The holiday season is about to officially begin. When planning a vacation, we should first of all take care of health safety for ourselves and our loved ones. Especially since ticks have been awake since March, and there is an upward trend in TBE incidence in Europe …
Safe vacation
Sunscreen, bathing suit, flip-flops, insect bite gel, sunglasses? Stop! Vacation planning doesn’t end with the shopping list. If you are going to an area with tick-borne encephalitis (TBE) you should talk to your doctor at least 2-3 weeks before traveling about vaccination options.
This is important – because tick-free holidays are history. Small arachnids, which are a habitat for many pathogens that they transmit through stings, can be found all over Europe. And while Lyme disease can be cured with an antibiotic, there is no cure for TBE, a disease that can be fatal. There is a vaccination for this.
Therefore, when planning a holiday trip, it is worth checking where it is recommended, especially since the number of TBE cases has increased in recent years. This is the effect of climate change, as a consequence of which ticks occupy new areas, and the period of their feeding extends.
The highest risk of contracting TBE in Europe occurs in: Austria, Croatia, the Czech Republic, Slovakia, Slovenia, Switzerland, Hungary, as well as in the Baltic States and the Scandinavian Peninsula. In our country, an average of 200 to 300 cases of TBE are detected every year – most in the north-eastern part: in Podlasie, Lublin and Lesser Poland. However, according to experts, the numbers are clearly underestimated, and the entire territory of Poland should be treated as threatened by the occurrence of KZM [1].
According to the Protective Vaccination Program for 2022, vaccinations against TBE are especially recommended not only to people who often stay in forest areas (forest workers, stationed army, fire and border guards, farmers, youth undergoing internships and apprenticeships), but also people who are particularly frequent. people undertaking physical activity outdoors (eg runners, walkers, mushroom pickers, dog owners, hunters, families with young children) and other people undertaking outdoor activity, in particular tourists and participants of camps and colonies [2].
It is worth remembering that we are exposed to a tick, not only in forests, but also in parks, home gardens or allotments. The risk of contracting TBE increases, especially if we take part in outdoor activities, such as camping, camping, and caravanning. Also, when practicing sports – riding a bicycle, running, walking or walking with poles, we cannot feel safe.
Everyone is exposed to a tick bite. If we just leave the house and go to the park or the forest, we are exposed. Of course, there are professional groups such as foresters who work in the forest and spend a lot of time in the environment of ticks. Nevertheless, even if we go for a walk in a nearby park once a day, we can also meet a tick there – comments Dr. Anna Wierzbicka, zoologist and forester from the Department of Hunting and Forest Protection of the Faculty of Forestry of the University of Life Sciences in Poznań.
What is KZM?
It is a viral disease of the central nervous system that carries the risk of many dangerous complications. It is estimated that even one in six ticks can be infected with the TBE virus, and in fact, it only takes a few minutes to become infected. Importantly, even after removing the tick immediately after biting, the risk of TBE is not reduced.
Experts emphasize that TBE is an insidious disease. In the first phase, it usually resembles the flu or other viral disease of the upper respiratory tract. Patients may complain of weakness, headaches, malaise, pain in the muscles and eyes. The fever, if any, does not usually exceed 38 ° C. In some infected, the symptoms of tick-borne encephalitis end at the first stage.
In the second phase of the disease, referred to as neurological, structures in the central nervous system are affected – most often the meninges, and in more severe cases the brain and spinal cord. There is a fever (often high), severe headache and symptoms related to the involvement of the above structures – neck stiffness, epileptic seizures, paralysis, imbalance and consciousness disorders. All patients in this phase require a hospital stay. In the most severe cases, respiratory distress occurs, which may require respiratory support with a respirator.
Complications as a result of TBE virus infection occur even in every second patient who has developed the neurological phase of the disease [1]. They may even result in disability [3].
Rehabilitation after tick-borne encephalitis is necessary if the central and peripheral nervous systems are damaged in the course of the disease. Necessary when there is paresis of the upper and lower limbs and weakening of the trunk muscles. It is also recommended when mental functions are disturbed. In KZM, symptoms such as irritability, easy fatigue, problems with memory, concentration, headaches or sleep disorders are also observed – explains Dr. Jerzy Lewko, MD, specialist in medical rehabilitation, Wojewódzki Szpital Specjolony im. Jędrzej Śniadeckiego in Białystok.
Vaccination – the best prevention
Causal treatment of TBE is currently not possible, and therapy is limited to relieving the symptoms of the disease, i.e. relieving pain and reducing fever. To avoid stinging, we can protect ourselves by wearing the right clothes, using repellants, and avoiding places where ticks may be present. However, the only precaution you can rely on against TBE is vaccination.
The TBE vaccine is one of the best vaccines available on the medical market. Its effectiveness is up to 99%. The basic vaccination consists of 3 doses administered over 1 year and a booster dose (every few years). If rapid immunization is needed, vaccination can be used in an accelerated schedule. Unfortunately, experts point to the low social awareness of the possibility and importance of vaccination against TBE.
Patients have heard that ticks transmit serious diseases, but they did not usually distinguish TBE from Lyme disease. Unfortunately, the awareness that they can get vaccinated and thus protect themselves against TBE is not high – emphasizes Dr. Jerzy Lewko.
As the specialist adds, vacationers are most likely to go to rehabilitation after TBE, not people professionally exposed to tick bites. – We know ticks are ubiquitous. Apart from the fact that they are in the forest, they are also found on plots of land, in cities, on lawns. Many people go for walks, take their dogs, have contact with nature. I see many such people among my patients. There are more of them than those who often stay in the forest.
Parents who send their children to summer camps should remember about vaccination against TBE. In the case of the youngest, the disease can be very dramatic.
Most children are infected between the ages of 5-6. If we often go to the park with our child, spend time in nature, it is worth vaccinating the child against TBE. There is no risk associated with vaccination, and we are not able to predict the effects of the disease, especially the neurological ones – warns prof. dr hab. med. Joanna Zajkowska from the Department of Infectious Diseases and Neuroinfections, University Teaching Hospital in Białystok.