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Tick-borne encephalitis (TBE) virus is spread through the bite of an infected tick. Sometimes, TBE contagion can spread to people through eating or drinking raw milk or cheese from infected scapegoats, lamb, or cows.

TBE contagion can be set up in corridors of the region stretching from western and northern Europe through northern and eastern Asia. People who travel to these areas might be at threat for infection. TBE contagion isn’t set up in the United States. The ticks that spread TBE contagion are most active in warmer months (April through November). People who spend time outside in or near timbers are at loftiest threat of being stung by a tick infected with TBE contagion.

What’s Tick-Borne Encephalitis?

Tick-borne encephalitis (TBE) is a complaint caused by a contagion. The contagion spreads to people in a few ways:

• Bite from an infected tick.

• Eating or drinking unpasteurized dairy products (milk and cheese) from infected scapegoats, lamb, or cows.

Utmost people infected with tick-borne encephalitis don’t feel sick. When symptoms do, they may include fever, pangs, loss of appetite, headache, nausea, and vomiting. Some people develop swelling of the brain and/or spinal cord, confusion, and sensory disturbances. Tick-borne encephalitis can occasionally beget death.

Who can get Tick-Borne Encephalitis?

Travelers to numerous corridors of Europe and Asia may be at threat for infection with TBE contagion. Check if this complaint is a concern at your destination.
Activities that increase a traveler’s chances of getting tick-borne encephalitis include camping, hiking, and stalking. Travelers are more probable to get infected with TBE when voyaging to affected regions April through November, this is when ticks are most active.

What can Travelers do to Help Tick-Borne Encephalitis?

Travelers can cover themselves against TBE by taking the following preventives:

Prevent Tick Bites:

• Know where to anticipate ticks. Ticks live in grassy, rough, or wooded areas, or indeed on creatures. Spending time outside camping, gardening, or stalking could bring you in close contact with ticks. Numerous people get ticks in their own yard or neighborhood.

• Treat apparel and gear with products containing 0.5% permethrin. Permethrin can be used to treat thrills, apparel, and camping gear and remain defensive through several washings. Alternatively, you can buy permethrin-treated apparel and gear.

• Use Environmental Protection Agency (EPA)–registered insect repellents containing DEET, picaridin, IR3535, oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. EPA’s helpful search tool can help you find the product that best suits your requirements. Always follow product instructions. Don’t use products containing OLE or PMD on children under 3 years old.

• Avoid Contact with Ticks – Avoid wooded and rough areas with high lawn and leaf waste. Walk in the center of trails.

Find and Remove Ticks:

• Check your apparel for ticks. Ticks may be carried into the house on apparel. Any ticks that are set up should be removed. When possible, tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry apparel after you come indoors. If the clothes are damp, extra time may be needed. If the clothes need washing first, hot water is recommended. Cold and medium temperature water won’t kill ticks.

• Examine gear and pets. Ticks can ride on apparel and pets, then attach to a person later, so carefully examine pets, coats, and daypacks.

• Shower soon after being outside. Showering within two hours of coming indoors has been shown to reduce your threat of getting tick-borne conditions. Showering may help wash off unattached ticks and it’s a good occasion to do a tick check.

• Check your body for ticks. Conduct a full body check upon return from potentially tick-infested areas. Use a hand-held or full-length glass to view all corridors of your body. Check these corridors of your body for ticks:

  • Under the arms

  • In and around the ears

  • Inside belly button

  • Back of the knees

  • In and around the hair

  • Between the legs

  • Around the waist

If you find a tick attached to your skin, simply remove the tick as soon as possible.

Eat only Pasteurized Dairy Products:

Tick-borne encephalitis vaccine is recommended for travelers who are moving or traveling to a TBE-endemic area and will have extensive exposure to ticks based on their planned outdoor activities and diary.

In addition, TBE vaccine may be considered for persons traveling or moving to a TBE-endemic area who might engage in outdoor activities in areas ticks are likely to be set up. The decision to vaccinate should be based on an assessment of their planned activities and diary, threat factors for a poorer medical outcome, and personal perception and tolerance of threat.

Vaccine:

In 2021, the U.S. Food and Drug Administration approved a tick-borne encephalitis (TBE) vaccine for usage in the United States, known as TICOVAC. This vaccine has been used for over 20 years in Europe. U.S. travelers visiting corridors of Europe and Asia where TBE is set up who might share in outdoor activities with threat of tick exposure should talk to their healthcare provider about vaccination.

Who Should Get Vaccinated?

The threat for TBE is very low for utmost travelers visiting countries where TBE is set up. Still, travelers are at increased threat if they plan to:

• Visit regions with TBE when ticks are most active (April through November).

• Take part in outdoor activities in or near forested regions such as hiking, camping, stalking, fishing, or birdwatching.

