How can you tell that you were bitten by an encephalitic tick?

Recognizing a Tick Bite

What a Tick Looks Like

Size and Shape

When a tick capable of transmitting encephalitis attaches to skin, the bite site often reveals clues through its dimensions and contour. The lesion typically measures between 2 mm and 5 mm in diameter, matching the size of the engorged arthropod. A circular or slightly oval outline reflects the tick’s rounded body; irregular borders may indicate movement or partial detachment.

Key size‑related indicators include:

Diameter comparable to a grain of rice or a small pea.
Uniform swelling around the central puncture point.
Absence of a larger, spreading rash within the first 24 hours.

Shape characteristics to observe:

Central punctum surrounded by a smooth, raised rim.
Symmetrical elevation when the tick remains attached; asymmetry suggests the insect has shifted.
Presence of a tiny, darkened spot at the center, marking the mouthparts.

These physical parameters, combined with a recent exposure to tick‑infested environments, provide reliable evidence of an encephalitic tick bite. Accurate measurement and description of the lesion support prompt medical evaluation.

Common Hiding Spots

Ticks capable of transmitting encephalitis favor microhabitats that provide humidity, shade, and host access. Recognizing these locations increases the likelihood of detecting a recent bite.

• Leaf litter in deciduous forests
• Underbrush and low vegetation near trails
• Mossy rocks and fallen logs
• Dense grass edges of pastureland
• Brush piles and hedgerows bordering fields

When a bite occurs, the attachment site often appears on exposed skin that contacts the listed habitats. Early symptoms may include a red, painless puncture surrounded by a small halo, sometimes accompanied by a mild rash. Progression to headache, fever, or neurological signs within days suggests infection by an encephalitic agent. Regular inspection of body areas that contact the identified hiding spots—especially ankles, wrists, and scalp—provides the most reliable method for confirming exposure.

Initial Signs of a Tick Bite

The Bite Mark Itself

The bite mark left by an encephalitic tick often appears as a small, painless puncture on the skin. Unlike many arthropod bites, the lesion may lack redness or swelling, making it easy to overlook.

Typical characteristics include:

Two closely spaced puncture sites, reflecting the tick’s mouthparts.
A central area of slight discoloration, sometimes a faint pink or reddish hue.
Absence of significant itching or immediate irritation.
Persistence of the mark for several days without noticeable change.

A careful inspection of exposed skin, especially after outdoor activities in tick‑infested regions, can reveal these subtle signs. Prompt identification of the puncture sites enables early medical evaluation and reduces the risk of severe complications associated with tick‑borne encephalitis.

Localized Skin Reactions

A bite from a tick capable of transmitting encephalitis often produces a distinct cutaneous response at the attachment site. The reaction typically appears within 24 hours and may persist for several days.

Common localized manifestations include:

A small, erythematous papule or macule at the bite point;
An expanding annular erythema, sometimes described as a target lesion;
Mild edema surrounding the primary mark;
Pruritus or a tingling sensation confined to the area;
Occasional central necrosis or crust formation.

The intensity of the skin change varies with the tick species and the host’s immune response. Absence of systemic symptoms does not exclude infection; however, the presence of a rapidly enlarging erythema, especially when exceeding 5 cm in diameter, warrants prompt evaluation.

Medical assessment is recommended when any of the following are observed:

Lesion enlargement beyond the initial size within 48 hours;
Persistent pain or swelling unresponsive to over‑the‑counter analgesics;
Development of a fever, headache, or neurological signs concurrent with the skin finding.

Early identification of these cutaneous clues facilitates timely diagnostic testing and, if necessary, initiation of appropriate antiviral or supportive therapy.«»

Symptoms of Tick-Borne Encephalitis (TBE)

Early Stage Symptoms (Pre-meningitic Phase)

General Flu-Like Illness

Encephalitic tick bites frequently begin with a nonspecific febrile syndrome that resembles a common viral infection. The initial presentation often includes a sudden rise in body temperature, headache, muscle aches, and fatigue, all of which fall under the category of «general flu‑like illness».

Typical manifestations at this stage are:

Fever exceeding 38 °C
Persistent headache, sometimes described as frontal or occipital
Myalgia affecting large muscle groups
Malaise and profound tiredness
Nausea or loss of appetite

These symptoms appear within a few days after exposure to an infected tick and may be indistinguishable from ordinary influenza. Distinguishing factors include a recent history of tick attachment, residence or travel in endemic regions, and the absence of respiratory symptoms such as cough or sore throat that commonly accompany seasonal flu.

