Tick-borne Encephalitis
Introduction
Tick-borne encephalitis (TBE) is an infection spread mainly through tick bites. It can cause a flu-like illness or lead to more severe symptoms such as meningitis or brain inflammation.
Recommendations for Travellers
If you are planning to spend long periods of time outdoors in forests or rural areas of countries where TBE infection is common, you should be aware of how to avoid tick bites.
The most effective way to prevent infection is by having the TBE vaccine, particularly if you are planning to do outdoor activities such as walking, hiking, camping, cycling, fishing orienteering or running in rural or forested areas.
When travelling in high risk areas, you should inspect your whole body daily for ticks, particularly after outdoor activities. Ticks should be removed as early as possible.
- See the insect bite avoidance page for advice on how to safely remove ticks.
Vaccination
The vaccine available in the UK against TBE is called TicoVac. There is a vaccine called TicoVac junior available for children.
The vaccination course consists of three doses (injections) of vaccine.
- You should aim to have the first injection at least one month before you travel.
- You will need at least 2 doses to provide you with adequate protection for your trip.
- A third injection will offer you protection for about 3 years.
You can find out more information about each of these vaccines from the patient information leaflets supplied by the manufacturer:
Overview of Disease
TBE is a viral infection that can affect the brain and central nervous system. It is transmitted to humans from infected tick bites. Occasionally, you can become infected by drinking unpasteurised milk from infected animals, especially goats.
The ticks that transmit TBE can be found in Europe and parts of Russia, China, Japan and South Korea. TBE transmission occurs during 'tick season' which runs from late spring until early autumn. Not all ticks are infected with TBE.
Most human infections are contracted during outdoor leisure activities such as forestry working, camping, rambling and mountain biking during tick season.
The Illness
Most people infected with TBE won’t experience any symptoms.
Some people will develop a high temperature (fever) and flu-like symptoms (such as feeling hot and shivery, headaches, aching muscles or feeling sick) which will last for around a week.
A small number of people who appear to have recovered from the flu-like illness will go on to develop more serious symptoms several days later. These symptoms might include a very high temperature (fever) and neurological symptoms (for example severe headache, neck stiffness, seizure (fit), sudden confusion, or weakness or loss of movement in parts of the body).
- If you, or someone you know, experiences any of these symptoms during or after travel to a region where TBE exists, you should seek urgent medical assistance.
Those who experience severe disease might develop permanent neurological damage. About 1 in every 100 patients will die from TBE.
Treatment
There is no specific treatment available for TBE, but supportive treatment in hospital (for example with hydrating fluids) can be very effective in aiding recovery.