All travelers visiting countries with TBE should take steps to avoid tick-bites. However, you should discuss the need for vaccination with your healthcare provider, if you plan to travel during the warmer months of the year and take part in outdoor activities. When deciding whether or not to be vaccinated against TBE, consider the following:

• What locations you’ll be visiting.

• What activities you’ll share in while traveling.

• Likelihood of future travel to countries where TBE is set up.

• Possible severe issues of TBE complaint.

• Vaccine doses, cost, and possible side effects.

The TBE vaccine is available for children aged 1 year and older, and for grown-ups. Three doses are needed to complete the series so you should talk to your healthcare provider as early as possible before travel.

Prevention & Transmission:

Tick-borne encephalitis (TBE) contagion is most commonly spread to people through the bite of an infected tick. Ticks that spread TBE contagion live in or near timbers in corridors of Europe and Asia. The best way to help TBE is to cover yourself from tick bites. Use insect repellent and treat apparel and gear with 0.5% permethrin. Check your body and apparel for ticks during and after outdoor activities.
To avoid getting TBE from infected dairy products, avoid eating or drinking unpasteurized (raw) milk and cheese from scapegoats, lamb, or cows in affected areas.
Get vaccinated before touring, if vaccination is recommended for you.

Ticks, specifically hard ticks of the family Ixodidae, transmit tick-borne encephalitis (TBE) contagion. Ticks become infected when they feed on blood from infected invertebrate hosts, particularly small rodents, and can later transmit the contagion during the next blood meal. Ticks can also pick up the virus transtadially (from nymph to dryad to mature ticks), transovarially (from mature female tick to eggs), or when co-feeding on infected creatures. The highest period of tick activity and threat of spread is during the warmer months from April through November.

Infection also may follow consumption of unpasteurized milk or cheese from infected scapegoats, lamb, or cows. Other rare modes of transmission include slaughtering infected creatures, blood transfusion, organ transplantation, breastfeeding, or exposure to the contagion in the laboratory.

Symptoms:

Numerous people infected with tick-borne encephalitis (TBE) contagion don’t have symptoms. For people with symptoms, the time from tick bite to feeling sick (incubation period) is generally about 7 to 14 days, but can range from about 4 to 28 days.
Severe complaint frequently occurs including infection of the brain (encephalitis) or the membranes around the brain and spinal cord (meningitis).

Original symptoms can include fever, headache, vomiting, and weakness.
A few days later, severe symptoms can develop including confusion, loss of coordination, difficulty speaking, weakness of the arms or legs, and seizures.
Occasionally original symptoms last a few days and fully resolve, but then about a week later the more severe symptoms develop (known as “biphasic illness”).

Diagnosis:

Still, see your healthcare provider, if you suppose you or a family member might have TBE.

Healthcare providers diagnose TBE contagion infection based on:

• Signs and symptoms

• Travel history and possible exposure to ticks while traveling

• Laboratory testing of blood or spinal fluid

Your healthcare provider can order tests to look for TBE contagion infection or other infections that can cause analogous symptoms.

Clinical Features and Sequelae:

The incubation period of TBE is seven days on average, but incubation of up to 28 days has been described. The incubation after foodborne infection is generally shorter, around four days.

Roughly two-thirds of human TBE contagion infections are non-symptomatic. In clinical cases, TBE frequently has a biphasic course. The first viraemic phase lasts roughly five (range 2–10) days, and is associated with non-specific symptoms (fever, fatigue, headache, myalgia, nausea). This phase is followed by an asymptomatic interval lasting seven (range 1–33) days that precedes the second phase, when the central nervous system is involved (meningitis, meningoencephalitis, myelitis, palsy, radiculitis).

The European subtype is associated with milder complaint, with 20–30% of cases passing the second phase, mortality rates of 0.5–2%, and severe neurological sequelae in up to 10% of cases. In children, the second phase of illness is generally limited to meningitis, whereas grown-ups older than 40 years are at increased threat of developing encephalitis, with higher mortality and long-lasting sequelae in those over the age of 60.

The Far Eastern subtype is associated with more severe complaint monophasic illness, with no asymptomatic interval preceding the onset of neurological complaint, mortality rates of up to 35%, and higher rates of severe neurological sequelae.

The Siberian subtype is associated with a less severe complaint (mortality rate of 1–3%), with a tendency for cases to develop habitual or extremely prolonged infections.

Treatment:

There’s no drug to treat TBE contagion infection. Still, a vaccine is available to help infection; visit our TBE vaccine page for further information on who the vaccine is recommended for.

Rest, fluids, and over-the-counter pain medicines may relieve some symptoms.

People with severe complaint frequently need to be hospitalized to admit support for breathing, staying hydrated, or reducing swelling in the brain.

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