Tick-borne encephalitis (FSME/TBE)
What is tick-borne encephalitis?
Tick-borne encephalitis, also known as FSME or TBE, is caused by a virus transmitted by a tick. The virus can cause severe meningitis.
The severity and duration of symptoms can vary between individuals. Two-thirds of people who contract FSME/TBE have no or only mild symptoms (stage 1). In a third of cases, the disease exacerbates to stage 2:
Stage 1:
The characteristics of this stage resemble flu-like symptoms. These can occur 2 to 28 days after the tick bite, usually between 7 to 14 days after the bite.
Common symptoms may include:
- Feeling unwell;
- (Mild) fever;
- Fatigue;
- Muscle and joint pain;
- Headache;
- Nausea and vomiting;
- Abdominal pain and diarrhoea.
Stage 2:
A third of people do not get better after stage 1. In these individuals, the disease progresses to stage 2. In this case, a person appears to get better but symptoms reappear after 1 to 21 days. In this stage, the central nervous system is affected and one may develop encephalitis, meningitis or spinal meningitis. At this point, it is imperative that the person is admitted to a hospital.
Stage 2 may include the following common symptoms:
- (High) fever;
- Severe headache;
- Impaired movement (ataxia);
- Muscle and joint pain;
- Intolerance to light;
- Paralysis and nerve damage;
- Reduced consciousness, drowsiness and disorientation;
- Cognitive impairment;
- Sleep disorders;
- Hearing problems;
- Swallowing and speech problems;
- Vision problems;
- Cramping;
- Vertigo;
- Nausea and vomiting;
- Abdominal pain, constipation and diarrhoea;
- Trembling of the arms and legs;
- Neck pain and stiffness;
- Imbalance;
- Personality and behavioural changes;
- sensory overload;
- Fatigue;
- Emotional lability, anxiety and depression;
- Autonomic dysregulation;
- In rare cases epilepsy, seizures and coma.
Men and people aged over 50 are at higher risk of becoming seriously ill.
In addition, ticks transmit several other viruses. You may contract multiple infections from one tick bite, such as Lyme disease and FSME/TBE. In that case, FSME/TBE may be more severe.
How do you get tick-borne encephalitis?
The virus that causes tick-borne encephalitis is transmitted by ticks. A person can be infected if he or she is bitten by a tick carrying the virus. Any activity in nature carries the risk of a tick bite. The risk is greatest during activities amid trees, in bushes or grass. Examples of high-risk activities include hiking, cycling, camping and picnicking. In the Netherlands, ticks carrying the tick-borne encephalitis virus are very rare. There are parts of Europe and Asia where the risk of tick-borne encephalitis is such that it is recommended to get vaccinated. We do see that the area with TBE is shifting towards the Netherlands. So it will become more and more common.
What can you do to prevent tick-borne encephalitis?
Besides vaccination, you can also take other preventive measures. For instance, it is recommended to wear clothes that cover you as much as possible. Also cover your ankles; when walking through grass fields, a tick can still bite you if your ankles are exposed. Apply an insect repellent such as DEET.
The measures mentioned above do not provide 100% protection. For this reason, it is important, especially when you are in a high-risk area, to check for tick bites every day. If you are bitten by a tick, remove it as soon as possible. Always contact a doctor if you develop symptoms.
What protection does the tick-borne encephalitis vaccination offer?
The FSME/TBE vaccine is given in a series of three shots spread over a minimum of six months. After this basic series, you are protected against the FSME/TBE virus for three years.
If you are travelling to a high-risk area but your TBE vaccination was more than three years ago you can get a booster vaccination with the same vaccine. One booster vaccination then gives you another five years of protection against the FSME/TBE virus. If you are over 60 years old, the booster will only give you three years of protection.
Please note! This vaccine does not protect against other viruses that ticks can transmit.
What are the side effects of a tick-borne encephalitis vaccination?
The tick-borne encephalitis vaccination may cause mild side effects. For example, the injection site may be painful, red or swollen. Some people experience headache, muscle pain, fever, swollen lymph nodes and nausea after the vaccination.
How much will a tick-borne encephalitis vaccination cost?
If you have supplementary health insurance, a tick-borne encephalitis vaccination will in some cases be covered by your health insurance. Check with your health insurance company whether the vaccination is (partially) covered. For more information on costs, please visit our prices page.
Questions or schedule an appointment?
