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What is tick-borne encephalitis & how do you catch it?
Tick-borne encephalitis (TBE) is a viral infection that’s spread by a type of tick, which looks a bit like a small spider. The infection is transmitted when an infected tick bites a human or animal. Infected ticks are mainly found in rural areas such as forests, woods, grasslands, riverside meadows, marshes, brushwood and scrublands in some European and Asian countries including Austria, Estonia, Croatia, Russia, China and Japan. Note: this isn’t an exhaustive list. TBE isn’t found in the UK.
In rare cases, TBE can also be contracted through eating or drinking unpasteurised dairy products from an infected animal.
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Signs and symptoms
Tick-borne encephalitis symptoms occur in two stages. First signs of TBE include flu-like symptoms such as:
• High temperature
• Headache
• Tiredness
• Muscle pain
On average, these symptoms last around eight days and most people make a full recovery. In around 20-30% of cases, people go on to develop more serious symptoms. This is when the virus has spread to the protective tissue that covers the brain and spinal cord (meningitis) and the brain itself (encephalitis).
More serious symptoms can include:
• Change in mental state: confusion, disorientation or drowsiness
• Seizures
• Sensitivity to bright light
• Inability to speak
• Paralysis
If these symptoms occur, you’ll most likely be admitted to hospital for medical attention. These more severe symptoms will subside after a few weeks, but it could take several months or even years to fully recover. There is a risk of long-term complications and around one in 100 cases of TBE turns out fatal.
Treatment
There is currently no available treatment, other than supportive treatment.
Prevention
It’s important to take precautions to reduce your risk of being bitten, particularly when you’re in high-risk areas, even if you’ve been vaccinated. Here are some precautions you should take:
• Wear long sleeves and trousers and tuck your trousers into your socks
• Wear light-coloured clothing so ticks are easier to spot
• Treat clothing with an insecticide such as permethrin, and apply DEET insect repellent to exposed skin
• Check your skin regularly for ticks – especially your hair line, behind ears, elbows, backs of knees, groin and armpits
You can also reduce your risk of contracting TBE by not eating or drinking unpasteurised dairy products.
How to remove a tick
If you find a tick on your skin, it’s important to remove it as soon as possible. Once attached ticks may not start feeding for several hours. Tick larvae can be very tiny but once they start to feed they can reach the size of a coffee bean. Removing the tick can be done as follows:
- Use a special tick remover tool or finely tipped tweezers
- Grasp the tick as close to the skin as possible and slowly pull upwards until all parts are removed
- Try to avoid sudden movements or twisting as this could cause the tick to leave mouthparts in the skin after the tick has been removed
- Don’t squeeze the body of the tick as the contents of its stomach could go back into the site of the bite
Once removed, wash your hands and the tick bite with soap and water or an antiseptic, such as an iodine scrub. If you’ve not been vaccinated and you’re in an area where there’s a risk of TBE and you develop a rash or fever, seek medical advice straight away.
TBE Vaccination
The tick-borne encephalitis vaccination is administered via injection. The vaccination course consists of three doses, but sufficient protection for the ongoing tick season is to be expected after the first two doses, the second dose usually being given one-three months after the first. However, if time is short, speak to a travel health pharmacist or another suitable healthcare professional.
How long does the tick-borne encephalitis vaccination last?
Following a course of three vaccinations, a first booster dose should be given after three years. For those aged between two and 60 years, subsequent boosters can be given five-yearly if at continued risk.
For travellers over 60 years, boosters should be given every three years if at continued risk.
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