Kersti Kink, chief medical officer at West Tallinn Central Hospital's (LTK) outpatient Infectious Diseases Clinic, acknowledged that Lyme disease is challenging for both patients and doctors. While TBE typically strikes quickly and severely, Lyme disease can be sneaky.

Kink told Vikerraadio that TBE cases have declined over the past 10–15 years, but Lyme disease diagnoses remain on the rise. Improved testing explains part of the increase, but repeat positive tests following successful treatment can also lead patients to believe they've been reinfected.

Most people associate Lyme disease with the tell-tale red bullseye rash at the bite site. But the rash can also appear striped, purplish, patchy or not at all.

"The classic bullseye doesn't always show up," the clinic chief warned, urging people to watch for other signs as well, especially after a tick bite — unexplained joint or muscle pain, fatigue or irregular heart rhythms.

Unlike tick-borne encephalitis, which can leave patients bedridden within a week, Lyme disease develops gradually. "The Lyme pathogen finds a spot in the body to wait for when the time is right," Kink described.

The widely used term "chronic Lyme disease" is misleading, Kink said. Late diagnoses, when the infection has already affected a patient's nerves or muscles, are often mistaken for chronic illness.

Tick checks vital

Early treatment leads to much better outcomes, though symptoms can sometimes return briefly — a condition known as post-treatment Lyme disease syndrome, or PTLDS.

While patients can be vaccinated against TBE, no vaccine exists for Lyme disease, which means prevention remains key.

Always perform a thorough tick check after spending time outdoors in wooded or grassy areas, and remove ticks promptly. The less time a tick remains attached, the lower the risk of infection.

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