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Tickborne encephalitis (TBE)

Tickborne encephalitis (TBE), also known as spring-summer encephalitis, is a viral infection of the central nervous system transmitted by bites of certain vector ticks. Human infections follow bites of infected Ixodes ricinus ticks, usually in persons who visit or work in forests, fields, or pastures. Infection also can be acquired by consuming unpasteurized dairy products from infected cows, goats, or sheep

Occurrence: The disease occurs in Scandinavia, western and central Europe, and countries of the former Soviet Union. Risk of acquiring the disease is greatest from April through August, when Ixodes ricinus, the principal tick vector, is most active..
TBE is common in:
• Austria
• Estonia
• Latvia
• Czech Republic
• Slovakia
• Germany
• Hungary
• Poland
• Switzerland
• Russia
• Ukraine
• Belarus
• Yugoslavia.
The risk for travelers who do not visit forested areas or consume un-pasteurised dairy products is low. Travellers with extensive unprotected outdoor, evening, and nighttime exposure in rural areas, such as might be experienced while bicycling, camping, or engaging in certain occupational activities, might be at high risk even if their trip is brief.

Manifestations: After an incubation period for usually 28 days illness begins with a non specific grippe with:
• Fever
• Malaise
• Headache
• Myalgias
• Nausea
• Vomiting
In most cases these symptoms resolve spontaneously in a week.
In a few cases the disease progresses into a neurological infection with:
• Headache
• High fever
• Neck stiffness
• Stupor
• Disorientation
• Coma
• Tremors Convulsions (especially in infants)
• Spastic paralysis
• Death in about 1% and serious neurological problems in approx.30%

Diagnosis and treatment: Human infection by the virus does not always result in the development of the disease. About 95% of human infections end with an in apparent infection resulting in development of immunity. The disease progresses with a two-phase pattern. The
Incubation period of the disease usually lasts from 7 to 14 days

How are embedded ticks removed?
Ticks embedded into the skin can be removed by using forceps or tweezers to grasp the tick’s mouth parts as close to the skin as possible. Slowly remove the tick by pulling with a single steady motion. Do not jerk, twist, or rip the tick from the attachment site. This will cause the tick
mouth parts to be left in the skin, increasing the chances of developing a secondary infection. Clean the wound and apply an antiseptic.

Do not use home remedies to remove ticks!
Removing ticks with fire, hot matches, cigarettes, fingernail polish, petroleum jelly, or other such methods can cause the tick to regurgitate it’s gut contents into your blood stream increasing the
chances of contracting TBE.

AFTER ANY TICK BITE

STAY ALERT FOR THE SIGNS AND SYMPTOMS OF TBE AND OTHER TICKBORNE DISEASES. IF A TICK BITE IS FOLLOWED BY "FLU" LIKE SYMPTOMS AND/OR A SKIN RASH, PROMPTLY SEE A PHYSICIAN FOR EVALUATION AND TREATMENT.

Prevent tick-borne encephalitis by:
• Vaccination
• Avoid tick-infested areas
• Protect yourselves from tick bites by dressing appropriately
• Using repellents. Repellents containing N,N-diethylmetatoluamide (DEET) can be applied directly on the skin. Compounds containing permethrin have an acaricidal and repellent effect and should be used on clothing and camping gear.
• Consumption of un-pasteurised dairy products should be avoided.

Vaccination: Effective vaccines can be obtained in Europe from and in Canada from many travellers' clinics. Available data does not support recommending its use by those whose risk for infection is low. Anyone at high risk for infection who plans to be in infected areas during the warm weather months when ticks are active should take advice as to whether they need to be vaccinated.