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:
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;
- Muscle and joint pain;
- Nausea and vomiting;
- Abdominal pain and diarrhoea.
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;
- Nausea and vomiting;
- Abdominal pain, constipation and diarrhoea;
- Trembling of the arms and legs;
- Neck pain and stiffness;
- Personality and behavioural changes;
- sensory overload;
- 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.
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 rates 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, make 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).
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