Travel health: Tick-borne encephalitis
Tick-borne encephalitis (TBE) is a viral infection spread to humans by the bite of a small spider-like parasite called a tick. It is acquired abroad in certain European and Asian countries – please ask our pharmacists for more specific advice. There is currently no cure for TBE, but it can be prevented with a vaccine and by taking certain precautions. Please read on for tips on what TBE is and how it can be prevented.
Ticks are usually found is suburban areas. They usually live in the undergrowth, where they can easily get onto people's clothes or skin.
You can become infected with TBE if you are bitten by an infected tick. The virus is present in the tick’s saliva, which also contains a natural anaesthetic so you may not feel the bite initially.
You can be bitten by an infected tick at any time of year, but tick activity is at its highest during the Spring and early Summer.
Drinking unpasteurised milk and eating unpasteurised dairy products from infected animals, particularly goats, can expose you to the TBE virus. However, this is rare.
What is TBE?
TBE produces clinical features similar to those of many other types of meningitis/encephalitis.
The disease may be restricted to the meninges (the membranes covering the brain and spinal cord), which usually leads to full recovery, but it may also affect the brain, the upper portions of the spinal cord and even the nerve roots. Severe disease can cause permanent neurological damage and some patients require long term rehabilitation.
Clinical signs and symptoms
Initial symptoms of TBE are similar to flu and can include a high temperature, a headache, tiredness and muscle pain.These symptoms usually last for up to eight days, after which point most people make a full recovery. However, some people go on to develop more serious symptoms.
The 'second-stage' symptoms can include changes in mental state such as confusion, drowsiness or disorientation, seizures (fits), sensitivity to bright light (photophobia), inability to speak and paralysis. If TBE reaches this stage, you will usually need to be admitted to a hospital. These symptoms tend to get slowly better over a few weeks, but it may take several months or years to make a full recovery, and there is a risk you could experience long-term complications. Around 1 in every 100 cases of TBE is fatal.
Tips for travelers
The best way to prevent TBE is to be vaccinated against the infection before you travel if you are going to be working or travelling in a part of the world where there's a risk of TBE, particularly if you're planning to visit rural areas or go hiking or camping.The vaccine, which is only available privately, provides protection against TBE in around nine out of every 10 people who receive it.
Even if you've been vaccinated, you should still take precautions to reduce your risk of being bitten by an infected tick.
For example, you should:
- wear long-sleeved tops and trousers tucked into your socks
- apply insect repellent containing DEET to exposed skin
- regularly check for ticks – common places to find them are around the hair line, behind the ears, on or around the elbows, the backs of the knees, the groin and the armpits
For more information please call our pharmacists or see your GP, alternatively you can visit www.nhs.uk.