid contact!

Move on wide paths on the well-trodden, middle part of the path. Avoid bushes and thickets and do not walk through tall grass.

Tick repellent

Applying insect repellent to exposed skin also provides some protection and may reduce the risk of a tick bite. If suitable (no staining), repellents (repellent harmless substances to repel ticks) should also be applied to clothing.

Vaccination

There is a vaccination against early summer meningoencephalitis (FSME), which is recommended according to the Austrian vaccination schedule.

Body and clothing control

Since ticks do not bite immediately, but first walk around on the body or clothing in search of a suitable bite site, they can be removed by regular scanning even before they bite. After a bite, it takes up to two days for borrelia (bacteria) to be transmitted. Timely removal of ticks therefore significantly reduces the risk of infection with Borrelia. In contrast, transmission of TBE viruses occurs within a short time after the bite.

After an outdoor excursion, the body should be systematically checked for attached ticks, especially at the preferred biting sites: Pubic area, inner thigh, belly button and surrounding area, under the breasts, armpits, shoulders, neck and nape, hairline, auricle and behind the ears, in the back of the knee and crook of the arm.

Pay special attention to larvae and small nymphs as well: they are very small and can be easily overlooked because they look almost like freckles.

Children should definitely be scanned by adults, especially on the head and neck.

Since ticks do not bite immediately, they could possibly be washed off by showering. However, showering cannot replace scanning, but should only be done as a supplement. If the tick has already bitten, showering is in no case suitable to remove the tick.

After spending time outdoors, change your clothes and remove attached ticks from worn clothing, for example with a clothes roller. Hang damp clothing to dry, as ticks survive in it for several hours. Clothing dried in the dryer is free of ticks.

Pets transport ticks into the house

Caution is advised with dogs and cats, they can carry ticks picked up outdoors into the apartment/house. Therefore, they should also be given repellents to repel ticks when they are outdoors in the countryside and should be checked for attached ticks.

Preferred biting sites in dogs

A study(Duscher et al. Parasites & Vectors 2013, 6:76) analyzed the bite sites of 700 ticks on 90 dogs. The areas colored red represent the areas with more tick findings, and the blue areas were found to have lower tick densities. It is noticeable that the dogs' heads, necks and chests are the most infested areas. These are also the localizations where the ticks reach their host. Unlike in humans, where the ticks first have to find their way through clothing, in dogs the ticks crawl along the hair to the skin and bite without wasting much time.

Remove ticks correctly

Grasp the tick with pointed tweezers close to the skin at the front of the biting apparatus and pull it out with as even a pull as possible. Any remnants remaining in the skin are removed by the skin itself as foreign bodies.

If signs of illness occur several days or weeks after tick removal, such as an increasing redness of the skin, fever, headache or joint pain, a visit to the doctor is necessary.

Do not choke

Do not use oil, wax, glue, nail polish remover or other substances when removing ticks. This would unnecessarily irritate the animal and could cause it to shed its saliva and thus possible infectious agents.

Removing ticks from pets

Ticks can be removed from pets using the same procedure as for humans.

Dispose of ticks properly

Fold the tick in an adhesive strip e.g. TIXO and dispose of it in household waste, not in the compost.

Biology and zoology

Ticks(Ixodida) belong to the class of arachnids and subclass of mites. Adults (adults) have eight legs, and the body is lenticular in shape. Since ticks are parasites, they need another organism as a host to survive. Therefore, they suck blood from vertebrates and can be vectors (transmitters) of disease.

Tick species in Austria

So far, 18 native tick species have been described in Austria, the most common beingIxodes ricinus(common wood tick),Dermacentor reticulatus(floodplain tick) andHaemaphysalis concinna(relict tick). In addition, another species can be introduced via vacation trips with pets:Rhipicephalus sanguineus(brown dog tick). Furthermore, two other tick species can reach us, e.g. via migratory birds:Hyalomma marginatum andHyalomma rufipes.

Regarding species composition,Ixodes ricinus(common wood tick) represents about 95 percent of the tick fauna in Austria (Fig. 1).

