Tick-Borne Encephalitis: The Summer Risk for Hikers and Campers in Europe

What is tick-borne encephalitis?

Tick-borne encephalitis is a viral infection spread mainly through the bite of an infected tick. Many people who catch it have only mild, flu-like symptoms or none at all. But in some, the illness moves in two stages: a first phase of fever, headache and aches, followed after a short recovery by a second phase in which the virus reaches the brain and the membranes around it, causing encephalitis or meningitis.

TBE is rarely fatal in Europe, but it can be serious: a proportion of people who develop the neurological form are left with long-lasting problems such as headaches, difficulty concentrating or nerve damage. The Far Eastern subtype found in parts of Asia is more severe and can be fatal in a higher proportion of cases. There is no specific antiviral treatment, care is supportive, which is why prevention is the focus.

Where and when is the risk?

TBE occurs across around 25 countries in central, northern and eastern Europe, as well as Siberia and parts of Asia. Popular destinations with risk areas include Austria, Germany, Switzerland, Czechia, Poland, Hungary, the Baltic states and parts of Scandinavia. Worryingly for travellers, the range has been expanding and reported cases have risen in recent years. You can check destination-specific advice on TravelHealthPro.

Ticks are most active from spring through to late autumn, so summer walking and camping holidays coincide with the peak season. Risk is concentrated in rural settings, forest edges, grassy clearings, riverside meadows, but ticks also turn up in parks and gardens within risk areas.

Who should consider the vaccine?

TBE vaccination is aimed at people whose plans put them in contact with ticks in risk areas, rather than every traveller to Europe. It is worth considering if you will be:

• hiking, camping, cycling or trail running in rural or forested risk areas
• staying for a longer period, or making repeated trips, during the tick season
• working outdoors, for example in forestry, farming or fieldwork, in an affected region

The vaccine schedule

The primary course is three doses. The first two are given one to three months apart, and good protection is usually achieved after that second dose, so even two doses before you travel are worthwhile. The third dose, five to twelve months later, extends protection, and boosters keep it topped up for frequent or long-term travellers. An accelerated schedule, with the second dose about two weeks after the first, can be used when time is short.

Keeping ticks off you

Bite prevention is the foundation of protection, and it is simple to do well:

• Cover up in tick habitat: long sleeves, and long trousers tucked into your socks.
• Wear light-coloured clothing so you can spot ticks, and use an insect repellent containing DEET on exposed skin.
• Stick to the centre of paths and avoid brushing through long grass and undergrowth where you can.
• Check your whole body each day, including the scalp, behind the knees, the waistband and the groin, and check children and pets too.
• Avoid unpasteurised milk and cheese in risk areas, as the virus can occasionally be spread this way.

How to remove a tick safely

If you find a tick attached, remove it promptly. Using fine-tipped tweezers or a tick-removal tool, grip the tick as close to the skin as possible and pull upwards with steady, even pressure. Do not twist or crush it, and do not try to burn it off or smother it with petroleum jelly: those old methods can make things worse. Clean the bite with antiseptic afterwards and note the date. If you become unwell within about four weeks of a bite, seek medical advice and mention the tick.

Ticks in Europe can also carry Lyme disease, which is far more common than TBE and is not prevented by the TBE vaccine. That is another good reason to take bite prevention seriously and to watch for an expanding circular rash or flu-like illness after a bite.

Book tick and travel advice in Medway

Book a travel health appointment at 465 Canterbury Street, Gillingham, ME7 5LJ. Our pharmacists can advise on TBE and your wider travel vaccines, and help you build a simple tick-prevention plan for your trip. Open 7 days a week until 10pm, with same-day appointments. Call 01634 575805.

Frequently asked questions