As a travel nurse based in London, I was concerned to hear the recent warning from health officials about the spread of tick-borne encephalitis (TBE) virus in several parts of the country. The UK Health Security Agency (UKHSA) has confirmed three cases of TBE virus in patients in Yorkshire, Norfolk, and on the border of Hampshire and Dorset. Further tests on ticks across the country have found that the disease, which was commonly found in parts of Europe and Asia until now, is now present in the UK. The experts have warned that it is unlikely that TBE virus will disappear, so it’s essential to establish a surveillance program.
Public health officials say the risk is low, but it’s essential for walkers to take precautions and seek medical help if they fall ill after being bitten, especially if by a tick.
As a clinic that specialises in travel, we are used to urging everyone to take precautions to protect themselves from tick bites anyway, but this news reinforces the importance of doing this at home as well as when travelling abroad. It is essential to cover your ankles and legs, apply insect repellent, and check clothes and your body for ticks, particularly when visiting areas with long grass such as woods, moorlands, and parks.
In most cases the TBE virus typically causes mild flu-like symptoms, but it can also lead to severe infection in the central nervous system resulting in meningitis or encephalitis a high fever with headache, neck stiffness, confusion, or reduced consciousness, and long-term impairment.
As a travel nurse, I think it is really important to educate people about the symptoms of TBE to encourage them to seek medical help immediately if they experience any of these symptoms, but also to emphasise the fact that infections are preventable.
Ticks are becoming more common in parts of the UK, mainly due to increasing deer numbers. They live in undergrowth and latch on to humans when they walk through long grass. It is thought infected ticks may have arrived in the UK via migrating birds. Scientists had suspected the virus had arrived in the UK in 2019, following a couple of cases, but complexities involved in testing meant these could not be confirmed.
It’s crucial to emphasise the significance of vaccination for individuals who are considered of a higher risk. You are much more likely to catch TBE if you work outdoors or if you enjoy outdoor activities such as camping, hiking, dog-walking, countryside rambling and even jogging. Children playing outside may be especially vulnerable.
Vaccines can provide protection, and as there is currently no known cure for tick-borne encephalitis virus, those individuals who would be considered at higher risk are advised to be vaccinated as a precaution.
It’s worth noting that a vaccine is used routinely in areas of high incidence in Europe, and its advisable to consider vaccination for individuals with outdoor occupations in regions where the virus is prevalent.
For the general public the risk of contracting TBE is relatively low. Therefore, it’s essential to educate people about TBE and encourage them to take precautions to protect themselves from tick bites, particularly when travelling to areas where the virus is found.
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ADVICE ON TICK-BORNE DISEASE IN EUROPE
Tick-borne Encephalitis (TBE) is a viral disease that is spread by the bite of an infected Ixodes tick. It is estimated that the disease infects at least 13,000 people every year.
Symptoms can occur from 4-28 days post-bite and include fever, fatigue and muscle aches.
The virus can also go on to affect the brain and spinal cord, causing meningitis, with up to 20% of cases resulting in death. Unfortunately, there is no specific treatment for TBE.
TBE occurs in 3 main geographical locations:
European TBE – Western Europe
Siberian TBE – Urals, Siberia, Far-Eastern Russia and Finland
Far Eastern TBE – far Eastern Russia, China and Japan
Transmission of TBE occurs mainly during the summer months, mainly via wild vertebrate animals such as rodents. It can be transmitted either by ingestion of unpasteurised milk, or milk products from infected animals or by the bite of an infected tick.
If you’re travelling to affected countries during the transmission period, you are most at risk if you are doing outdoor activities such as hiking, camping and walking in forested areas where ticks are abundant.
Take the following precautions to avoid infection:
Wear long trousers and sleeves. Impregnating clothing with permethrin and using insect repellents such as DEET are also good ways of preventing tick bites.
Get vaccinated. Ticovac (and Ticovac Junior for children) is advised for travellers who may be at risk. It requires two vaccinations prior to travel, and the third dose after a year can provide up to 5 years protection.
Check your body for ticks -especially in the armpits, groin and behind the knees.
Remove ticks promptly and correctly and clean the bite site with antiseptic.
|Eastern Europe, Scandinavia, Siberia
|Infected bite of a tick
|Can it be prevented?
|Yes – Vaccination and tick-prevention
Tick Removal Tips
If you find a tick embedded on your skin you need to remove it, asap:
To remove a tick follow these steps :
- Use a pair of fine tweezers or a tick-remover
- Grasp the tick head as close the skin as possible
- Pull upwards at right-angles to the skin
Top tip: Avoid putting pressure on the body to avoid incomplete removal which may cause infection.
TICK-BORNE ENCEPHALITIS VACCINATION
There is a vaccination against tick-borne encephalitis (Ticovac and Ticovac Junior) which is highly effective against TBE. The primary schedule requires two vaccinations to be given 14 days apart, and a third dose to be given one year later. A booster vaccination is recommended after 3 years. The vaccination is suitable for adults and children over the age of one-year-old.
You can book a travel consultation appointment online to find out if you beed a tick-borne encephalitis vaccine for your next trip.