If bitten by an encephalitic tick, when do symptoms appear?

If bitten by an encephalitic tick, when do symptoms appear? - briefly

Symptoms usually develop within 7–14 days after the bite, though onset can be delayed up to a month in some cases.

If bitten by an encephalitic tick, when do symptoms appear? - in detail

A bite from a tick infected with the tick‑borne encephalitis (TBE) virus initiates an incubation period that typically lasts 7–14 days. The interval can be shorter, as few as 3 days, or longer, extending up to 28 days, depending on viral strain, inoculum size, and host factors such as age and immune status.

During the incubation phase the patient feels well; no rash or systemic signs appear. When the virus reaches the central nervous system, the first clinical manifestations emerge. Early symptoms often include:

  • Sudden high fever
  • Severe headache, especially behind the eyes
  • Nausea or vomiting
  • General weakness and fatigue
  • Muscle or joint pain

These prodromal signs persist for 1–3 days and may be mistaken for a common viral infection. In many cases they resolve spontaneously, entering a second phase characterized by neurological involvement:

  • Neck stiffness and photophobia
  • Confusion, irritability, or reduced consciousness
  • Motor deficits such as tremor, ataxia, or paralysis
  • Seizures in severe cases

The neurological phase can begin 2–7 days after the initial fever, and its duration ranges from a few days to several weeks. Recovery may be complete, but persistent deficits—particularly cognitive impairment, gait disturbances, or hearing loss—occur in up to 30 % of patients.

Factors influencing the timing and severity of symptom onset include:

  1. Tick species and viral genotype – certain strains produce shorter incubation.
  2. Location of bite – bites on the scalp or face may deliver virus closer to the brain.
  3. Host immunity – prior vaccination or previous exposure shortens incubation and lessens severity.
  4. Age – children and the elderly often experience more rapid progression.

Prompt medical evaluation after a suspected tick bite is essential. Laboratory confirmation (serology for IgM/IgG antibodies or PCR) should be performed as soon as fever develops. Early supportive care and, where indicated, antiviral therapy can improve outcomes.