Progression to the second phase of the disease introduces neurological signs—confusion, photophobia, or seizures—indicating central nervous system involvement. Early identification of the flu‑like phase enables timely laboratory testing for specific antibodies or viral RNA, which guides antiviral therapy and prevents severe complications.

Prompt medical assessment is essential whenever flu‑like symptoms follow a known tick bite, especially in areas where tick‑borne encephalitis is reported.

Fever and Headache

Fever and headache often appear together within days of a bite from a tick capable of transmitting encephalitic viruses. The fever typically rises above 38 °C, may be continuous or fluctuate, and can persist for several days despite antipyretic treatment. A sudden increase in temperature after an initial asymptomatic period frequently signals the onset of the second phase of the infection.

Headache associated with encephalitic tick bites is usually severe, bilateral, and throbbing. It may be accompanied by neck stiffness, photophobia, or mild confusion, indicating early involvement of the central nervous system. The pain often intensifies as the fever peaks and does not respond adequately to over‑the‑counter analgesics.

When fever and headache co‑occur after a known or suspected tick exposure, immediate medical assessment is warranted. Key actions include:

Reporting the bite and symptom timeline to healthcare providers.
Obtaining laboratory testing for tick‑borne encephalitis antibodies or PCR detection.
Initiating supportive care and, if indicated, antiviral therapy under specialist guidance.

Prompt recognition of these symptoms reduces the risk of progression to severe neurological complications such as meningitis or encephalitis.

Muscle Aches and Fatigue

Muscle aches and fatigue often appear early after a bite from a tick capable of transmitting encephalitic viruses. The discomfort typically begins within a few days and may persist for a week or longer. Unlike ordinary strain, the pain is generalized, affecting multiple muscle groups simultaneously, and is accompanied by a marked decrease in stamina that does not improve with rest.

Key characteristics that differentiate this presentation from common viral infections include:

Sudden onset of widespread muscular soreness without a clear exertional trigger.
Persistent exhaustion that interferes with routine activities despite adequate sleep.
Co‑occurrence with other early signs such as low‑grade fever, headache, or mild neck stiffness.

When these symptoms develop after a known or suspected tick exposure, especially in regions where tick‑borne encephalitis is endemic, prompt medical evaluation is warranted. Laboratory testing for specific antibodies can confirm infection, while early antiviral or supportive therapy may reduce the risk of neurological complications.

Later Stage Symptoms (Neurological Phase)

Meningitis or Encephalitis

Ticks that transmit encephalitic viruses can leave a bite mark before systemic illness appears. The bite site often shows a small, red papule that may develop a target‑shaped rash (« bull’s‑eye »). Local pain or itching may accompany the lesion, but the presence of a rash is not required for infection.

Systemic manifestations indicating meningitis or encephalitis include:

Sudden fever exceeding 38 °C
Severe, throbbing headache
Neck stiffness or pain with passive flexion
Photophobia and nausea
Confusion, disorientation, or difficulty concentrating
Seizures or focal neurological deficits
Rapid progression to loss of consciousness in severe cases

These symptoms typically emerge within 5 – 14 days after the tick bite. An initial flu‑like phase—fatigue, muscle aches, and mild fever—may precede neurological signs.

Diagnostic evaluation should comprise:

Lumbar puncture: elevated white‑cell count (predominantly lymphocytes), increased protein, normal or reduced glucose
Polymerase chain reaction (PCR) testing of cerebrospinal fluid for viral RNA (e.g., tick‑borne encephalitis virus, Powassan virus)
Serologic assays for specific IgM and IgG antibodies
Magnetic resonance imaging to identify brain inflammation or edema

Immediate medical attention is warranted when fever combines with headache, neck rigidity, or altered mental status, especially if a recent tick exposure is reported. Early antiviral or supportive therapy improves outcomes and reduces the risk of permanent neurological damage.

Severe Headache and Neck Stiffness

Severe headache accompanied by neck stiffness often signals irritation of the meninges, a hallmark of central‑nervous‑system involvement after a tick bite that may transmit encephalitic pathogens. The pain typically presents as constant, throbbing pressure resistant to over‑the‑counter analgesics, while neck rigidity limits passive flexion and may be painful to touch.

