Tick-Borne Encephalitis (TBE)

TBE is endemic to areas of eastern, central, northern and increasingly western Europe; northern China, Mongolia, Russia, Japan and South Korea. Cases have occurred recently in England.

It is quite widespread and certain activities and locations within these countries increase the risk further.

You should book a travel consultation with a travel nurse to better understand your risk if you are unsure.

No. They are both typically transmitted by ticks, which is where the confusion comes from, and precautions to avoid tick bites will protect against.

However, they are separate diseases with different symptoms and risks. Tick-borne encephalitis is caused by a virus and Lyme disease is bacterial. Vaccines to protect against Lyme disease are not currently available but are in development.

No. Both illnesses cause encephalitis (inflammation and damage to the brain and nervous system), but TBE and JE are two distinct diseases in terms of the virus, transmission and geographical areas.

TBE is spread by ticks and JE is spread by mosquitoes.

See our Japanese encephalitis page for more information on JE.

The risk of TBE in England is considered low. There have only been small numbers of clinical cases. However, this reflects increasing and probably irreversible presence of the virus in the tick population, and growing risk. TBE risk in England is therefore on the rise.

As ticks live in forested and grassy areas, you are much more likely to catch TBE if you enjoy camping, hiking or are a dog walker. Those individuals would be considered higher risk and advised to be vaccinated as a precaution.

Between 10–12,000 cases of TBE are reported annually globally, but this number is thought to be an under-estimate because not all cases result in symptoms, not all symptoms result in a confirmed diagnosis, and not all cases are reported to public health authorities. Severe cases are relatively rare but have a very high impact.

Yes, this is the only option. TBE vaccination is not available on the NHS.

We will discuss your travel plans in detail, so a copy of your travel itinerary including proposed dates of travel, destination(s) you’re travelling to and length of your stay are all helpful details for our nurses. We’ll also discuss your health so information about your vaccination history to date is useful, as well as any medication you are currently taking.

The vaccine is given in your upper arm. We would therefore advise you to wear loose comfortable clothing or short sleeves for ease of access.

A full course of TBE vaccination consists of 3 vaccine doses. The initial (primary) course of vaccination consists of two vaccinations given a minimum of 14 days apart, followed by the third dose given 5-12 months later. Booster doses are advised every 3 years for those at ongoing risk.

The initial two dose course of vaccination protects for at least a year.

The third dose, given 5-12 months later, gives protection for up to 3-years.

A booster dose is advised every 3-years for continuing protection.

Yes. It is given routinely on a very wide scale in many European countries such as Germany and Austria. TBE vaccination is inactivated and does not contain live organisms. You cannot catch TBE from vaccination.

There is no specific treatment for TBE which is why the emphasis is placed upon prevention of the illness. Fatality occurs in up to 3% of European / Siberian strains, and up to 30% in Asian strains. People who survive severe infections are often left with lasting disability.

Those who are at risk should consider prevention of the illness with a TBE vaccine.