Spain begins to monitor the spread of two diseases after the increase in the number of cases

Spain has started a tick monitoring project after a surge in cases of two serious diseases spread by the blood-sucking mites. Spanish authorities have added mutes to their National Plan for the Surveillance and Control of Vector-Borne Diseases.

The move comes after an increase in cases of Lyme disease and Crimean-Congo haemorrhagic fever (CCHF) – and amid fears that the outbreaks of both diseases will continue to rise in Spain.

Ticks carry viruses, bacteria and protozoa that are transmitted to humans when they bite the skin to drink blood.

The two most serious, to be monitored in the new study, are Lyme disease and (CCHF). Lucía García San Miguel, head of the Coordination Center for Health Alerts and Emergencies (CCAES), said of Lyme disease: “It is not an infection that is cured and finished, but over the months, manifestations can continue to appear and it causes serious and life-long disabling sequelae, but it is extremely difficult to diagnose because there are no adequate methods.”

CCHF is a member of the Nairovirus genus in the Bunyaviridae family. It is endemic to many countries in Africa, the Balkans, the Middle East and Asia. It has a high mortality rate, ranging from 10% to 40%, making early diagnosis and supportive care crucial to improving patient outcomes.

There have been 15 cases in Spain in the last eight years. García San Miguel said: “We think it will grow.”

Lyme disease is mainly concentrated in the north of Spain, especially in Asturias and Galicia, but it has also been found in the rest of the country. CCHF cases were concentrated in Salamanca and Extremadura.

The number of tick bites in Spain has risen rapidly – including a six-fold increase in Valencia over the past five years.

Lyme disease can cause a variety of symptoms, which are often categorized into early and late stages:

1. Localized early stage (3-30 days after the tick bite)

   • Erythema migrans (EM) : A red, expanding rash that often has a bull’s-eye appearance. This rash occurs in about 70-80% of infected people.
   • Flu-like symptoms : Fever, chills, headache, fatigue, muscle and joint pain, and swollen lymph nodes.

2. Early disseminated stage (days to weeks after tick bite)

   • Additional rashes on other parts of the body.
   • Facial or Bell’s palsy (loss of muscle tone on one or both sides of the face).
   • Severe headaches and neck stiffness due to meningitis.
   • Pain and swelling in large joints.
   • Palpitations and dizziness due to Lyme carditis (which affects the heart).

3. Late disseminated stage (months to years after tick bite)

   • Arthritis with severe joint pain and swelling, especially in the knees.
   • Neurological problems, such as numbness, tingling in the hands or feet, and problems with short-term memory.

Symptoms of CCHF usually progress through several stages:

1. Pre-hemorrhagic phase (1-7 days)

   • Sudden onset of fever.
   • Muscle pain, dizziness, neck pain, stiffness, back pain, headache, eye pain and photophobia (sensitivity to light).
   • Nausea, vomiting, diarrhea, abdominal pain and sore throat at first, followed by sudden mood swings and confusion.

2. Hemorrhagic phase (starts around day 4)

   • Severe bruising, nosebleeds and uncontrolled bleeding at injection sites.
   • Bleeding can occur in the internal organs, gums and skin.
   • Hepatomegaly (enlarged liver), jaundice and rapid kidney damage.

3. The convalescence phase (recovery phase)

   • It starts about 10-20 days after the onset of the disease if the patient survives.