Meningeal irritation suggests that the infectious agent has crossed the blood‑brain barrier, increasing the risk of encephalitis. Prompt recognition of these signs enables early diagnostic testing, such as cerebrospinal fluid analysis and serology, and timely initiation of antiviral or supportive therapy.

Key clinical considerations include:

Sudden onset of intense headache, often described as “worst ever.”
Inability to fully flex the neck without discomfort.
Accompanying symptoms: fever, photophobia, vomiting, altered mental status.
Recent exposure to wooded or grassy areas where ticks are prevalent.
Immediate medical evaluation: lumbar puncture, imaging, and laboratory confirmation.

Confusion and Disorientation

Confusion and disorientation represent early neurological manifestations of tick‑borne encephalitis. Onset typically occurs within a few days after the bite, coinciding with the second phase of the infection when the virus spreads to the central nervous system.

Patients may exhibit an inability to focus on simple tasks, loss of orientation to time and place, and difficulty recognizing familiar environments. Cognitive clarity deteriorates rapidly, often accompanied by slowed speech and impaired judgment.

Common accompanying symptoms include:

Persistent fever
Severe headache
Neck stiffness
Photophobia
Nausea or vomiting
Muscle weakness

These signs signal progression to meningo‑encephalitic involvement and require immediate medical assessment. Laboratory confirmation through serologic testing for specific antibodies guides antiviral and supportive therapy. Early intervention reduces the risk of long‑term neurological deficits.

Seizures and Paralysis

Encephalitic tick bites frequently produce acute neurological disturbances. Two of the most reliable indicators are the emergence of seizures and the development of paralysis.

Seizures typically appear within days to weeks after exposure. They may manifest as generalized tonic‑clonic episodes, focal motor activity, or brief loss of consciousness. Accompanying signs often include fever, headache, and altered mental status. Rapid escalation in seizure frequency suggests central nervous system involvement.

Paralysis commonly begins with weakness in the lower extremities and can progress proximally. Motor loss may be asymmetric and accompanied by diminished reflexes. In some cases, facial muscles become involved, producing drooping or difficulty with speech. The onset of paralysis without an obvious traumatic cause warrants immediate investigation.

Key clinical clues that differentiate encephalitic tick infection from other etiologies:

Sudden onset of seizures in a previously healthy individual.
Progressive, asymmetric limb weakness.
Recent history of outdoor activity in tick‑prevalent regions.
Absence of rash typical of other tick‑borne diseases.

Prompt medical assessment is essential. Diagnostic steps include lumbar puncture for cerebrospinal fluid analysis, polymerase chain reaction testing for viral RNA, and serologic assays. Early initiation of antiviral therapy and supportive care reduces the risk of permanent neurological damage.

Differentiating TBE from Other Tick-Borne Diseases

Lyme Disease vs. TBE

Rash Characteristics (Erythema Migrans)

Erythema migrans is the hallmark skin manifestation associated with bites from ticks capable of transmitting encephalitic viruses. The lesion typically appears 3–30 days after attachment and expands outward from the attachment site. Initial presentation may be a small, flat, reddish macule that rapidly enlarges to a raised, oval or circular patch up to 5 cm in diameter. The border often exhibits a characteristic “bull’s‑eye” pattern, with a central clearing surrounded by a peripheral ring of erythema. Color ranges from pink to deep red, occasionally developing a dusky or purpuric hue as the lesion matures.

Key clinical features include:

Progressive enlargement at a rate of 2–3 cm per day.
Asymmetrical shape; edges may be irregular rather than perfectly circular.
Absence of vesiculation or necrosis in early stages.
Possible accompanying symptoms such as mild fever, fatigue, or headache, though these are not universal.

Recognition of these attributes enables timely differentiation from other arthropod‑borne rashes, such as those caused by Lyme disease or viral exanthems. Prompt identification of the expanding erythematous patch, especially when accompanied by a history of exposure to wooded or grassy environments, should trigger further evaluation for tick‑borne encephalitis and initiation of appropriate antimicrobial or antiviral therapy.

Neurological Differences

Neurological manifestations distinguish encephalitic tick bites from ordinary arthropod encounters. Early symptoms frequently include severe headache, photophobia, and neck stiffness, reflecting meningeal irritation. Progression may present as altered mental status, ranging from confusion to lethargy, indicating cerebral involvement. Focal deficits, such as unilateral weakness, facial droop, or ataxia, suggest localized cortical or cerebellar impairment. Seizure activity, either generalized or focal, often emerges during the acute phase and signals heightened neuronal excitability.

