Lyme Disease

Romania: General Health Risks

Lyme Disease

Country Risk

Risk of Lyme Disease is present in Romania. Infected ticks are typically found in wooded and brush areas.


Lyme Disease is caused by bacteria belonging to the genus Borrelia transmitted through the bite of infected ticks belonging to the Ixodes genus. Borrelia burgdorferi is the predominant cause of the illness in North America, and Borrelia afzelii and Borrelia garinii in Europe and Asia. Ticks get infected when they feed on deer, birds, and rodents who are reservoirs for the bacteria and spread it to humans typically by nymphs (immature ticks). Due to climate change, tick populations are moving further north in latitude.


Lyme Disease is present in North America, Europe, and Asia. Travellers involved in outdoor activities in forested areas are at risk, including campers, hikers, and hunters. Brushing against vegetation or walking in city parks known to have infected ticks can also put a person at risk. Risk of Lyme Disease increases during the warmer months when ticks are most active, but they can be found year-round in areas where temperatures are above freezing. 


Lyme Disease usually progresses in three stages. One of the first symptoms (for approximately 70-80% of persons) is a small bump and skin rash at the site of the bite which usually goes away after 1 or 2 days. After 3 to 30 days, the rash expands to an encircled red patch (known as Erythema migrans or Bull's Eye rash) which is warm to the touch but not painful or itchy. The rash may produce lesions. Other symptoms include fever, headache, muscle and joint pain, chills, fatigue, and swollen lymph nodes. Contact your healthcare practitioner immediately if you develop symptoms.

If untreated, the illness progresses to the second stage within days or weeks after exposure. Symptoms include severe headaches, meningitis, swollen joints, skin lesions, heart palpitations, dizziness, persistent fatigue, sleep disturbance, as well as loss of muscle tone in the face (Bell's palsy). Some of these symptoms usually disappear within weeks or months. However, if untreated, the illness will progress to a third stage which includes arthritis and chronic pain, numbness, tingling of hands and feet, and short-term memory loss.

Lyme Disease usually takes 2 to 4 weeks to treat if started promptly and includes taking antibiotics.


Travellers who hike, camp, or undertake outdoor activities in wooded regions or who frequent city parks of endemic areas should take measures to prevent tick bites.

  • Use a repellent containing 20%-30% DEET or 20% Picaridin. Re-apply according to manufacturer's directions.
  • Wear neutral-coloured (beige, light grey) and breathable garments, including long-sleeved shirts and pants. Tuck pants into socks.
  • If available, apply a permethrin spray or solution to clothing and gear.
  • When hiking in wooded areas, stay in the middle of the trail and avoid tall grasses and shrubs.
  • Use a tarp when sitting on the ground.
  • Carefully examine your body, clothing, gear, and pets for ticks before entering a dwelling.
  • Promptly remove ticks using tweezers by grasping the tick's head and mouth parts as much as possible and by pulling perpendicular from the skin. See How to: Tick Edition for videos on removing ticks correctly.
  • Thoroughly disinfect the bite site with soap and water or disinfectant. If travelling in an endemic area, save the tick in a zip-lock bag or container for up to 10 days (refrigerate live ticks; keep dead ticks in the freezer). Write down the date and location of your contact with the tick. Your healthcare practitioner may advise you to submit the tick for testing.
  • If you develop symptoms of a tick-borne disease, contact your healthcare practitioner immediately.
  • Apply sunscreen first followed by the repellent (preferably 20 minutes later).
  • For more details, see IAMAT's: insect bite prevention.

There is no preventive vaccine or medication against Lyme Disease.

Borrelia bacteria images, life cycle, and distribution maps: Infection Landscapes

Information last updated: February 23, 2021. 

  • Barbour A. Relapsing Fevers and other Borrelia Diseases. In: Guerrant, R; Walker D; Weller P, eds. Tropical Infectious Diseases. 3rd ed. New York: Saunders Elsevier; 2011: 295-302.
  • Sandford C. Lyme Disease. In: Jong, E; Stevens, D, eds. Netter’s Infectious Diseases. New York: Saunders Elsevier; 2012: 430-434.
  • Wertheim, Heiman; Horby, Peter; Woodall, John, eds. Atlas of Human Infectious Diseases. Oxford: Wiley-Blackwell; 2012. 273 p.
  • Centers for Disease Control and Prevention: Lyme Disease
  • Public Health Agency of Canada: Lyme Disease