The number of cases of tick-borne encephalitis (TBE) – a serious viral infection prevalent in central Europe – rose by almost a third last year, according to a leading expert.
Professor Michael Kunze, chairman of the International Scientific Working Group (ISWG) on TBE, says the number of people across Europe who needed hospital treatment for the infection rose from 10,000 cases in 2006 to 13,000 in 2007. The ISWG considers that climate change is partly to blame, with warmer temperatures and more rain creating perfect conditions for ticks to thrive.
Professor Kunze says that this year's toll could be higher still, as more than two million people travelled to Switzerland and Austria this summer to the UEFA European football championships. Many are expected to stay on to enjoy outdoor activities that could put them at risk.
TBE is an infection of the nervous system, spread by tick bites, that occurs in 30 countries across central Europe, Asia and the Far East. The disease is seasonal, with risk extending from spring to autumn. The risk is highest for those who take part in outdoor activities such as hiking, camping and mountain biking. There is also a risk of infection through consuming dairy products prepared from infected animals.
In severe cases the illness resembles meningitis and without specific testing can be mistaken for it. There is no specific treatment, and some sufferers are left with lasting neurological damage; approximately one per cent of cases are fatal. Within the affected parts of Europe, the risks are widely known and understood. In Austria, for example, an anti-TBE vaccine is offered to the entire population. Elsewhere, many people are ignorant of the disease.
A safe and effective vaccine is available, suitable for adults and for children at least one year old. At least two doses are needed for protection, with a two-week gap between the first and second doses.
How should ticks be removed?
Remove them gently by grasping the head at the point of contact with the skin with fine tweezers. An alternative is to use a thin piece of card with a narrow "V" cut out of it: ease it under the tick until the apex of the "V" is at the head, then lift gently. Do not grasp a tick by its body, since this might force its abdominal contents into the bite, increasing the risk of infection. Retain the tick so that it can be identified later, if necessary. Ticks need to remain attached for several hours for disease transmission to occur, so early removal greatly reduces the risk.
Do ticks spread other diseases?
Yes. Lyme disease is also on the increase in Europe. Even if you have been vaccinated, it is worth taking careful precautions to avoid tick bites.
How do I prevent them?
In high-risk areas, wear long trousers and tuck them into your socks. Light-coloured clothing makes ticks more visible. Inspect your skin carefully for ticks at the end of each day – travelling companions should inspect each other. Ticks can be tiny, and perhaps two thirds of tick bites pass unnoticed. The best available tick repellent is the insecticide permethrin, available as a liquid or a spray: apply it liberally to clothing, especially socks and trouser legs.
What should I do if I'm bitten?
Don't panic and seek advice, ideally from local doctors. The risk of TBE infection from a single bite has been estimated at between 1 in 200 and 1 in 1,000. Report a fever, rash or any other symptoms right away.
- Dr Dawood is a specialist in travel medicine at the Fleet Street Clinic (020 7353 5678).