March 25-31 is Tick Bite Prevention Week in the UK, which largely focuses on Lyme Disease and preventing tick bites and their impacts on pets. But whilst this is a serious insect-borne disease in the Northern Hemisphere, particularly for animals, not as much attention seems to be focused on the human impacts of Tick-borne Encephalitis (TBE).
In fact, the average traveller perhaps focuses more on the higher profile Japanese Encephalitis (JE). This is a viral infection of the brain spread by the bite of mosquitoes. It particularly occurs in rural environments, in Japan and other countries, often around paddy fields and farmland, outside of major cities.
Tick-borne Encephalitis, on the other hand, seems to go under the radar far more. This is despite there being a Tick-borne Encephalitis (TBE) vaccine, which is recommended for those who are travelling to endemic areas.
What is Tick-borne Encephalitis?
The disease is common in not just Africa but in places nearer to home, such as Central, Northern and Eastern Europe, as well as parts of Asia. In fact, there was a significant increase in cases within the EU between 2012 and 2020.
TBE can actually be a very serious disease, causing long-term neurological complications. TBE is also fatal in up to 20% of cases in Africa. It can cause anything from mild flu-like symptoms to a serious infection of the central nervous system, brain and spinal cord.
TBE is caused by the bite of infected Ixodes ticks found in woodland areas and transition zones between grasslands and forests. TBE can also occur when an individual consumes unpasteurised dairy products made from the milk of infected animals. Most cases within Europe occur between spring and later Autumn. It has become a human health challenge, with a rise in human cases of almost 400% in the past 30 years.[i]
Symptoms and treatment of Tick-borne Encephalitis (TBE)
The symptoms that signal that TBE may be being suffered include a high temperature, nausea, headache, aches and pains and tiredness. As the disease and infection spreads, it can result in a stiff neck, sensitivity to bright light, fits and seizures, confusion, behavioural change, slurred speech, movement loss and drooping of the face.
Treatment may not always succeed but can take the form of medicines, ventilation, fluids pumped into the veins and surgery, to drain the brain of fluid.
Protection against TBE
Preventing the penetration of the skin by ticks is one major defence tactic, involving the use of DEET insect repellents and the wearing of long-sleeved shirts and long trousers. Pale clothing can be advantageous, as it can help detect the presence of ticks. If a tick penetrates the skin and is observed, it should be pulled out carefully with tweezers, in one swift movement, so that the mouth of the tick is not left in the skin. That area of the skin should then be cleaned with soap and water or disinfectant.
Which travellers are at risk from Tick-borne Encephalitis (TBE)?
Travellers who are most susceptible to TBE are those holidaying or working in forest areas or in open countryside and on farmland. This can include military who are on training exercises in forest areas.
Another group of travellers who are at risk in endemic areas are those who are on outdoor holidays, camping, fishing, canoeing, hiking, biking hunting or engaging in forest-based activities. However, TBE can also be an issue in urban parks and grassed areas. In such habitats, people should try to stick to pathways, rather than brushing through tall grass or wooded glades.
The risk increases according to the length of time spent in an endemic area, so sensible precaution is required, according to individual travel plans, activities and duration of stay.
The most affected areas in Europe are Austria, southern Germany, Czechia, Slovenia, Baltic States and southern Scandinavia. However, northern Italy and Switzerland also have a TBE risk and there have even been cases in Greece and Russia. Beyond Europe, there is a TBE risk in Japan and China.
The Tick-borne Encephalitis vaccine
The only proven form of prevention is a TBE vaccine, which is generally effective and well-tolerated. Generally, this takes the form of two injections, at least two weeks apart. It is highly recommended for those planning outdoor activities in areas in which TBE is an issue.
To quickly discover whether this recommendation could be one for your trip and individual travel plans, you can complete a Pinpoint Travel Health online form and create your own individual Travel Health Brief. This will highlight whether a TBE vaccine might be a suitable travel precaution for your schedule, area of travel and activities.
To order your Travel Health Brief and discover the TBE risk to you, simply start the process and let our advanced software do the rest. For a small outlay, you can gain peace of mind and clarity over the vaccines that your trip, and your trip alone, requires. Why not do that today?
[i] https://www.ecdc.europa.eu/en/tick-borne-encephalitis/facts/factsheet#:~:text=Tickborne%20encephalitis%20is%20caused%20by,subtype%2C%20transmitted%20mainly%20by%20I.