Lyme disease: how the disease progresses

There are three phases in the progression of Lyme disease, which is sometimes referred to as Lyme borreliosis. Learn how to spot the symptoms of each phase.


Lyme disease is caused by the Borrelia burgdorferi bacteria. In Switzerland, between 5% and 50% of ticks carry Borrelia bacteria, depending on the area. According to the Federal Office of Public Health, around 10,000 people are infected with Lyme disease every year.

Lyme disease: progression and symptoms

The clinical symptoms of Lyme disease can vary a lot, so it is not always easy to diagnose. There are three phases in the progression of the disease. Catching and treating the disease as early as possible is the best way to ensure a full recovery. Lyme disease is treated by a course of antibiotics. Somewhere between 98% and 99% of patients who receive treatment during the initial phase do not experience any further symptoms. If Lyme disease is not diagnosed early or not treated properly, it can have lasting effects.

Lyme disease: stage 1

A circular rash, also called bull’s-eye rash, develops around the site of the tick bite. The technical name for the rash is erythema migrans. Unlike the harmless but itchy redness of the site of the bite, this rash is not painful or itchy. The rash may be accompanied by flu-like symptoms like fever or aching limbs.

Lyme disease: stage 2

Out of 100 infected patients, 15 reach stage 2, which usually occurs within a few months. In this stage, the disease has spread from the skin to other organs.

  • Skin: swelling and red or purple blotches
  • Nervous system: pain or paralysis
  • Heart: elevated heart rate, chest pain

Lyme disease: stage 3

The third stage of Lyme disease usually only occurs months or years after the initial bite. Patients may experience the following symptoms:

  • Inflammation of the joints: joint pain and swelling in the joints
  • Changes in skin texture: discolouration, skin becomes thin and wrinkled
  • Chronic nervous system problems: depression, insomnia, poor concentration and muscle paralysis

Even when there are no longer any active bacteria in the body, patients may still experience fatigue, headaches and depression. These symptoms are known as post-treatment Lyme disease or chronic Lyme disease.

Not all stage 3 symptoms can be attributed directly to Lyme disease. Often the symptoms are associated with other disorders such as arthritis, rheumatism, multiple sclerosis or a burnout.

Tick-borne encephalitis (TBE)

Ticks don’t just spread Lyme disease. They can also transmit a viral infection known as tick-borne encephalitis. The disease has two distinct phases. In the days immediately after being infected, patients present flu-like symptoms such as a fever or aching limbs. Up to 15% of patients then experience a period during which they have no symptoms, after which the flu-like symptoms recur. At that point, one of the following may be observed:

  • Meningitis – inflammation of the membrane enclosing the brain and spinal cord
  • Meningoencephalitis – inflammation of the brain membranes and tissue
  • Meningoencephalomyelitis or meningoradiculitis – inflammation of the brain and spinal cord tissue

A small number of patients also experience paralysis in their arms, legs or facial muscles. The disease is fatal in around 1% of cases.

The best way to prevent TBE is to have the TBE vaccine


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