Tick-borne encephalitis (TBE) can be prevented by:
- having a vaccination against TBE
- avoiding tick bites when in risk areas
Vaccination
A vaccination is the best way to prevent TBE for people living, working or travelling in risk countries. You may consider having the TBE vaccination if:
- You are living in or planning to move to a risk country.
- Your work puts you at risk of TBE (for example, if you are a farmer, forestry worker or soldier).
- You are planning to travel to a risk area during late spring or summer and will be taking part in activities that put you at risk, such as camping, hiking or bird watching.
The best time to start a course of TBE vaccination is during the winter months to make sure you are protected before the start of the tick season in spring.
You cannot get the TBE vaccine on the NHS. Your doctor may be able to order it in for you from a specialised travel clinic, but you will still have to pay for the course of vaccine. You may prefer to go directly to your local travel health clinic.
Vaccination course
The TBE vaccine is usually given in three doses, with the second dose given one to three months after the first dose, and the third dose given five and 12 months after the second dose.
If you need more urgent protection, two doses of the vaccine can be given at least two weeks apart. In this case, the third dose should be given five to 12 months after the second dose.
If you are under 60, you should have your first booster three years after your original course of the vaccine. Further boosters should be given every three to five years.
If you are over 60, you should have booster doses every three years. This is because studies have shown that TBE immunity (resistance) does not last as long in older people.
Side effects
Any reactions to the TBE vaccination are usually mild and do not last long.
Adults may experience swelling, redness and pain at the site of the injection. Other possible side effects include tiredness, headache, muscle pain and nausea.
Children usually experience mild side effects such as pain and tenderness at the site of injection, restlessness and headache. They may also experience a fever (temperature of 38C (100.4F) or above) after their first dose of the vaccine. In very rare cases, a more serious reaction can cause meningitis.
Precautions
You should not have the vaccination if:
- You are allergic to eggs (as the vaccine contains egg protein).
- You have a fever.
You must also tell your doctor or nurse if any of the following apply to you:
- You have problems with your immune system.
- You have a brain disorder.
- You are pregnant.
- You are breastfeeding.
You may still be advised to have the vaccine, but your doctor or nurse will need to check your risk with a travel medicine specialist before giving it to you.
Protecting yourself
The best way to lower your risk of TBE is to avoid tick bites as much as possible when in risk areas:
- Wear long-sleeved tops and long trousers (tucked into socks). You can treat your clothes with insecticides such as permethrin.
- Apply insect repellent containing DEET to any exposed skin.
- Check your body for ticks regularly. Common places to find them are the hair line, behind the ears, elbows, backs of knees, the groin and armpits.
- Avoid eating and drinking milk and unpasteurised dairy products in countries where there is a high risk of TBE.
What to do if you find a tick
After a tick has attached itself to you, it may not start feeding for several hours. Adult ticks, once they have fed, can be up to the size of a coffee bean, but tick larvae can be tiny.
If you find a tick on your body, you should remove it as quickly as possible with a pair of tweezers or tick remover:
- Place the tweezers as close as possible to your skin and pull the tick off very firmly and slowly until the tick lets go of your skin (make sure you remove its head and mouth).
- Avoid squeezing the body of the tick and the contents of its stomach into the site of your bite.
- After you have removed the tick, wash your hands and the affected area with soap and water.