Additional clues derive from autonomic dysregulation. Rapid heart rate, hypertension, and diaphoresis accompany central nervous system inflammation. Sensory disturbances, including paresthesia or dysesthesia, may precede motor signs, highlighting peripheral nerve irritation before central spread.

Key laboratory findings support clinical suspicion. Cerebrospinal fluid analysis typically reveals lymphocytic pleocytosis, elevated protein, and normal glucose, consistent with viral encephalitis. Polymerase chain reaction detection of viral RNA in cerebrospinal fluid confirms the etiologic agent.

Management priorities focus on prompt antiviral therapy, supportive care, and monitoring for complications such as increased intracranial pressure. Early identification of the described neurological differences improves outcomes by facilitating timely intervention.

Anaplasmosis and Babesiosis

Distinct Clinical Presentations

Tick‑borne encephalitis presents with several recognizable patterns that differentiate it from other arthropod bites. Early recognition relies on matching symptom clusters to the known clinical spectrum of the disease.

« Biphasic illness »: initial febrile stage lasting 3‑7 days with headache, malaise and myalgia, followed by a symptom‑free interval, then a second phase marked by neurologic signs.
« Acute meningitis »: severe headache, neck stiffness, photophobia and fever; cerebrospinal fluid shows pleocytosis with lymphocytic predominance.
« Encephalitis »: altered consciousness, confusion, seizures, focal neurological deficits; often accompanied by tremor or ataxia.
« Myelitis »: progressive weakness, sensory loss and urinary retention; spinal MRI reveals inflammatory changes.
« Mixed meningo‑encephalitis »: combination of meningeal irritation and encephalitic features, producing a broader range of neurologic disturbances.
« Peripheral neuropathy »: paresthesia, burning pain or motor weakness in distal limbs, emerging weeks after the initial bite.

Recognition of these distinct presentations enables timely diagnostic testing and initiation of appropriate supportive care.

Diagnostic Considerations

Diagnostic considerations for a suspected bite by an encephalitic tick focus on clinical presentation, temporal pattern, and laboratory confirmation. Early symptoms often include sudden fever, severe headache, and malaise within 7–14 days after exposure. Neurological signs may emerge rapidly, comprising neck stiffness, photophobia, altered mental status, or focal deficits.

Key diagnostic steps:

Detailed exposure history: geographic location, recent outdoor activity, and observation of a tick attachment.
Physical examination: identification of a recent tick bite, erythema, or a localized eschar.
Laboratory analysis:
- Serologic testing for specific IgM and IgG antibodies against tick‑borne encephalitis virus.
- Reverse‑transcriptase polymerase chain reaction (RT‑PCR) on blood or cerebrospinal fluid to detect viral RNA.
- Cerebrospinal fluid examination: elevated white‑cell count with lymphocytic predominance, increased protein, and normal or slightly reduced glucose.
Neuroimaging: magnetic resonance imaging to rule out alternative causes of encephalitis and assess inflammatory changes.

Differential diagnosis must include other viral encephalitides, bacterial meningitis, autoimmune encephalitis, and metabolic disturbances. Prompt recognition of these diagnostic elements enables timely antiviral therapy and supportive care, reducing the risk of long‑term neurological sequelae.

When to Seek Medical Attention

Red Flags After a Tick Bite

Persistent Symptoms

Persistent symptoms may appear weeks after a tick bite that transmitted a neurotropic virus. Neurological deficits often dominate the clinical picture. Common manifestations include:

Chronic headache lasting more than several weeks
Cognitive decline such as memory loss, reduced concentration, and slowed processing speed
Persistent fatigue that interferes with daily activities
Motor disturbances, including tremor, gait instability, or muscle weakness
Sensory abnormalities like tingling, numbness, or heightened pain sensitivity
Mood alterations, for example depression or anxiety, that develop or worsen over time

These signs can persist for months and may fluctuate in intensity. Laboratory testing frequently reveals ongoing inflammation, demonstrated by elevated cerebrospinal fluid protein or persistent antibodies against the viral agent. Neuroimaging may show lingering lesions or atrophy in affected brain regions.

Early recognition of long‑term manifestations guides appropriate management. Antiviral therapy, when indicated, should be continued according to specialist recommendations. Rehabilitation programs focusing on physical therapy, cognitive training, and psychological support improve functional outcomes. Regular follow‑up appointments enable monitoring of symptom evolution and adjustment of therapeutic strategies.

