Tick-borne encephalitis

Tick-borne encephalitis, known as TBE, is an uncommon but potentially serious disease caused by tick bites. Tick-borne encephalitis symptoms can be mild, but TBE can cause serious complications, such as meningitis.

Risk areas
Central, Eastern and Northern Europe, Russia, South Korea and parts of China and Japan
Survival rate
Infections a year
Cases in UK travellers
6 since 2011
European infections a year

01. Transmission of tick-borne encephalitis

Tick-borne encephalitis transmission can occur when an infected tick bites you in a risk country, usually during spring to autumn.

TBE transmission is most common when travellers are doing outdoor activities, such as hiking, cycling and camping in rural areas where ticks are present.

Therefore, it is particularly important to check whether you need the vaccine if you are planning these kinds of activities.

TBE can also be spread through drinking unpasteurised milk from infected animals, such as goats. However, this is uncommon.

02. Risk areas

Tick-borne encephalitis is found in Central, Eastern and Northern Europe, Russia, South Korea and parts of China and Japan.

Travellers are most at risk of tick-borne encephalitis transmission when visiting forests and woodland, but TBE is found in gardens and parks in cities too. So city travellers should also check if they need to get vaccinated.

Ticks infected with tick-borne encephalitis are not currently present in the UK, but it is important to know that TBE outbreaks can occur anywhere in the world. This means that the tick-borne encephalitis risk areas change.

Check if the country you are travelling to has a risk of tick-borne encephalitis through the search bar below.

03. Symptoms of tick-borne encephalitis

Most people infected with TBE do not experience any tick-borne encephalitis symptoms at all.

Up to 30% of people develop a fever between seven and 28 days after becoming infected.

Tick-borne encephalitis symptoms usually occur in two stages. The first stage usually lasts for approximately seven days, and can include:

  • fever

  • fatigue

  • headaches

  • muscle pains

  • nausea

  • shivers

  • a circular red rash

In most cases, tick-borne encephalitis symptoms then disappear for one to 20 days before the second stage begins.

During stage two, TBE can cause meningitis and other conditions to develop. These conditions can damage the brain and spinal cord.

If you experience tick-borne encephalitis symptoms, it is important to see a doctor as soon as possible, as this greatly increases your chance of making a full recovery.

04. Diagnosis of tick-borne encephalitis

You only need to see a doctor for a tick-borne encephalitis diagnosis if you have been bitten by a tick in a risk area, and you are feeling unwell.

This is because not all ticks carry TBE, but if you are bitten by an infected tick, your chances of getting the disease are high.

When you see a doctor, it is important to tell them as much information as possible about your recent travels and activities, as tick-borne encephalitis diagnosis can be difficult.

Tests do not always show the disease in the first stage after infection, so you may need to be monitored in hospital for a short time.

Several samples of your blood and fluid from your spine may be taken to help your doctor make a diagnosis.

05. Treatment of tick-borne encephalitis

Tick-borne encephalitis treatment usually involves a stay in hospital. In hospital you will be given fluids, oxygen and medication through a small tube in your vein, known as an IV.

You may also need a machine to help you breathe, which is known as a ventilator.

There is no specific cure for the disease, but prompt tick-borne encephalitis treatment is very effective. Only 1 in 100 patients die from TBE.

If you develop meningitis or other conditions that damage the brain and spinal cord after having TBE, you may require long-term support.

This treatment may include physiotherapy, mobility aids, therapy and specialist help in school or at work.

06. Prevention of tick-borne encephalitis

There are many things you can do to decrease your risk of becoming infected with tick-borne encephalitis.

Preventing tick bites is one of them, as tick bites are the most common cause of the disease.

Even though there are things you can do to limit your chances of being bitten by ticks, it is impossible to guarantee that you will not be bitten in a risk area. This is why it is important to check if you need the vaccine.

If you think you need to get vaccinated for tick-borne encephalitis, you can book a vaccination appointment online today.

If you are still unsure if the tick-borne encephalitis vaccine is right for you, you can book a free telephone consultation to speak to one of our prescribing nurses. They can give you a personal recommendation based on your health and travel plans.

It is also important that you learn how to remove a tick safely if needed, as quick removal reduces your risk of becoming unwell.

To prevent tick-borne encephalitis effectively while travelling in areas where there is a risk of the disease, it is recommended that you:

  • check if you need the tick-borne encephalitis vaccine

  • learn about tick-borne encephalitis so you can spot signs

  • get a tick removal tool

  • wear clothing that covers your arms and legs

  • tuck your trousers into your socks while outside

  • wear light coloured clothing so ticks are easier to see

  • use insect repellent containing DEET

  • stick to paths in forests and grassy areas

  • check your skin and hair for ticks after being outdoors

Content reviewed by

Anne Marie Major, Independent Nurse Prescriber
24 June 2019