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Ticks: Lyme, TBE and the bite you never noticed

A tick bite is painless, and the tick is often the size of a poppy seed. That combination is why tick-borne illness is so often diagnosed late. The three things worth knowing as a traveller are Lyme disease, tick-borne encephalitis, and — increasingly — alpha-gal syndrome, the red-meat allergy that a tick bite can trigger.

  • 13High risk
  • 17Medium
  • 14Low
  • 44Zones tracked

The three conditions

Lyme disease is widespread across Europe and North America and usually treatable with antibiotics when caught early; the classic sign is an expanding circular rash, though many cases never show one. Tick-borne encephalitis is a viral infection of the brain found in Central and Eastern Europe, the Nordics and parts of Asia — there is no treatment, but there is an effective vaccine. Alpha-gal syndrome is a delayed allergic reaction to mammalian meat that develops after certain tick bites, now recorded across the Americas, Europe, Australia and South Africa.

Removal is the critical step

Transmission risk rises sharply with attachment time, so the tick that comes off within a few hours rarely infects. Use fine-tipped tweezers as close to the skin as possible and pull straight out with steady pressure. Do not twist, burn, smother in oil or petroleum jelly, or crush the body — all of these increase the chance of the tick regurgitating into the wound.

How to avoid it

  • Wear long trousers tucked into socks in grass, bracken and woodland edges.
  • Treat clothing with permethrin and use DEET or picaridin on exposed skin.
  • Do a full body check every evening — behind knees, groin, waistband, armpits, hairline, and on children's necks and scalps.
  • Shower within a couple of hours of coming in; it washes off unattached ticks.
  • Consider the TBE vaccine for forested parts of Central Europe, the Baltics, Scandinavia and Russia.
  • Check dogs as well; they carry ticks indoors.

If it happens

  • Remove with fine-tipped tweezers close to the skin, pulling straight out. Disinfect afterwards.
  • Note the date and where you were, and mark the spot.
  • See a doctor for any expanding rash, flu-like illness, facial weakness or joint pain in the weeks after a bite.
  • If you develop hives or anaphylaxis hours after eating red meat, mention the tick bite — that is the alpha-gal pattern.

General guidance only — not a substitute for medical advice or local emergency services.

Where we track it

44 zones in the Dangers Here hazard database, by danger level.

High

  • Bornholm Forests
  • Central Europe Forests (Germany / Austria / Poland)
  • Eastern Australia — Alpha-gal Syndrome
  • Japan — Forested Rural Areas
  • New England (USA) — Lyme Belt
  • North Zealand Forests
  • Northeast China — Temperate Forest Zone
  • Scandinavia (Sweden / Finland)
  • South-Central USA — Alpha-gal Syndrome
  • South-Eastern USA — Alpha-gal Syndrome
  • Southern Canada — Emerging Tick Zone
  • Upper Midwest (USA) — Wisconsin / Minnesota
  • Western Russia — Taiga & Forest Belt

Medium

  • Central Zealand (emerging TBE)
  • Dyrehaven (Deer Park), Copenhagen
  • France — Rural & Forest Areas
  • Germany — Alpha-gal Syndrome
  • Long Island (NY) — Alpha-gal Syndrome
  • Marselisborg Forests, Aarhus
  • New Zealand — Forested Regions
  • Northern Italy (Alpine & Po Valley Foothills)
  • Rold Skov, North Jutland
  • South Africa — Bush & Forest Edges
  • South Jutland Forests
  • Southern Australia — Coastal Bushland
  • Southern Brazil & Argentina
  • Sweden — Alpha-gal Syndrome
  • United Kingdom — Alpha-gal Syndrome
  • United Kingdom (Southern England)
  • Western USA (Rocky Mountain / Pacific States)

Low

  • Central America — Alpha-gal Syndrome
  • East Asia — Alpha-gal Syndrome
  • Feddet & Stensved Area (South Zealand)
  • France — Alpha-gal Syndrome
  • Funen (Fyn) Forests
  • Hareskoven & Allerød Forests
  • Jylland — Alpha-gal Syndrome
  • Lolland-Falster Forests
  • Mediterranean Basin (Lower Risk)
  • New Zealand — Alpha-gal Syndrome
  • South Africa — Alpha-gal Syndrome
  • South America — Alpha-gal Syndrome
  • South Asia — Alpha-gal Syndrome
  • Spain — Alpha-gal Syndrome

Questions

Where are ticks a risk?

We track 44 zones for this hazard. 13 are rated high risk, including Bornholm Forests, Central Europe Forests (Germany / Austria / Poland), Eastern Australia — Alpha-gal Syndrome, Japan — Forested Rural Areas, New England (USA) — Lyme Belt. 17 are rated medium and 14 low.

How do you avoid ticks?

Wear long trousers tucked into socks in grass, bracken and woodland edges. Treat clothing with permethrin and use DEET or picaridin on exposed skin. Do a full body check every evening — behind knees, groin, waistband, armpits, hairline, and on children's necks and scalps.

What is the first aid for ticks?

Remove with fine-tipped tweezers close to the skin, pulling straight out. Disinfect afterwards. Note the date and where you were, and mark the spot. See a doctor for any expanding rash, flu-like illness, facial weakness or joint pain in the weeks after a bite.

The three conditions

Lyme disease is widespread across Europe and North America and usually treatable with antibiotics when caught early; the classic sign is an expanding circular rash, though many cases never show one. Tick-borne encephalitis is a viral infection of the brain found in Central and Eastern Europe, the Nordics and parts of Asia — there is no treatment, but there is an effective vaccine. Alpha-gal syndrome is a delayed allergic reaction to mammalian meat that develops after certain tick bites, now recorded across the Americas, Europe, Australia and South Africa.

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