January 26, 2026, 8:57 am | Read time: 7 minutes

A stroll through the wilderness, some time spent gardening, or a picnic amidst greenery—and then you notice it, that odd black dot: yikes, a tick! It has burrowed into your skin unnoticed. The first thing to remember is not to panic. Most tick bites only cause mild discomfort and heal well^.1 However, it’s important to be aware that ticks can transmit serious diseases, such as TBE. That’s why you should keep a close eye on every tick bite.

How Do You Get Infected with TBE?

TBE stands for “tick-borne encephalitis.” This is a viral infection. Small rodents (such as mice) in particular carry the pathogen. However, studies have also shown infections through the consumption of raw milk from goats, sheep, or cows^.2 The most common transmission route is a tick bite. The viruses are located in the salivary glands of the tick and can quickly enter our blood through the bite^.3 The virus can then infect the brain and the meninges (the protective covering of the brain) and cause severe inflammation^.4 The virus is transmitted directly through the bite, in contrast to Lyme disease, which is transmitted only after the tick has been attached and feeding for several hours. This is why prompt removal of the tick may not always prevent an infection. TBE cannot be transmitted from person to person. Therefore, a person with TBE is not contagious to others.

Where Does TBE Occur?

TBE occurs mainly in Europe and parts of Asia. In Germany, Bavaria, Baden-Württemberg, southern Hesse, south-eastern Thuringia, Saxony, and south-eastern Brandenburg are among the regions particularly at risk. However, there are also individual districts outside these larger areas that are “tick hotspots”. The Robert Koch Institute (RKI) regularly publishes maps showing the current TBE risk areas.

Since 2001, the RKI has been tracking the incidence of TBE cases. In 2024, the highest number of TBE cases since data collection began in 2001 was reported, with 775 TBE cases^.5 However, the Professional Association of German Internists suspects there are many unreported cases and anticipates “an upward trend in case numbers over time, along with more frequent tick seasons characterized by earlier onset of tick activity.”⁶

Ticks prefer moist, shady places such as forests, meadows, and tall grass as their habitat. They are mainly active between April and October, but can be found all year round in mild winters. However, they do not fall from trees, as was long assumed, but prefer to sit on broad tufts of grass or low foliage. When we walk past them, we “brush” them off onto our clothes or skin, so to speak. Between 0.5 and 5 percent of all ticks in risk areas carry the TBE virus.

TBE Causes These Symptoms

TBE usually develops in two phases. The incubation period, i.e., the time between the tick bite and the first symptoms, is usually seven to 14 days. In individual cases, it can be up to 28 days^.7 The typical course of a TBE disease occurs in two phases:

1st Phase

At first, you feel as if you have the flu—with fever, headaches, muscle aches, and general malaise. Many people initially think it is a harmless cold. In around 40 percent of cases, this first phase persists, especially in severe cases or in older people (over 65).

2nd Phase

After a symptom-free phase (about a week), the virus makes itself felt through the damage it causes to the nervous system. This is when high fever, severe headaches, neck stiffness, and neurological symptoms occur. In severe cases, meningitis, encephalitis, or myelitis can occur. These can cause permanent damage such as persistent, leaden tiredness, headaches, concentration problems, paralysis, or memory problems. In around one percent of cases, the disease is even fatal^.8

More on the topic

Dangerous Pathogens 6 Tips to Protect Children from Tick Bites, Lyme Disease, and TBE

Transmitted by Ticks Lyme Borreliosis – Causes, Symptoms and Treatment

How Is TBE Detected and Treated?

TBE can be diagnosed by means of a blood test: Antibodies are present in the blood during an infection, which can be identified in the laboratory. Antibodies can usually be detected at the beginning of the second phase of the disease. In the early phase, a PCR test can be useful. The genetic material of the TBE virus can be detected in the blood or cerebrospinal fluid using this laboratory test. However, this test is only possible in the first phase of the disease, around seven days after the tick bite^.9

There is no specific treatment for the virus. Treatment is limited to alleviating the symptoms. In severe cases, those affected must be treated in hospital, sometimes even in intensive care.

How to protect yourself against TBE

Vaccination

As TBE cannot be treated specifically, vaccination is the best form of protection. The Standing Committee on Vaccination (STIKO) recommends this vaccination for everyone who regularly spends time in TBE risk areas. It consists of three doses and must be boosted regularly. There are two vaccines that are approved for children aged twelve months and over^.10 The vaccination schedules are different for the two vaccines—they apply to children and adults.

Clothing and Sprays

The most effective strategy is to prevent tick bites altogether. Ticks are unable to penetrate clothing. Therefore, suitable clothing can help prevent them from reaching our skin. Wearing clothing that covers more skin can significantly reduce the risk of tick infestation, particularly during activities like walking through underbrush or tall grass, or while berry picking. Long pants, a long-sleeved shirt, and sturdy shoes are helpful. It’s also advisable to tuck the legs of your trousers into your socks. Light-colored clothing is also often recommended to ward off ticks. However, this is controversial: In a Swedish study, almost 21 times more ticks were “attracted” to light-colored clothing than to dark-colored clothing^.11 The advantage of light-colored clothing, however, is that you can spot and remove the crawling pests more quickly before they have found their way to your skin.

There are also special sprays against tick bites (e.g., products with the active ingredients DEET or Icaridin). They can keep ticks away and reduce the risk of being bitten. However, the Professional Association of Pediatricians notes that the effectiveness of these sprays is limited in duration, recommending reapplication every three to four hours.^.12 You can also “impregnate” your clothing with sprays against ticks. The insecticide “permethrin” is used for this, which house dust allergy sufferers sometimes spray on their mattresses. A study from Korea has confirmed that the active ingredient repels ticks well, but points out that the “anti-tick effect” of clothing impregnated with permethrin fades over time^.13

Adapted Leisure Planning

As already mentioned: ticks like damp, shady places such as forests, meadows, and tall grass. If you mainly walk on paved paths when hiking, the risk of contact is also reduced. What’s more, the weather also plays a role. The density of ticks is higher in warmer temperatures and lower in dry weather. Accordingly, you should plan your hike, picnic, or gardening on certain days that are less dangerous for ticks^.14

Search for and Remove Ticks

Ticks have poor eyesight, are slow, and therefore often wander around on the skin for a while before they bite. They particularly like soft areas. Particularly vulnerable areas are therefore the back of the knees, armpits, neck, genital area, belly button, elbows, hairline, and the area behind the ears. You should always check your skin for ticks after spending time outdoors. If a tick is discovered, it should be removed quickly with fine tweezers or a tick card. The Stiftung Gesundheitswissen recommends using tweezers that are angled inwards. If the two ends are flat, you run the risk of squeezing the tick when you grab it—then you may push even more pathogens into the wound^.15 The tick should be grasped close to the head (not on the engorged abdomen) and gently pulled straight out.