There is a seasonal sequence in the activity of ticks (Fig. 2). The first to be encountered in the year is the more cold-tolerant floodplain tick(D. reticulatus), followed by the common wood tick(I. ricinus). During the hot summer months, their activity declines somewhat and the relict tick(H. concinna) can be found, for example, on domestic animals.(Duscher et al. Parasites & Vectors 2013, 6:76)

First detection of Hyalomma marginatum

In October 2018, the tick species Hyalomma marginatum (tropical giant tick) was detected in Austria for the first time by the University of Veterinary Medicine Vienna. The detection of this 5 to 6 millimeter tick is significant in that it is a vector for rickettsiae (bacteria) and Crimean-Congo fever virus (CCHFV). Our molecular biology studies did not detect any virus; however, Rickettsia aeschlimannii was detected in the discovered specimen for the first time in Austria.

Since 2018, 10 specimens of the tropical giant tick have been detected in Austria. If you think you have found a tropical giant tick, please send a photo via email to zecken@ages.at.

Family: shield ticks (Ixodidae) Occurrence: widespread throughout Europe (entire European continent from the islands and peninsulas in the north, across the entire mainland to the southern Mediterranean) Activity focus: spring/early summer, late summer/early fall Carriers of: borrelia, TBE viruses, anaplasma, rickettsia, babesia, Francisella tularensis

Family: shield ticks (Ixodidae) Occurrence: from Western Europe, the British Isles through Central and Eastern Europe to Central and Eastern Asia, not in Northern Europe and not in the Mediterranean region Activity focus:early summer, late summer/fall Vectors of: babesia, TBE viruses, Francisella tularensis, rickettsiae

Family: Shield ticks (Ixodidae) Occurrence: Western, Central and Eastern Europe to China and Japan Activity focus: March to August, October Carriers of: TBE viruses, Francisella tularensis, Rickettsiae

Family: Shield ticks (Ixodidae) Occurrence: Mediterranean region Special features: They mainly bite dogs, rarely also humans and other mammals Carrier of: Rickettsiae

Family: shield ticks (Ixodidae) Occurrence: North Africa, European Mediterranean region, west and center of Asia, south of Russia, Pakistan and Turkmenistan, in October 2018 for the first time in Austria Special features: relatively large with body length of about 5 to 6 millimeters Carriers of : Crimean-Congo fever virus, rickettsiae

One cycle, three tick stages

The tick larva hatches from the egg, develops into a nymph and finally into a male or female tick.

At each stage of development, the tick takes a blood meal, sucking blood while anchored in the host skin for several days. Ticks feed on the blood of mammals (including humans), birds, reptiles, and amphibians. During the sucking process, the tick's body swells and becomes spherical. Once the tick is full, it drops to the ground where it digests the blood meal and sheds its skin to the next stage.

One tick cycle

  • 3,000 to 5,000 eggs
  • Duration between three to six years, depending on climate and food supply
  • Three blood meals

1st stage: larva, gender-neutral.

The tick larva hatches from one of the approximately 3,000 eggs laid by the female. It has only three pairs of walking legs and appears pale skin-colored to transparent. The tick larva seeks out small rodents or birds, bites for the first time, and sucks for about two to three days until it drops and molts into a nymph after a few months. After molting, the larva enters the next stage.

The larva, which requires moisture, is found close to the ground and up to a height of about 10 cm. Here it encounters its preferred hosts: small rodents such as bank voles, yellow-necked mice, and wood mice.

2nd stage: Nymph, gender-neutral.

The nymph, now with four pairs of walking legs, wears a stable chitinous carapace after molting. The nymph usually overwinters in the Central European climate before seeking the second intermediate host for further development into a sexually mature tick. The nymph takes its second blood meal from larger rodents such as squirrels or medium-sized mammals such as cats, rabbits, or foxes. Nymphs also sting humans. Once the nymph has chosen its place on the intermediate host and bites, it sucks itself full of a pulpy mixture of blood and tissue for several days, drops, and sheds its skin to become an adult tick.

Nymphs climb higher on plants than larvae. They reach a height of up to 50 cm above the ground and reach larger animals.

3rd stage: Adult tick ♀ or ♂.

After the nymph molts, the adult tick is expressed as female or male. The adult female tick infests large wild animals, domestic animals, and humans for the final blood meal. The sucking process of an adult female tick takes seven to eleven days and its own body weight can increase up to one hundred times. Using attractants, the sucking female signals the adult male that she is ready to reproduce. During mating, the attracted male climbs under the female's abdomen to deliver a sperm packet into her sexual orifice.

Egg laying

The fertilized, fully suckled female drops from the final host after a good week and looks for a protected place on the ground to lay her eggs. The eggs are covered with a waxy protective layer. This protects the fresh egg from drying out. After laying the eggs, the female dies and the cycle begins again.