Have you not had a tick-borne encephalitis vaccination before? In that case, keep in mind that there is at least six months between the three vaccinations. Therefore, book an appointment well in advance if you want to get the vaccination because you will be travelling (whether or not to a high-risk area).
Do you have questions or would you like to book an appointment for a personal (travel)consultation? Use the button below, email us at info@vaccinatiecentrum.nl or call 085-9020303.
Diphtheria, Whooping cough, Tetanus and Polio
Diphtheria
What is diphtheria?
Diphtheria is caused by bacteria that produce a powerful toxin. This toxin damages tissues around the part of the body where the infection takes place. For example, it can damage the skin or lungs, as well as the heart, nervous system or kidneys. Which symptoms a person gets depends on where the toxins damage the body. The two bacteria that cause most diphtheria infections are Corynebacterium diphtheriae and Corynebacterium Ulcerans.
The time between infection and the first symptoms of illness is usually two to five days and never more than seven days. If the infection is limited to the nose, the disease often progresses mildly. In the case of skin diphtheria, sores develop on the skin. If the infection goes beyond the nose, for example to the throat or lungs, one may become very sick and short of breath. In some cases, the toxins can damage the heart muscle or nervous system. The disease can be fatal but is treatable with drugs.
How do you get diphtheria?
The diphtheria bacterium spreads from person to person through the air by, for example, coughing or sneezing. The bacteria can also spread through direct contact, for example through kissing or open wounds. The bacteria can sometimes also be found in animals. The majority of known diphtheria infections occur in India, but it also occurs in Nepal, Indonesia and Brazil.
Whooping cough
What is whooping cough?
Whooping cough is a respiratory infection caused by bacteria. Characteristic of whooping cough are coughing fits that can last up to three to four months. The first symptoms of whooping cough resemble a normal cold and occur between seven and 10 days after infection. These symptoms are followed by coughing fits that can eventually lead to pneumonia. During the coughing fits, tough mucus is often coughed up. Whooping cough can be very dangerous for young babies. Babies are at risk of oxygen deprivation and brain haemorrhage. This can eventually cause brain damage.
How do you get whooping cough?
The whooping cough bacteria spread through coughing. Having experienced whooping cough in the past does not protect against a subsequent infection.
Tetanus
What is tetanus?
Tetanus is caused by toxin-producing bacteria (Clostridium tetani). The tetanus bacteria enter the body through a wound. There are usually three to twenty-one days between infection and the first symptoms, but this can be several months in some cases. Tetanus can cause stiffness around the infected wound and severe muscle cramps. The muscle cramps can lead to breathing problems and cramping. These cramps can get so bad that the body contorts like a hoop. The disease can cause bone fractures and heart problems. If tetanus is not treated properly, it is fatal.
How do you get tetanus?
Infection can occur through an open wound if it comes into contact with, for example, street dirt, manure or soil. This can be direct, for example by a fall on the street, but also indirect, for example by the bite of an animal with street dirt in its mouth. the disease cannot be transmitted from person to person.
Polio
What is polio?
Polio can be caused by three different types of polio viruses. Most people do not notice any infection or experience only flu-like symptoms. On average, the first symptoms start between seven and 14 days after infection. In a small group, the virus enters the spinal cord via the bloodstream, where it can damage nerves. Depending on the location of the damage, this can lead to (permanent) paralysis or death.
How do you get polio?
Poliovirus can spread from person to person. This can be through the mouth (talking or shouting) or through the faeces of an infected person. A person who is infected can contaminate other surfaces or food by not washing their hands properly after going to the toilet.
Vaccination against diphtheria, whooping cough, tetanus, and polio
Since 1962, vaccinations against diphtheria, whooping cough, tetanus, and polio have been included in the National Immunization Program for children. Later in life, a booster vaccination may be necessary, for example when traveling or for certain occupations. The protection lasts between five and ten years, depending on the vaccine. Based on your vaccination history and destination, we are happy to advise which booster you need. You can get the DTP vaccine, the DKT vaccine, or a separate polio vaccination with us.
DTP vaccination
The DTP vaccine protects against diphtheria, tetanus, and polio. A booster shot for diphtheria and tetanus is recommended every ten years to maintain protection. For polio, the primary vaccination usually provides lifelong protection. Only when traveling to countries where polio still occurs or where a recent vaccination is required, an additional dose may be necessary.
