Ask a doctor on the topic of Neurology

FSME - Risk and Progression First Question

August 2, 2019 | 35,00 EUR | answered by Dr. med. Frauke Gehring

I was bitten by a tick in an FSME risk area (Winterthur, Switzerland) 11 days ago, and I am not vaccinated against FSME. Since then, I have been worried that I may have been infected with FSME. I have read that the disease progresses in two phases - first with mild fever, then after a short break with stronger fever. Currently, I do not have a fever, only slight (possibly weather-related) headaches, and no joint pain.

(1) If no or only very mild symptoms (as described above) occur in the first phase, does this decrease the likelihood of a second phase with a severe course of the disease, or can it occur independently of the first phase's progression?
(2) I have read multiple times that the symptoms in the first phase would resemble a flu or cold. How noticeable are the symptoms in this phase? I have no fever, no joint pain, and slight headaches - will I notice this first phase, or is it so mild that I could miss it?
(3) What is the likelihood of experiencing a severe course of the disease 15 days after the bite without significant symptoms?

Kind regards

Dr. med. Frauke Gehring

Good day,
I am happy to help you.

1.) The first phase is never skipped. If you feel good all the time and no "flu-like" symptoms occur, there is no need to worry about a second phase.

2.) You cannot miss the phase! You will have headaches and body aches, but especially you will feel very weak.

3.) The incubation period of tick-borne encephalitis (TBE) is 1 to 2 weeks. So, nothing can happen in three days, and after 15 days you are on the safe side. Not even a mild course of the disease can be expected.

I wish you all the best!

Warm regards, Dr. Gehring