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
The DTP vaccine protects against diphtheria, tetanus, and polio. The vaccine is often recommended for travellers visiting certain countries. The protection typically lasts for ten years. Whether you need a booster dose depends on your vaccination history and travel destination.
What is the DTP-vaccine?
The DTP-vaccine protects against diphtheria, tetanus, and polio.
Diphtheria is a bacterial infection that spreads from person to person. An infected person can spread the bacteria through coughing and sneezing (airborne droplets), but the bacteria can also spread through physical contact, such as contact with open wounds or kissing. Symptoms of diphtheria can be mild, but in some cases the infection can be deadly.
Tetanus is an infection caused by bacteria that can enter the body through broken skin, such as an open wound. Risk factors include wounds caused by animal bites or open wounds that come into contact with dirt or soil. Tetanus can cause severe muscle spasms.
Polio is a highly contagious disease caused by a virus. While most infections are mild or have no symptoms, severe cases can cause muscle paralysis and may even lead to death. The virus spreads mostly by eating contaminated food and from person to person primarily through the fecal–oral route, and less commonly through airborne droplets or direct physical contact.
The DTP-vaccine protects you against these three infectious diseases.
What is the duration of immunisation?
Protection from the DTP vaccine usually lasts for ten years. It protects against diphtheria and tetanus during this period. Most people already have lifelong immunity to polio through their childhood immunisation programme and only need one booster dose. If you were not vaccinated as a child, the vaccination course consists of three doses given over a period of seven months.
When is vaccination needed?
Vaccination against DTP is recommended for many (sub)tropical countries. For some countries, a recent polio vaccination is mandatory. You can check which countries require a DTP vaccine in our list of travel destinations.
What is the difference between DTP, DKT, and DKTP?
The difference between these vaccines is the specific diseases they protect against. For most travel destinations, a DTP vaccine is recommended. The DKT vaccine offers protection not only against diphtheria and tetanus, but also against ‘kinkhoest’, which is Dutch for pertussis, or whooping cough. Whooping cough is a contagious respiratory infection that is mainly dangerous for infants. Healthy adults usually don’t need a booster vaccination for whooping cough.
| DTP | Diphtheria, Tetanus, Polio | Regular vaccine, recommended for travel abroad. |
| DKT | Diphtheria, Whooping Cough, Tetanus | Specifically for work with young children in the Netherlands, not for standard travel abroad. |
| DKTP | Diphtheria, Whooping Cough, Tetanus, Polio | Specifically for children following the Dutch immunisation programme. |
What are the side effects of the DTP vaccine?
The vaccine can cause some mild side effects, such as pain, redness of the skin, and/or swelling around the injection site. In rare cases, the vaccine can cause tiredness or a mild fever. An allergic reaction can occur if you are allergic to a component of the DTP vaccine.
What does a DTP vaccine cost?
Please see our prices page for the current cost of the DTP vaccine.
Can the DTP vaccine be given simultaneously with other vaccines?
The DTP vaccine consists of inactivated toxins from diphtheria and tetanus bacteria, as well as inactivated poliovirus strains. Inactivated vaccines can be safely combined with other vaccines, such as vaccines against hepatitis A, typhoid, or yellow fever.
Frequently asked questions
A recent polio vaccination can be mandatory in some countries. Please see our list of destinations for a current overview of these countries. These mandatory polio vaccinations are only required for trips with a duration of four weeks or longer, and the vaccination must have been given no more than twelve months ago. The DTP vaccine is recommended for almost all countries outside Western Europe.
The DTP vaccine is usually given as a booster, because most people have already received it as part of their childhood immunisation programme. The vaccine starts working almost immediately in the case of a booster dose, and you will have enough antibodies after a few days. If you did not participate in a childhood immunisation programme, the DTP vaccine will offer sufficient protection after a series of three doses.
About ten years after your last DTP vaccination, you need a booster to help maintain your immunity. This is because immunity fades over time. A booster is recommended after ten years, especially when travelling to an area where DTP is common.
A DTP vaccination is recommended for a trip to Thailand.
Prices
Would you like to know more about costs? Please visit our prices page:
Book an appointment
Do you have any other questions, or would you like to book an appointment for personal (travel) advice? Click the appointment button below or contact us via email 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.