Worsening Neurological Signs

Encephalitic tick bites often present initially with nonspecific symptoms, yet rapid deterioration of neurological function signals a severe infection. Early detection relies on recognizing patterns of progression rather than isolated complaints.

Worsening neurological signs typically follow a predictable trajectory:

Increasing headache intensity, unresponsive to standard analgesics.
Development of fever exceeding 38 °C, persisting beyond 24 hours.
Onset of neck stiffness, indicating meningeal irritation.
Emergence of photophobia and phonophobia, reflecting cortical involvement.
Appearance of confusion, disorientation, or difficulty concentrating.
Progression to seizures, focal motor deficits, or loss of coordination.
Decline in consciousness, ranging from somnolence to coma.

Each new or intensifying symptom demands immediate reassessment. Laboratory analysis of cerebrospinal fluid, serologic testing for tick-borne pathogens, and neuroimaging should be initiated without delay. Prompt antimicrobial therapy markedly improves prognosis; delay increases the risk of permanent neurological impairment.

Diagnostic Procedures

Blood Tests for TBE Antibodies

Blood testing for tick‑borne encephalitis (TBE) antibodies provides the most reliable laboratory evidence of infection after a suspected bite from an encephalitic tick. The assay detects immunoglobulins produced in response to the virus, allowing clinicians to distinguish recent from past exposure.

The standard approach includes two serological markers:

IgM antibodies – appear within 5–10 days after symptom onset, indicate a current or very recent infection.
IgG antibodies – become detectable after 2–3 weeks, persist for months to years, confirm prior exposure.

Interpretation depends on the timing of specimen collection. An early sample may show only IgM, while a convalescent sample taken 2–3 weeks later should reveal IgG seroconversion. A single negative result obtained within the first week of illness does not exclude infection; repeat testing is recommended.

Key considerations for accurate diagnosis:

Use enzyme‑linked immunosorbent assay (ELISA) or immunofluorescence assay (IFA) validated for TBE.
Ensure the laboratory follows quality‑controlled protocols to avoid cross‑reactivity with related flaviviruses.
Combine serology with clinical assessment, including neurological signs and a history of tick exposure in endemic areas.

Prompt identification of TBE antibodies guides appropriate medical management and informs public‑health measures to prevent further cases.

Lumbar Puncture for CSF Analysis

Lumbar puncture provides a direct assessment of central‑nervous‑system involvement after a bite from a tick capable of transmitting encephalitis‑causing pathogens.

Indications for the procedure include fever, severe headache, neck rigidity, altered mental status, or focal neurological deficits occurring within weeks of known or suspected tick exposure.

The technique requires strict asepsis, lateral decubitus or sitting position, insertion of a 20‑22 G spinal needle into the L3‑L4 or L4‑L5 interspace, and collection of 3–5 mL of cerebrospinal fluid for immediate laboratory analysis.

Typical cerebrospinal‑fluid abnormalities are:

Elevated white‑cell count (predominantly lymphocytes)
Increased protein concentration
Normal or mildly reduced glucose level
Detection of specific IgM antibodies or viral RNA by PCR

When these findings align with the clinical picture, they confirm central‑nervous‑system infection attributable to an encephalitic tick bite, guiding antiviral or supportive therapy.

Prevention and Risk Reduction

Tick Bite Prevention Strategies

Protective Clothing

Detecting a bite from a tick that can transmit encephalitis relies on recognizing early symptoms and noting any recent exposure to tick‑infested areas. Protective clothing serves as the primary barrier that prevents the arthropod from attaching to the skin, thereby reducing the likelihood of unnoticed exposure.

Effective protective clothing includes long sleeves, high collars, and tightly woven fabrics that resist penetration by small arthropods. Pants should be tucked into socks or boots, and seams sealed with tape when possible. Materials treated with permethrin or similar repellents add an extra layer of defense without compromising comfort.

When clothing fails to prevent attachment, the bite site may appear as a small, red papule, often accompanied by a clear halo. Absence of a rash does not eliminate risk; monitoring for fever, headache, or neck stiffness within 7‑14 days after outdoor activity remains essential.

Practical measures:

Wear light‑colored garments to facilitate visual inspection of the body.
Conduct a thorough body check after each outing, paying special attention to hidden areas such as behind the knees and under the arms.
Remove and launder clothing at temperatures above 60 °C to kill any attached ticks.
Replace worn or damaged garments that no longer provide full coverage.