DKT vaccination
The DKT vaccine protects against diphtheria, whooping cough, and tetanus. A booster every ten years is also advised for diphtheria and tetanus. Protection against whooping cough is shorter, lasting about five years. This vaccine is often recommended for pregnant women, healthcare workers, or others who come into contact with young babies or vulnerable individuals.
Polio vaccination (separate)
A separate polio vaccination is only necessary if you are traveling to a country where a recent polio vaccination is mandatory. If you completed the full primary series in childhood, you are generally protected for life, and boosters are usually not required.
Side effects
These vaccinations may cause mild side effects such as redness, swelling, or pain at the injection site. Sometimes mild flu-like symptoms occur, including fatigue, headache, or a slight fever. These symptoms usually disappear within a few days.
Costs and reimbursements
For children, these vaccinations are free through the National Immunization Program. Adults pay for booster vaccinations themselves unless these costs are (partially) reimbursed by supplementary health insurance. You can find the current prices on our pricing page.
Any questions or want to book an appointment?
Haven’t had a DKTP vaccination before? Then keep in mind that there is a total of at least seven months between the three vaccinations. Therefore, book an appointment well in advance if you want to get the vaccination for a trip (whether or not to a high-risk area).
Do you have questions or would you like to book an appointment for a personal (travel)consultation? Use the button below, email us at info@vaccinatiecentrum.nl or call 085-9020303.
Cholera
What is cholera?
Cholera is an intestinal infection caused by the bacterium Vibrio cholerae. Cholera often starts with sudden vomiting, lots of watery diarrhoea and sometimes abdominal pain. Because of the watery diarrhoea, a person with cholera can quickly become dehydrated. Generally, people do not get very sick and recover on their own.
How do you get cholera?
The disease spreads mainly through the contaminated faeces of infected people and is predominantly found in South Asia, Africa, South America and the Gulf of Mexico. People can contract it by eating or drinking contaminated food. Eating seafood is particularly risky because the bacteria accumulate in it. This is because the bacteria attach to plankton and end up in seafood this way.
What can you do to prevent cholera?
You can be vaccinated against cholera. In high-risk areas, be careful what you eat and drink. Especially people who do not have access to clean drinking water are at risk. Based on your destination and health, we will be happy to give you personal advice.
Do I still need to get a cholera stamp?
In the past, when travelling to certain African countries, you had to show on arrival that you had a cholera stamp in your vaccination booklet. This is now no longer compulsory.
What protection does the cholera vaccination offer?
At vaccinatiecentrum.nl, we offer a cholera vaccine (Dukoral). This is an oral vaccine. This means that you take it in the form of a drink. Dukoral consists of two doses taken one to six weeks apart. It is important to take the vaccine at least one week before possible exposure. Depending on your age, the vaccine’s protection is 50-80% and lasts for two years.
How much will a cholera vaccination cost?
If you have supplementary health insurance, a cholera vaccination is usually covered by your health insurance. Check with your health insurance company whether the vaccination is (partially) covered. For more information on the price of a vaccination, please visit our prices page.
Questions or schedule an appointment?
Keep in mind that there should be one to six weeks between doses of the cholera vaccine. Therefore, book an appointment well before the start of your trip.
Do you have questions or would you like to book an appointment for a personal (travel)consultation? Use the button below, email us at info@vaccinatiecentrum.nl or call 085-9020303.
Please note! This vaccine is generally available within a few days but is not always in stock at every location. Please contact us by phone before your appointment.
Typhoid fever
What is typhoid fever?
Typhoid fever is an infectious intestinal disease caused by Salmonella Typhi bacteria. After infection, it takes one to two weeks for a person to become ill. The most common symptoms are fever, abdominal pain, headache, decreased appetite, red spots (mainly on the skin of the abdomen), constipation and, in some cases, diarrhoea. In severe cases, intestinal ulceration(s) with bleeding or intestinal perforation may occur.
How do you get typhoid fever and in which countries is it prevalent?
Typhoid fever occurs worldwide, but especially in parts of Africa and Asia. The disease primarily occurs in areas where sanitation is poor. Someone carrying the bacteria can pass it on through poor (hand) hygiene, for example, by not washing their hands after going to the toilet. This person can then contaminate other surfaces, such as door handles or food and drinks. This allows the disease to spread easily.
What can you do to prevent typhoid fever?
