Lyme disease in Germany, and the advice after a tick bite

The Robert Koch Institute names Lyme borreliosis among the most important tick-borne infections in Germany and makes the geographic point that matters most to a mover: it “bundesweit vorkommt” — it occurs nationwide. Tick-borne encephalitis is mainly a southern risk; Lyme disease is not confined anywhere.

The common wood tick, Ixodes ricinus, is Germany's most common tick and carries both. The RKI states that the proportion of ticks carrying Lyme bacteria varies sharply over short distances and can reach 30%.

It also gives a sense of how ordinary exposure is: around 3% of three- to six-year-olds and 7% of 14- to 17-year-olds are bitten at least once by a tick carrying Lyme bacteria. Ticks are mainly active in spring, summer and autumn, and in warm weather infections can occasionally happen in winter.

Source: Robert Koch Institute — Zecken, Zeckenstich, Infektion: FAQ (entries dated up to 28 November 2024), read 7 October 2026.

The RKI's advice after a tick bite is observation, not alarm. It recommends watching the bite site regularly, so that a developing red ring — Wanderröte, or erythema migrans, an early sign of Lyme disease — can be followed. Taking a photo of the bite can help.

What to look for, in the RKI's description: a clear, ring-shaped redness of the skin, typically paler in the centre than at the edge, appearing after a few days to weeks and spreading. If that happens, see a doctor.

Remove the tick as soon as you find it, and keep checking skin after time outdoors — in gardens, parks and woodland, anywhere in the country.

Many people expect a precautionary course of antibiotics after a tick bite. The RKI says no: “Eine generelle Antibiotikatherapie nach einem Zeckenstich wird nicht empfohlen” — general antibiotic treatment after a bite is not recommended. It is indicated only when Lyme disease is actually suspected, such as the characteristic rash, neurological symptoms or marked joint swelling.

The RKI also advises against sending the tick off for testing. A positive result for Lyme bacteria or TBE virus in the tick, it says, allows no conclusion about whether you have been infected.

So the useful action is the boring one: note the date, watch the site, and go to a doctor if the rash or symptoms appear. Nothing here is medical advice; the decision to treat belongs to that doctor.

There is no vaccine against Lyme disease, so nothing to pay for in advance; the TBE vaccine does not protect against it.

A Lyme infection caught after you arrive is acute, and the consultation and antibiotics are ordinary outpatient care. Your plan level decides what is paid: the Prescribed Medication benefit is not covered on Major Medical, US$750 on Standard and Comprehensive, and covered in full on Fully Comprehensive.

If a missed infection turns into a long-lasting problem, the chronic conditions exclusion applies unless the plan includes a Chronic Conditions benefit. The cover we arrange is worldwide — the United States is the one exception — and pre-existing conditions are excluded.