Tick-borne encephalitis is a viral infection that is spread to human via the bite of parasitic ticks. Initial symptoms are similar to flu, and the virus can spread to the lining of the brain and spinal cord (meningitis) and the brain (encephalitis). The World Health Organisation estimates that between 10,000 and 12,000 cases of tick-borne encephalitis are reported worldwide each year, although the actual number of cases is believed to be much higher than this because it is likely many cases are not reported.
The initial symptoms occur two to 28 days after a tick bite are flu like and include high fever, headache, tiredness and muscle pain. These usually last for eight days and most people make a full recovery.
In some people the virus can spread to the lining of the brain to cause meningitis or the brain to cause encephalitis. The symptoms in these cases include:
Confusion, Drowsiness, Seizures
Paralysis & Even Death
Sensitivity to Bright Light
Countries at risk
Infected ticks are normally found in rural areas of central, northern and Eastern Europe, in countries such as Poland, Romania, Lithuania, some parts of Scandinavia and throughout Russia. They are also in some countries in East Asia, such as the forest regions of China and Japan.
Advice for travellers
You can reduce your risk of tick-borne encephalitis is by getting vaccinated and by taking precautions to avoid tick bites in high risk areas. Ticks can also spread other diseases such as Lyme disease. Tick bites can be avoided by:
• Wearing long-sleeved tops and long trousers tucked into your socks. You can also treat your clothes with insecticides such as permethrin.
• Wearing light-coloured clothes so ticks are easier to spot and brush off.
• Apply insect repellent containing DEET to exposed skin.
• Check your body for ticks regularly – common places to find them are the hair line, behind the ears, in the elbows, the backs of the knees, the groin and the armpits.
• Walkers should stick to the centre of trails as ticks are frequently found on protruding trees and branches.
Also avoid drinking unpasteurised milk or dairy products in countries that are high risk, as the milk form infected animals can carry the virus.
Vaccination is recommended for anyone travelling or working in high risk countries and is 90% effective. The vaccine is an injection is given as a three doses for full protection. An accelerated course can be given with the second dose two weeks after the first. If you continue to be at risk a third dose can be given five to twelve months after the second and then booster doses three yearly.
Number of doses
Three doses. Day 0, 2nd dose given 1-3 months after 1st dose, 3rd dose given 5-12 months after 2nd dose
From 16 years
Three doses at 0, 1-3 months after 1st and 5-12 months after 2nd dose
First booster after 3 years, thereafter boosters needed after 5 years
Meningitis ACWY For Hajj/Umrah
Meningitis symptoms can develop quickly and they can be difficult to spot as they as similar to symptoms of flu. Infection with meningitis is an emergency and requires admission into a hospital where you will be given antibiotics. All pilgrims to Saudi Arabia for Hajj or Umrah are required to show proof of vaccination in the last three years against meningitis ACWY.
Vaccination is required at least 10 days before you are due to travel and you will also receive a certificate as part of your vaccination.