Blueprint of the tick

The common tick is the largest representative of the mites.

"Tick head" Capitulum.

The mouthparts of the tick consist of a stinging appart with stinging proboscis (hypostome), jaw feelers (chelicerae) and jaw palps (pedipalps).

 

Adhesive organ with claws and adhesive flap

At the end of the leg is the adhesion organ with two claws and an adhesion flap. The claws provide grip on rough surfaces, the adhesive flap on smooth surfaces.

Haller's organ

The Haller's organ is used to find the host. Sensory bristles of the unique and highly sensitive organ emerge in the pit on the last leg segment of the foremost pair of legs. This chemoreceptor senses substances such as ammonia, carbon dioxide, lactic and butyric acid and detects approaching host animals.

Evolution

The origin of the tick is about 300 million years ago in the Carboniferous (age of ferns). Even older findings of the related scorpions and mites are proven with fossil findings. At the latest from 70 million years before our time the most important groups of theIxodida, the family of the ticks, exist.

As natural enemies of the ticks have been found so far:

  • Fungal species such asMetarhizium anisopliae andBeauveria bassiana, which grow on ticks and kill them.
  • Nematodes, which infest and kill ticks.
  • Pea wasp(Ixodiphagus hookeri), which lays eggs in the tick. Hatched wasp larvae eat ticks from the inside.
  • Observations that wood ants eat scale ticks are controversial among scientists.

Habitat and myths

Tick lurks near the ground

The tick does not fall from trees, but lives on the ground on the low vegetation. There it lies in wait for a passing animal or human. If the host passes the lurking tick, it allows itself to be stripped from the plant and clings on. The risk of shedding a tick is much lower in winter than between March and October.

Children are particularly at risk

Children are at increased risk because of their disposition and size. This is because children like to play where ticks are found: in undergrowth, along forest edges, in tall grass. Ticks like to settle in the head area of children.

Preferred living conditions

Ticks are found throughout the year, but are more common in the spring and fall. During the summer and winter periods, when it is too hot, too dry or too cold, the tick seeks shelter on the ground. If the ground is vegetated and covered with a litter layer of dead materials, the tick can hold on well. Ticks survive brief freezes at minus 20 degrees Celsius. As soon as weather conditions permit, they climb back up onto the vegetation and lie in wait for a host.

Ticks have spread with climate change. The altitude limit of 1,000 meters above sea level has long ceased to exist. Individual sites are higher than 1,500 meters above sea level.

Typical habitats of ticks

Ticks live on the ground or on low vegetation. Therefore, stay outdoors on trails. Avoid bushes, thickets and tall grass.

Myths about ticks

"Ticks drop from trees onto their victims."

On the one hand, ticks allow themselves to be stripped from the host/human, but on the other hand, ticks live close to the ground and rarely climb more than a meter in height. Because ticks travel only short distances, they tend to stay close to the ground, lurking on grasses, shrubs and in the herb layer (first layer of vegetation above the ground) for hosts for their next blood meal. Read more here.

"Ticks pretreated with oil, butter and glue are easier to remove."

Use only tapered tick tweezers, a tick hook, or have a health care professional remove the tick. Chemical treatment is not recommended because ticks suffocate very slowly and pathogens such as Borrelia can be transmitted during this time. You can read more about this here.

"I can only get infected with a tick-borne disease in high-risk areas."

Tick hazard maps often show TBE risk areas. These are areas where ticks are particularly likely to carry the tick-borne encephalitis pathogen. But anywhere ticks are found, a tick can carry pathogens.

"I just need to protect myself from ticks in the summer."

If the temperature and humidity are right, the tick can be active year-round. Generally, ticks are most comfortable from spring through fall, and that's when the risk of a tick bite is greatest. Ticks like temperatures of 10 to 20 degrees Celsius and humid weather. Read more here.

"Vaccination is effective against all tick diseases."

Unfortunately, this is not true. Vaccination effectively protects against infection with the tick-borne encephalitis virus. However, tick vaccination does not protect against infection with the Lyme disease bacterium. Only preventive measures such as appropriate clothing, the use of repellents and tick control during and after outdoor activities can help.

This project was developed in cooperation with the University of Veterinary Medicine Vienna and the Medical University Vienna on behalf of the Federal Ministry of Social Affairs, Health, Care and Consumer Protection.

Contact

Leitung

Dr. med. Mateusz Markowicz

Priv.-Doz. Dr. Georg Duscher

Last updated: 10.10.2022

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