Tick Repellents

Encephalitic ticks transmit viruses that can cause severe neurological disease; early recognition of a bite is essential for timely medical evaluation. Typical indicators include a localized erythematous lesion, often expanding to a bull’s‑eye pattern, and systemic symptoms such as fever, headache, or malaise within days of exposure. Absence of these signs does not exclude infection, but they guide clinical suspicion.

Effective repellents mitigate the risk of such bites by creating a chemical barrier that deters attachment. Synthetic compounds, notably N,N‑diethyl‑m‑toluamide (DEET) and picaridin, provide long‑lasting protection on skin and clothing. Natural oils, including lemon‑eucalyptus (PMD) and citronella, offer shorter duration of activity and require frequent reapplication. Permethrin, applied to garments, remains active through multiple washes and kills ticks on contact.

Application of repellents reduces the probability of tick attachment, thereby decreasing the likelihood of encountering the characteristic lesion and subsequent systemic manifestations. Consistent use in endemic areas aligns with public‑health recommendations for preventing encephalitic tick‑borne disease.

Recommendations for optimal protection:

Apply DEET (20‑30 %) to exposed skin; reapply every 4 hours or after swimming.
Use picaridin (10‑20 %) as an alternative for individuals with DEET sensitivity.
Treat clothing, boots, and hats with permethrin (0.5 %); allow to dry before wear.
For children, limit DEET concentration to 10 % and avoid application to hands and face.
Reapply natural‑oil repellents (lemon‑eucalyptus, citronella) every 2 hours; verify product efficacy against ticks.

Performing Tick Checks

Performing thorough tick checks is a primary measure for early identification of a bite that may transmit encephalitic infection. Immediate removal of an attached tick reduces the risk of pathogen transmission and limits the development of symptoms.

Examine the entire body after outdoor activities, focusing on hidden areas such as scalp, behind ears, underarms, groin, and between toes.
Use a fine‑toothed comb or tweezers to separate hair and clothing layers, exposing skin surfaces.
Inspect clothing for ticks that may have fallen off; shake out garments before entering indoor spaces.
Conduct the check within two hours of returning from a tick‑infested environment; delayed inspection increases the chance of attachment beyond the critical transmission window.

After removal, observe the bite site for the following indicators:

Redness or a small papule at the attachment point.
A clear area surrounding the bite, known as the “bull’s‑eye” pattern, which may suggest pathogen presence.
Persistent itching, swelling, or a raised rash developing within 24‑48 hours.

Repeat examinations daily for a week following exposure, especially after prolonged stays in wooded or grassy regions. Document any findings and seek medical evaluation promptly if any of the listed signs appear, as early treatment improves outcomes for encephalitic conditions.

Post-Bite Measures

Proper Tick Removal

When a tick capable of transmitting encephalitis attaches, prompt and correct removal reduces infection risk. Improper techniques can cause the mouthparts to remain embedded, increasing pathogen exposure.

Use fine‑pointed tweezers or a specialized tick‑removal tool.
Grasp the tick as close to the skin surface as possible, avoiding squeezing the body.
Apply steady, upward pressure to pull the tick straight out without twisting.
Disinfect the bite area with an antiseptic after removal.
Store the tick in a sealed container for possible laboratory identification, if recommended by a health professional.

Following extraction, monitor the bite site for redness, swelling, or a bullseye rash. Observe for systemic symptoms such as fever, severe headache, neck stiffness, or confusion within weeks after the bite. Seek medical evaluation immediately if any of these signs appear. Early treatment improves outcomes for tick‑borne encephalitis.

Monitoring for Symptoms

After a possible encounter with a tick that can transmit encephalitis, systematic observation of clinical signs determines whether infection has occurred.

Key early indicators include:

Fever exceeding 38 °C (100.4 °F)
Severe headache, often localized behind the eyes
Generalized fatigue and muscle aches
Nausea or vomiting

Neurological manifestations may appear within days to weeks and require immediate attention:

Neck stiffness or photophobia
Confusion, disorientation, or difficulty concentrating
Tremor, loss of coordination, or gait instability
Seizures or sudden loss of consciousness

Symptoms typically emerge between 5 and 15 days after the bite, though incubation can extend to three weeks. Prompt medical evaluation is advised when any of the listed signs develop. Laboratory testing for tick‑borne encephalitis virus and supportive care improve outcomes.

«Seek medical care if symptoms develop within 2 weeks of a tick bite». Early treatment reduces the risk of severe neurological damage.