In general, it is important to pay attention to (hand) hygiene. Other recommendations include eating only well-done or freshly cooked food, drinking water only from (previously) unopened bottles, and avoiding ice cubes. If you are traveling to a country where typhoid fever is common, you can protect yourself through vaccination. Based on your destination and health, we would be happy to provide you with personalized advice.
What protection does the typhoid fever vaccination offer?
The typhoid fever vaccination consists of one shot and provides protection for three years. The vaccination protects 60-70% against the serious complications of typhoid fever and is available from the age of 2 years. It takes 1-2 weeks for the vaccine to be effective.
What are the side effects of a typhoid fever vaccination?
The typhoid fever vaccination may cause mild side effects. For example, the injection site may be painful or swollen. Some people experience mild flu symptoms such as fever, fatigue and a headache.
How much will a typhoid fever vaccination cost?
If you have supplementary insurance, the cost of a typhoid fever vaccination is covered by your health insurance in most cases. For more information, please visit our prices page.
Questions or schedule an appointment?
Do you have questions or would you like to book an appointment for a personal (travel)consultation? Use the button below, email us at info@vaccinatiecentrum.nl or call 085-9020303.
Rabies
Rabies
What is rabies?
Rabies is an infection of the brain or nervous system. This infection is caused by the rabies virus, which is transmitted through contact with infected animals. In general, rabies infections do not occur in the Netherlands; the disease is almost always contracted abroad. In the Netherlands, a mild version of the rabies virus occurs in bats, but this virus almost never causes infection in humans. It is recommended not to touch bats and to see a doctor if you have been scratched or bitten by a bat.
After infection, rabies progresses in several distinctive stages. Without treatment, it takes twenty to ninety days from the time of infection before symptoms develop. The length of this incubation period depends on the site of infection. The closer to the central nervous system the infection takes place, the faster the disease usually progresses.
In the first stage, the following symptoms occur:
· a reduced appetite;
· Nausea;
· Chills;
· Headache;
· Vomiting.
In the next stage, neurological symptoms occur, such as:
· Muscle spasms;
· Paralysis;
· Convulsions;
· Difficulty swallowing and breathing.
Because swallowing water or mucus might become very painful, some people develop hydrophobia.
The disease is fatal, a person often ends up dying from swallowing and breathing problems. For this reason, it is important for anyone going to an high risk area to take preventive measures. It is also important to take immediate action when someone does get bitten or scratched.
How do you get rabies?
The rabies virus can be found all over the world, except in Japan, New Zealand and Antarctica. The risk of a rabies infection can vary greatly from country to country. The likelihood of contact with certain mammals is higher in some countries than in others. The activities undertaken during travel also affect the risk a person faces.
The virus that causes rabies can be present in many mammals. It is therefore recommended to stay away from (wild) animals when abroad. These include dogs, cats, bats and monkeys. Contact with many of these animals is risky. Although the chance of the animal being infected with rabies is very low, any contact can be a potential danger. In such cases, treatment is imperative.
What can you do to prevent rabies?
It is always best to prevent infection, this is especially important when it comes to rabies. When abroad, avoid contact with animals and pay extra attention to children since children are more likely to touch animals. If in your situation there is an increased risk of rabies during your trip, it is advisable to take preventive measures but also to have an emergency plan at hand. You are at increased risk of a rabies infection when:
- You are travelling to an area where rabies is common;
- You expect to come into frequent contact with (wild or stray) animals, for example because of your profession;
- You plan to cycle a lot (cyclists are at increased risk of dog bites);
- You spend more than three months in a high-risk country or make frequent short trips;
- You are travelling with small children;
- Medical care not readily available during (part of) your trip.
If one or more of these conditions apply to your trip, it may be wise to get a preventive rabies vaccination. If you are vaccinated against rabies, treatment after a bite or scratch is easier and more readily available.
What to do if you are bitten or scratched?
Regardless of your vaccination status, you should first clean the wound properly. You do this by rinsing the wound for at least ten minutes with lukewarm water and soap. Then disinfect the wound, which can be done with alcohol 70% or iodine. You may dress the wound, but do not stitch it; it is important that the wound remains open.
What to do after disinfecting depends on whether you have been vaccinated or not. In any case, make sure you monitor the wound closely and keep your vaccination passport at hand. That way, the doctor treating you will know which vaccinations you have had and which treatment is best for you.
