TBE is a viral infection usually transmitted through the bite of an infected tick that exists in parts of central, eastern and northern Europe across Russia to parts of eastern Asia predominantly at altitudes lower than 1,500m

Tick-borne encephalitis (TBE) is a viral infection usually transmitted through the bite of an infected tick. The disease occurs in parts of central, northern and Eastern Europe, Siberia and parts of Asia. Ticks are found on forest fringes within adjacent grassland, forest glades, riverside meadows and marshland, forest plantations with brushwood and shrubbery. Ticks can also be found in parks and gardens.

Travellers to areas where TBE occurs may be at risk when walking, camping or working in woodland. In Europe, spring and summer are generally higher risk, but seasons vary according to location. Since 2011, six confirmed cases of TBE have been reported in the UK. All had history of travel to the TBE endemic areas of Europe.

Typically, the disease occurs in two stages: a mild flu-like illness and a potentially serious infection of the central nervous system (brain and spinal cord). TBE is rarely fatal in Europe: however in Asia it can be fatal in up to 20 percent of cases. Long-term neurological complications are common.

Prevention

Travellers should:

• Avoid known heavily tick-infested areas of forest and woodland during the spring, summer and autumn where possible
  Practise bite avoidance methods: for example wear appropriate clothing and use effective insect repellents
• Check the body for ticks regularly. The larval forms of Ixodes ticks are tiny and difficult to see
  Remove ticks as soon as possible by using a pair of fine tipped tweezers or tick remover
• Avoid consumption of unpasteurised dairy products in areas of risk (a potential route of transmission)
  Seek advice from a medical practitioner if any signs of illness occur within 28 days of a tick bite

TBE vaccination is available for those travellers intending to visit rural risk areas, or whose occupation may put them at higher risk (see below).

Tick-borne encephalitis vaccine – TBE vaccine should be considered for:

• All persons living in TBE risk areas
• Those at occupational risk in risk areas: farmers, forestry workers, soldiers Travellers at risk of disease
• Laboratory workers who may be exposed to TBE