Occupational risks of tick bites: Sirnacher and Wiler Förster report diseases caused by borreliosis

Two foresters in the area have already suffered from Lyme disease several times. This is not uncommon: locally and nationally, the number of tick-borne diseases is increasing. Doctors advise to scan regularly – and get vaccinated.

Nicola Ryser

A tick of 0.5 to 6 millimeters can stick to a human for several days and suck blood. This can cause serious health problems. (Image: Fotolia)

A tick of 0.5 to 6 millimeters can stick to a human for several days and suck blood. This can cause serious health problems. (Image: Fotolia)

Renaldo Vanzo was not doing well physically, something was wrong. The forester from the local community, who could no longer walk suddenly, was suffering from emotional problems in his legs. He quickly went to see a doctor. He diagnosed her: Lyme disease, an infectious disease transmitted by a tick that Vanzo had forgotten about her body. Antibiotics were immediately administered to the Wiler Förster. It's been ten years, he recalls. Vanzo recovered, but the misfortune was – literally – to adhere to him. Because only a few years later, he experienced a Deja vu:

"I suddenly had vision problems and had to go back to the doctor."

Once again, he had missed a tick, again, he was suffering from Lyme disease, again he had to take antibiotics.

Claude Engeler, forestry officer of the Sirnach Forest District, did the same. Ten years ago, he found a tick stuck in his popliteal fossa. He kidnapped her, but only a week later, he had problems with the tendon located there. "Then I remembered that there was only a tick recently." He was also diagnosed with Lyme disease and had to be treated with antibiotics. Sometime later, a tick was on his chest and he fell ill again with the bacterium Borrelia burgdorferi.

The Wil region, like most of Switzerland, is a high risk area

Vanzo, a 16-year-old forester, and Engeler, who have been working in the field for four decades, are often buried in thickets, bushes or grasslands to provide protection and order in the forest. Therefore, tick bites are not unusual for them, they often get caught. "For us, foresters, this is part of the occupational risk," says Vanzo. Therefore, it is important to protect yourself every time you go to the forest, for example by wearing long clothes and covering your skin.

"If it's the bite, you have to react quickly."

The examples of Renaldo Vanzo and Claude Engeler show that even well-protected people who are aware of the risk of being bitten by a tick can not prevent it from happening and getting sick. Foresters are not rare victims, quite the contrary: in July 2018 alone, about 4,500 people were infected with Lyme disease by a tick bite – a new record. In addition, 377 people were infected last year with tick – borne encephalitis (TCE), the second tick – borne disease. The virus is much more dangerous because it can cause inflammation of the meninges or even the brain (see box).

As in almost all of Switzerland, with the exception of Ticino, the Wil region is one of the areas at risk. 83 cases were treated in Spital Wil in 2018, they were 14 since early 2019. These are actually lower values ​​than expected. At the same time, there were 20 patients with tick bite at the same time, but Markus Rütti, Chief Medical Officer, puts it in perspective: This is mainly because the spring of this year has not been particularly hot so far. "This influences not only the activity of the tick population, but also the behavior of the population.

Because: the more beautiful the weather, the more people move in the wilderness. Rütti even expects the upward trend in the number of tick bites to continue to increase: "The risk of tick bites depends on our recreational behavior and as the climate warms, it could attract more people into the wild and into the forest. "As a result, the number of people with Lyme disease and TBE would also increase.

Immunization makes sense in children and the elderly

Although Lyme disease has a good chance of healing – "in early and correctly treated Lyme disease, healing rates are very good, so over 90%" – there is no cure of cause and effect in the FSME. "Immediate mortality is low, but up to 50% of sufferers may have long-term neurological symptoms."

This is why Rütti insists that people who regularly visit risk areas must protect themselves from the TBE virus by vaccinating them, even at an early age.

"Vaccination is possible in children over one year old.In children under six, the risk of severe disease progression is virtually nil, which is why a vaccine does not occur. makes sense only from this age.

Three injections in nine to twelve months provide long-term protection of more than 95%. After ten years, the vaccine should be refreshed. There is no upper age limit: "It makes sense to get vaccinated against FSME, even in old age."

Otherwise, the usual rules apply. "Close the clothes well, avoid the undergrowth and apply substances against insects in the form of sprays. And of course, it is advisable, after the stay in the forest, to look for ticks in the body and clothes, "says Rütti.If a tick bite is found, remove it quickly, disinfect the stain and note the 39th hour of the sting.

Note everything – and maybe put on coconut oil

Renaldo Vanzo and Claude Engeler have always respected the security measures imposed by the Cantons Forest Office. They are also vaccinated. Yet she got caught.

Especially Engeler, who was not subject to ticks, was surprised by the diseases:

"There were years when I did not have tick bites – it's just a matter of luck."

Since the incidents, it is important for him to remember when and when he was caught by a tick. "You should take a note, write it down or just tell someone that you have found a tick and that you have removed it.Because if you have flu-like symptoms a week or more later, you quickly forget that the tick could be the trigger, and then it becomes dangerous. "

Nevertheless, Renaldo Vanzo does not think much about tick bites. He will continue to go to the forest and to search his body. And maybe he chooses an unorthodox alternative:

"One of my colleagues always rubs his neck and hands with coconut oil to protect himself, apparently it works, he never had a tick on his body."

The tick bite (engraving) and its consequences

Bite the tick or sting? In the definition of the term, how a tick takes humans and animals, we disagree. The word "tick bite" is commonly used, but the word "tick bite" is scientifically correct. This has to do with the anatomy of the parasitic species. Ticks has mouthparts in the shape of scissors and a Stechrüssel. With this, they tear the skin of the host, dig a pit in the tissues and absorb the blood. We do not feel the sting because the animal secretes an anesthetic with its own saliva.

If the tick sticks to a human for a long time, serious consequences can result. Because: Up to 30% of ticks carry the bacterium Borrelia burgdorferi, thus infecting 1 to 6% of people after a tick bite caused by Lyme disease. The disease is progressive. It manifests itself in the initial phase in the form of a reddish ring around the puncture site, which gradually enlarges. If borreliosis is not treated immediately, the muscles, joints or nervous system may also be affected. These are flu-like symptoms, paralysis and joint inflammation.

Also in TBE disease, the symptoms are similar to those of the beginning of the flu. A high fever that reappears after an initial phase of illness and a severe headache may be the first signs of meningitis. This can spread to the brain and cause speech disorders, paralysis and disorders of consciousness. But: Only one percent of ticks carry the TBE virus. (NIR)