Even if you are fully vaccinated, you should still see a doctor as soon as possible. You will then receive two vaccinations in three days. Always have these vaccinations recorded in your vaccination passport.
Are you bitten or scratched but not vaccinated against rabies? In that case, use the emergency number of your health insurance and/or travel insurance. Within 12 to 24 hours, MARIG, or human anti-rabies immunoglobulin, should be started. This drug is difficult to obtain or of poor quality in many countries. At the same time, a vaccination series is started, consisting of at least four vaccinations. This is usually done on day 0, 3, 7, 14-28. An embassy or consulate can tell you where the vaccine is in stock.
When is it advisable to do a rabies antibody determination?
If your profession involves a lot of contact with animals that may be infected with the rabies virus, a different procedure applies to you. Are you a veterinarian, biologist or do you research bats? Then you are at greatly increased risk and it is advisable to do a titre check four weeks after your vaccination. This is a blood test that determines your level of protection against rabies.
Based on the result, it can be decided to do a booster vaccination. Another titre check is then done four weeks after the booster vaccination. After that, checks should be done every six months. This ensures that you can continue to do your job safely.
In addition, a booster vaccination may be recommended if you are travelling to a very remote area and are unlikely to be able to start your treatment within 24 hours. A booster vaccination provides long-term protection for at least five years.
What protection does the rabies vaccination offer?
The vaccination provides lifelong protection against rabies after a full pre-exposure prophylaxis (PrEP) series. As a treatment, anti-serum (MARIG) is no longer required. However, additional vaccinations may be required as treatment. This depends on the wound and what kind of animal it has been. Always have this assessed by a doctor or expert.
How much will a rabies vaccination cost?
If you meet a number of high-risk criteria, a rabies vaccination is usually covered by your health insurance. Check with your health insurance company whether the vaccination is (partially) covered. For more information on costs, please visit our prices page.
Questions or schedule an appointment?
Do you have questions or would you like to book an appointment for a personal (travel)consultation? Use the button below, email us at info@vaccinatiecentrum.nl or call 085-9020303.
Malaria profylaxe
Malaria
What is malaria?
Malaria is caused by the plasmodium parasite. There are six species of this parasite, which, when infected, all give a different but characteristic pattern of symptoms. On average, symptoms begin ten to 14 days after infection. In some cases, the parasites can remain inactive in the liver for months to years before becoming active again. Malaria often starts with a flu-like feeling followed by fever, chills, muscle aches and headache. Typical of malaria are recurrent fever attacks. Depending on the parasite a person is infected with, these fever attacks occur every 48 or 72 hours.
How do you get malaria?
The malaria parasite is not transmitted directly from person to person, but is transmitted by the Anopheles mosquito. This mosquito transmits the parasites through mosquito bites and is active between sunset and sunrise.
What can you do to prevent malaria?
You can protect yourself from malaria in several ways. The most important thing is to take the proper anti-mosquito measures. This is especially important in the evening and at night, when mosquitoes are active. These include wearing clothing that covers you, applying a mosquito repellent such as DEET and sleeping under an (impregnated) mosquito net. Besides these measures, depending on your destination and the duration of your trip, it is sometimes necessary to take malaria pills. We will be happy to give you personal advice based on your destination and health.
When do I need malaria pills?
Malaria is more common in some areas than others. Depending on your travel destination and health, you will be given a prescription for malaria tablets. There is no vaccination against malaria. In most of Asia and South America, emergency treatment is sufficient. This means taking malaria tablets with you so that you can treat yourself for malaria if you become sick. In most of Africa, we recommend a preventive treatment with malaria tablets. This means that you take malaria tablets before you get sick. That way, you prevent getting sick with malaria.
There are several types of malaria tablets. Together, we will look at your health and travel plans to determine which tablets are best suited for you.
What are the side effects of malaria pills?
Malaria pills can cause side effects. The exact side effects depend on the tablets you have been prescribed. We will discuss this with you during your appointment at Vaccinatiecentrum.nl.
What do malaria pills cost?
If you have (Dutch) supplementary healthcare insurance, the cost of malaria pills is in most cases covered by your health insurance. For more information on costs, please visit our prices page.
Any questions or want to book an appointment?
Do you have questions or would you like to book an appointment for a personal consultation? Use the button below, email us at info@vaccinatiecentrum.nl or call 085-9020303.