Central European encephalitis (English: Tick-borne Encephalitis, TBE) is a very rare inflammation of the meninges and the brain, triggered by a virus. The virus is transmitted by the bite of infected ticks (Ixodes ricinus), which in turn obtained them from other animals in the forest, such as mice, deer etc.
In some areas of Central Europe, the disease is endemic – meaning that it occurs every spring and summer (the months of March to November, mostly in July and August), but to a very limited extent. In addition in Central Europe and Siberia have the disease in recent years gained more foothold in Northern Europe, gave way by climate change in the form of warmer winters and thus better living conditions for ticks.
Virus-infected ticks in southern Sweden. In Denmark the only Bornholm, where a significant part of forest workers (20 percent) have antibodies against the disease, without any of these have been ill.
What is the risk of being bitten by an infectious tick and get sick?
The risk of contracting an infection depends very much on where you are. The frequency of virus in ticks in Europe varies between 0.1procent and 5 percent. In some parts of Central Europe, the frequency of cases of Central European encephalitis 3-4 fold over the last 10 years. In Austria offered vaccination for all, and here we have seen a fall of 90 percent of the number of sick.
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The countries in Europe, which recorded the most infections, the Czech Republic, Slovakia, Slovenia, Lithuania, Poland and (South) Germany. However, it is probably only a maximum of 25 percent of those infected who develop noticeable disease, and of these maybe about a third, which causes symptoms of encephalitis.
How does the disease itself?
Sygdmmen often occurs in two phases. From infection to go there about a week (it can take up to three weeks). The symptoms in the first phase, which lasts about 5 days, similar to the flu:
- muscle pain
- Overall weakness.
In approximately two-thirds of patients end up with the disease, the fever disappears and they become completely healthy.
At rest may, however, after a symptom-free interval of one week to develop nervous system symptoms in the second phase:
- Encephalitis with severe headache and stiff neck (meningitis)
- Encephalitis with confusion, altered consciousness possible. faintness, trembling and management hassles (encephalitis)
- inflammation of the brain with strong nerve pain, partial paralysis, or sensory disturbances.
Much of the difficulty recover completely from the disease, but studies have demonstrated incomplete healing of the problems in the nervous system of Cika 40 percent of the patients who really developed encephalitis (encephalitis). It is especially adults over 60 years, which may be hard hit, while children often escape very easily from the disease.
How is it diagnosed?
The diagnosis is made by a blood test. Only about half of patients have noted that they have been bitten by a tick, and the diagnosis can not be made without a blood test. The sample used above all for the boundary to other infectious diseases with similar symptoms.
The preferred method to obtain a definite diagnosis is the search for antibodies to virus. These drugs will almost always be detected in a blood test and / or cerebrospinal fluid when the symptoms of nervous system kicks in.
How is Central European encephalitis?
There is no specific treatment for the central European encephalitis, once it has occurred, therefore it is recommended for people who live in areas with high risk of infection with the virus to have a preventive vaccination. This also applies to people who travel to such areas and because of special recreational activities must be regarded as particularly exposed to tick bites.
What can you do yourself?
If you have to travel areas in Central and Eastern Europe with high prevalence of Central European encephalitis, and you have to stay out in nature (forest areas and uncultivated areas), you can choose to be vaccinated. The vaccine comprised of inactivated virus, which is injected into the shoulder muscle. It is given in three stages:
- dose of 28-90 days later
- dose 5-12 months later.
Protection starts about two weeks after the second vaccination and lasts for three years.
What are the side effects of vaccination?
The type of vaccine used in Denmark (TicoVac), is well tolerated by most. However, in some cases, cause discomfort in the form of redness and swelling at the injection site and fever, especially in children. Rarer symptoms are headache, muscle and joint pain. In turn, the full vaccination with three doses probably more than 90% protection against the disease. Children between 1 and 16 years only receive half dose (TicoVac junior).
When should vaccination be omitted?
- At various acute feverish infections and diseases that have affected the immune system.
- By hypersensitivity to eggs (albumen) or against the vaccine preservative.
- In pregnancy and lactation periods are often reluctant to give vaccinations. However, there is nothing to prevent if vaccination is otherwise justified that pregnant and nursing vaccinated since it concerns a so-called killed vaccine