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What you need to know about ticks in Denmark and how to avoid them

Emma Firth
Emma Firth - [email protected]
What you need to know about ticks in Denmark and how to avoid them
Danish infectious disease control agency SSI, have said that only limited groups should consider a TBE vaccination after a small spread of ticks carrying the virus. Photo by Bertrand Guay/ AFP

There's been a surge in the number of people in Denmark getting vaccinated against tick-borne encephalitis (TBE) this year. Although ticks are common in the Danish countryside, the chances of getting TBE are very slim. Here's everything you need to know about ticks and getting bitten in Denmark.

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Ticks (skovflåter) can be found all over Denmark in forests, meadows, and long grass. They are particularly active during the summer months and increase in number if the weather has been warm and humid. So if you're hiking, camping or berry-picking this summer, there's a risk of getting a tick bite (skovflåtbid).

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What are ticks?

Ticks are small, spider-like creatures which vary in size, usually between 1mm to 1cm long. They do not fly or jump but climb on to animals or humans as they brush past. Once a tick bites into the skin, it feeds on blood for a few days before dropping off. In Denmark, ticks are often found on rodents or deer and they are particularly prevalent between May and October. 

Lyme Disease (Borreliose

In Denmark, the most common disease ticks transmit is Lyme disease and around 15 per cent of ticks in Denmark's forests carry this.

It is not known exactly how many people in Denmark get Lyme disease every year, but it is estimated that there are a few thousand cases.

However this is a very small percentage of those who have been bitten by a tick. Broadcaster TV2 has reported that in 98 per cent of cases, people do not get ill from a tick bite.

"If you remove the tick within 24 hours, you most likely won't get Lyme disease, as it takes longer than this for the bacteria, called borrelia, to transfer to the bloodstream," Peter Andersen, senior medical officer at the State Serum Institute's Infectious Disease Epidemiology and Prevention department, told The Local.

For those who do develop Lyme disease, the symptoms usually appear between two and six weeks after the bite, but sometimes longer.

Some people can get flu-like symptoms a few days or weeks after being bitten by an infected tick. Children may complain of stomach ache, lose their appetite or lack energy.

But the most obvious sign of Lyme disease is a red circular rash around the bite. There is no vaccination for Lyme disease.

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"If you've had a tick bite, observe the area to check you don't get a circular rash, which can indicate you've been infected. If this happens, contact a doctor to get treatment. Most infections will be treated with penicillin," Andersen said, adding that treating Lyme disease is straight forward.

"But the danger is if you don't acknowledge the rash, then the disease can spread to the nervous system," Andersen warned.

This is called neuroborreliosis and occurs in around one in ten of of Lyme disease cases.

The symptoms of neuroborreliosis typically appear as headaches and neck or back stiffness and radiating nerve pain or muscle paralysis, typically in the face.

People with neuroborreliosis need to be treated in hospital.

There were 66 cases of neuroborreliosis in Denmark last year, according to the State Serum Institute, the country's infectious disease control agency. So far this year, there have been 3 cases. 

Most cases are detected between July and September and neuroborreliosis most frequently occurs in children aged 5-10 and adults aged 60-70.

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TBE - Tick-borne encephalitis (flåtbåren hjernebetændelse)

This is what people are currently concerned about in Denmark as ticks carrying the disease have recently spread to North Zealand.

This has caused thousands of people to enquire about vaccinations for TBE. State Serum Institute's medical director Tyra Grove Krause has since reassured people that it is still very rare to get the disease.

Only those who spend extended time in forests near Tisvilde Hegn as well as on the island of Bornholm should consider vaccination, she said. This could include foresters, mushroom foragers and trail runners.

TBE is a viral brain infection caused by a particular tick bite. Flu-like symptoms can occur a week or more after the bite and can develop to include nausea, dizziness, and in around a third of cases, severe long-term problems or permanent neurological damage.

In Denmark, TBE cases tended to only occur on Baltic Sea island Bornholm, where there are around 3 cases a year. However ticks carrying TBE have now started to spread and in 2020, a total of five TBE cases with suspected infection were detected in Denmark: three in Tisvilde Hegn, one on Lolland-Falster and one on Bornholm.

READ MORE: Danish disease agency calm over tick-borne encephalitis

What happens if I get bitten by a tick?

If you do find a tick, you should remove it quickly with a special tick remover (available at all pharmacies), tweezers or your nail. The sooner you can do this, the lower the risk the tick will be able to infect you.

The important thing is making sure you remove the whole tick, by grabbing it as close to the skin as possible and pulling slowly. Then wash and clean the bite, and contact a doctor if you’re worried.

Prevention

If you’ll be spending time in wooded areas with long grass, especially those known to have a high tick presence, you should wear boots along with long sleeved light clothing so you can see the ticks, and tuck trousers into socks. Mosquito repellent has also been proven to help deter ticks.

"Proper clothing is a good prevention but it's not always realistic to wear long sleeves and trousers when it's warm. So if you have been outside in nature, you should check yourself in the evening or get a family member to check you for ticks," Andersen suggested to The Local.

Ticks tend to bite around thin areas of the skin such as kneecaps, groin, armpits and hairline. In children, they can often be found on their scalp and behind the ears.

"Ticks are very small and look like a tiny dot so they can be easily missed. They start to enlarge when they suck blood and then the red rash can appear," Andersen said. 

Despite their high presence, ticks shouldn't put you off enjoying Denmark's nature this summer; keeping vigilant to the tiny black insects should keep any tick-related illness at bay.

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