Tick-borne encephalitis

A press release from Public Health England (PHE) recently confirmed that the tick-borne encephalitis (TBE) virus has been detected for the first time in two parts of England (PHE, 2019a). This was understandably reported by mainstream media, making people concerned. Experts have described the risk of infection as ‘very low,’ but there is a call for the public to be aware. Health professionals need to have the knowledge to put public health stories such as this into perspective and an awareness of patients presenting with possible TBE symptoms.

TBE is an infection spread by tick bites, but it can also be acquired from consumption of raw (unpasteurised) milk or dairy products (Centers for Disease Control and Prevention (CDC), 2020). Ticks that can spread TBE are found in parts of Europe and Asia, extending from eastern France to northern Japan and from northern Russia to Albania (CDC, 2020). Most TBE virus infections resulting from tick bites are acquired through activities in forest areas, such as camping, hiking, fishing and bicycling, and from occupations such as forestry or military training (CDC, 2020). Hard ticks of the Ixodes genus are usually responsible for transmitting TBE (Barlow et al, 2016) via the bite of an infected tick. The same ticks can also transmit other pathogens, such as Borrelia burgdorferi (Lyme disease), Anaplasma phagocytophilum (anaplasmosis) and Babesia spp. (babesiosis); simultaneous infection with multiple organisms has been noted. (CDC, 2020).