Tick-borne encephalitis (TBE) is an inflammation of the meninges (meningitis) with inflammation of the brain (encephalitis) caused by TBE viruses. Infection usually occurs via the bite of the tick (Ixodes ricinus, common wood tick).
Tick Borne Encephalitis (TBE) Symptoms
TBE typically runs in two phases of the disease. The first phase occurs 4 to 28 days after being bitten by a TBE-infected tick. There is fever, exhaustion and possibly joint pain or headaches for about a week; the symptoms resemble those of the flu.
A second phase of the disease with a high fever occurs a few days later in about a third of those who become ill. In about half of the cases, there is only meningitis without encephalitis. Meningitis is characterized by headache, fever, fatigue and a pronounced general feeling of illness. In about four out of ten people affected, meningitis with encephalitis, or meningoencephalitis for short, develops with the second phase of the disease. The main symptoms are clouded consciousness, paralysis of the arms and legs and face, loss of concentration and memory, seizures (epileptic seizures) and other neurological symptoms can also occur. In the second phase of the disease, around one in ten sufferers develop inflammation of the spinal cord (myelitis) in addition to meningoencephalitis; one then speaks of meningoencephalomyelitis. In addition to flaccid paralysis of the arms and legs, swallowing and speech disorders as well as respiratory paralysis can also occur - signs of brainstem inflammation.
Tick Borne Encephalitis (TBE) Treatment
The second phase of TBE requires hospital treatment, with severe clouding of consciousness or respiratory paralysis in the intensive care unit. Since there is no means of combating the TBE virus directly, treatment is limited to alleviating the symptoms. These include, for example, medication for headaches or epileptic seizures and, in the case of paralysis, physiotherapy to restore mobility.
Tick Borne Encephalitis (TBE) Prevention
An important preventive measure against all diseases that are transmitted by ticks is to avoid tick bites.
Ticks usually lie in wait for their warm-blooded victims on blades of grass and bushes no more than one meter above the ground. For example, if you brush along a blade of grass on which the tick is sitting, it will cling to clothing or skin and crawl to a spot where it can easily bite the skin. Therefore, wearing closed foot and leg clothing is an important protective measure. Smooth fabrics have the advantage that ticks cannot cling to them easily. Ticks are easier to spot on light-colored clothing than on dark-colored clothing.
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Use tick repellents correctly
There are also special repellents against ticks that can be sprayed on clothing and skin. The active ingredient citriodiol from lemon eucalyptus and the synthetic active ingredient DEET (diethyltoluamide) have proven to be effective. As a rule, the protective effect of these agents decreases significantly after two to three hours and must be refreshed. Reapplying is also necessary after bathing and if you have sweated profusely. If both a sunscreen and a tick repellent are to be used on the same skin area, then the sunscreen should be applied half an hour before the tick repellent.
Full body manhunt
After a stay in the woods and meadows, you should carefully check the entire body for ticks, including hard-to-reach areas such as the skin folds in the back of the knees and groin, genital area, navel, armpits and the hairy scalp.
Tip: Ticks that have already attached themselves to the skin can be removed by grabbing their head with fine tweezers, special tick tweezers or a tick card and carefully pulling them out. Turning maneuvers and any attempts to smother the tick (e.g. with glue or oil) are not recommended – all of this increases the risk of infection. After removing the tick, the puncture site is disinfected with alcohol or treated with an iodine-based ointment and a small plaster.
Vaccination
The vaccine is injected into a muscle, usually the upper arm. The basic immunization according to the standard scheme requires three injections. The interval between the first and second vaccination is one to three months, between the second and third vaccination nine to twelve months. Alternatively, the primary immunization can also be done in the rapid schedule, with 7 and 21 days after the first injection and the first booster after 18 months. After the basic immunization has been completed, the FOPH recommends booster vaccinations every ten years. The vaccination provides reliable protection against TBE, but not against other tick-borne diseases such as Lyme disease. Therefore, the advice also applies to vaccinated people to avoid tick bites as much as possible.
Side effects of vaccination are usually mild and short-lived. The most common are pain, redness or swelling at the injection site, discomfort, headache, muscle or joint problems, flu-like symptoms and nausea. Rarely, allergic reactions to the vaccine can occur. Serious side effects such as meningitis, encephalitis or paralysis only occurred in isolated cases.