Tick Borne Encephalitis Immunisation

What is tick borne encephalitis?

Tick borne encephalitis is caused by a virus. It is usually spread by bites from ticks which are infected with the virus. Unpasteurised milk from infected animals, especially goats, is also thought to be a source of the virus. The incubation time is usually 7-14 days (which means it takes 7-14 days to develop symptoms after being infected).

Affected people may initially develop a flu-like illness that lasts about a week. This may then progress to encephalitis (brain inflammation) which can cause headache, fever, confusion, agitation, vomiting, and can lead to a coma. It is fatal in about 1 in 30 cases.

Tick borne encephalitis occurs in warm forested parts of central and eastern Europe, and Scandinavia. It does not occur in the UK.

Who should be immunised against tick borne encephalitis?

Your doctor or practice nurse can advise if you should have this immunisation for your travel destination.

Generally, the risk to the average traveller to affected countries is small. Immunisation is recommended for people who intend to walk, camp, or work in heavily forested regions of affected countries during late spring or summer when the ticks are most active. In particular, if you stay in areas where there is heavy undergrowth.

The vaccine schedule

The usual schedule is to have two injections of vaccine given 4-12 weeks apart. This protects you for one year. A third dose at 9-12 months extends immunity to three years. You should have booster doses every three years if you continue to be at risk of infection.

The vaccine stimulates your body to make antibodies against the virus. These antibodies protect you from illness should you become infected with this virus.

Who should not receive the tick borne encephalitis vaccine?

• If you are ill with a fever you should postpone the injection until you are better.
• You should not have an injection of this vaccine if you have had an allergic reaction to a previous dose.
• You should not have an injection of this vaccine if you are allergic to egg. (This is because the vaccine contains small amounts of egg protein. Allergy to egg is rare and it does not mean an upset stomach when you eat eggs, or disliking eggs.)

Are there any possible side-effects from the vaccine?

• Mild pain and redness occur at the site of injection in some people.
• Tiredness, mild fever, feeling sick, and itchy rash and headache occur for a short time in some cases following injection of the vaccine.
• Severe reactions are rare.

You should also try to prevent tick bites and infection

Immunisation is usually effective, although not 100% effective in all cases. So, if you are travelling to affected areas, whether you have been immunised or not, it is also important to:

• Cover arms, legs and ankles.
• Use insect repellent on exposed skin, socks and outer clothing.
• Not drink unpasteurised milk, especially goats milk.

What if I am bitten by a tick and am not immunised?

The risk of being infected from a single tick bite is small. However, you should seek medical attention if you have been bitten by a tick in an 'at risk' country. There is an effective anti-serum (antidote) to the virus which causes tick borne encephalitis. You may be given anti-serum if it is suspected that you have contracted the virus. So, as long as you get medical help soon, you should be fine.

Further information

Health Advice for Travellers.
All travellers going abroad are advised to get this booklet by the Department of Health. You can get a free copy:

• From main post offices, or
• By writing, phoning, faxing or emailing the Department of Health (allow 10 days to get it).

  Department of Health, PO Box 777, London, SE1 6XH
  Telephone: 08701 555455    Fax: 01623 724524    Email doh@prolog.uk.com

• Or view the content on the web www.dh.gov.uk/PolicyAndGuidance/HealthAdviceForTravellers/fs/en

Immunisation Against Infectious Disease (The Green Book)
www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/GreenBook/fs/en
From the Department of Health. Aimed at health professionals but of interest to all.

Health Information for Overseas Travel (The Yellow Book)
www.archive.official-documents.co.uk/document/doh/hinfo/index.htm
From the Department of Health. Aimed at health professionals but of interest to all.

Patient UK Travel Health Page
www.patient.co.uk/showdoc/38/
Has a comprehensive list of links to UK websites on travel health.

© EMIS and PIP 2004   Updated: April 2004   Review Date: May 2005   CHIQ Accredited