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Tick-borne encephalitis is a viral encephalitis caused by a tick bite. What are the symptoms of this dangerous disease? What is the diagnosis of TBE? We are checking what the treatment of tick-borne encephalitis looks like.
Characteristics of tick-borne encephalitis
Tick-borne encephalitis is a viral encephalitis also referred to as early encephalomyelitis or Central European encephalitis, most often caused by a group B virus that enters the human body as a result of a tick bite.
The virus reservoirs in Poland are generally wild:
- small rodents,
- deer,
- winding,
- hedgehogs,
- squirrels,
- roe deer,
- hares,
- birds
- domestic animals such as sheep, cows, goats, dogs.
Ticks belong to the arachnids of the order of large mites, usually parasitizing on the skin of these animals, also very willingly inhabiting shrubs and thickets at the edge of forests or meadows, areas overgrown with blackberries, ferns, hazel, along forest roads and paths or meadows over rivers. Ticks transmit the germs of tick-borne encephalitis, and sometimes also Lyme disease, both between animals and people through their bites.
- See also: We debunk the biggest myths about ticks
Ticks “hang” on trees, they are found in grass, bushes and on the underside of leaves, and their activity depends on climatic factors, especially wet summer and mild winter provide an excellent climate for their development.
In Europe, tick-borne encephalitis occurs in:
- Austria,
- Hungarian,
- Czech,
- Switzerland
- German,
- former USSR countries,
- Scandinavia,
- Slovakia,
- Great Britain.
The main endemic outbreaks of tick-borne encephalitis in Poland are observed in north-eastern voivodships (Warmińsko-Mazurskie, Pomorskie, Podlaskie and Zachodniopomorskie) and in the vicinity of the Lubelskie and Opolskie voivodeships.
- See also: Watch out for ticks in cities
How does tick-borne encephalitis occur?
The virus can be isolated from practically all organs of an infected tick, which does not get sick itself, but is its carrier for life (because it can be transferred from one developmental stage of a tick to another).
The virus can lose its infectivity very quickly as a result of drying, pasteurization, or by treating it with chemical or enzymatic agents. Under normal conditions, however, it can persist for many months, e.g. in milk and butter.
The virus is transmitted by various species of ticks, the most popular of which is the meadow tick (pasture tick).
Tick-borne encephalitis occurs when a person is pushed by an infected tick. In addition, it is also possible to become infected through the oral route by drinking raw milk of a goat, sheep or cow, which is a carrier of this virus, and through the respiratory tract by inhaling the faeces of contaminated ticks (e.g. hay) in the dust.
Ticks most often implant in the area of arms and legs, from where they move unnoticed into the bends of large joints. Given that their saliva has anesthetic properties, tick bites very often go unnoticed.
In most people, infection with TBE virus is practically asymptomatic or asymptomatic, and the only factor suggesting a past infection is serological confirmation. This is called abortion figure.
Tick-borne encephalitis – symptoms
If symptoms of TBE are present, the infection has two phases and may not be curable. The incubation (latency) period is 2-28 daysduring this time, the virus multiplies in cells at the site of the injection, and travels through the lymph to adjacent lymph nodes and organs that have a rich reticuloendothelial system.
After the incubation period, the first stage of the disease is observed, i.e. the clinical picture of a flu-like infection characterized by:
- general feeling of being unwell
- runny nose,
- fever,
- headaches,
- tiredness,
- arthralgia,
- back pain,
- lack of appetite
- nausea.
These symptoms may last for 1-8 days. During this time, the virus enters the central nervous system through the bloodstream. After a period of 1-20 days from the onset of the first symptoms, and about four weeks after the tick bite, the second stage of the disease develops, which is much more severe and may have the meningeal, cerebral, cerebrospinal or cerebrospinal spinal. During this period, the patient has a very high fever, even up to 41 ° C.
The most common and lightest form of TBE is the meningeal formin which the meningeal symptoms are accompanied by headaches, vomiting, and stiff neck. There may be asymmetric paresis of the limbs, muscle weakness, flaccid paralysis of the limbs with muscle atrophy. In addition, deep reflexes are disturbed in this form. There may be pathological reflexes. Often there are nagging muscle and osteoarticular pain as well as a feeling of tingling and numbness in the area of sore muscles.
In the cerebral form, symptoms from the central nervous system and the cerebellum dominate. Patients complain of headaches, vomiting, nausea, disturbances in consciousness, sleep and sensation, suicidal tendencies or excitement and racing thoughts. Rarely occur: short-term and generalized tremors or tremors of the whole body, uncontrolled movements of the fingers, and sometimes urine and stool retention, slurred speech, vision problems, mental and character disorders.
- Find out more: Should you be afraid of ticks? Check who they threaten the most
Tick-borne encephalitis – treatment
Treatment of tick-borne encephalitis is a lengthy process, therefore, decreased exercise capacity and depression may persist. There is no specific method of treating tick-borne encephalitis, only symptomatic treatment in the form of antipyretics, analgesics, anti-swelling drugs and vitamins. For this reason, it is very important to prevent the disease, which can be divided into:
- pre-exhibition,
- post-exposure.
Tick-borne encephalitis – pre-exposure prophylaxis
In pre-exposure prophylaxis, the recommended method is personal protection, i.e. avoiding exposure to infection, wearing appropriate clothing (tight pants, rubber boots, socks) in areas suspected of having ticks, early and careful removal of ticks from the skin, as well as cooking or pasteurization of milk from goats, cows and sheep from areas endemic to ticks.
To remove a tick from the skin, hold it with tweezers as far as possible and pull it straight out, without any additional twirling and very carefully, so as not to crush it, as this can squeeze its contents (including pathogenic viruses) into the human body .
Vaccination against tick-borne encephalitis is recommended for people who are in areas with high incidence of the disease, i.e. people working in forest exploitation, farmers, army stationed in the forest, youth, trainees, tourists and participants of various training camps, colonies and camps. The most convenient time to administer a vaccine dose is winter, with an interval of 1-2 months between the first and second doses, and 9-12 months between the second and third doses.
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Tick-borne encephalitis – post-exposure prophylaxis
Post-exposure prophylaxis involves the use of specific immunoglobulin (passive immunization). It can be applied to a sick person within 48-96 hours after a tick bite. The grace period is six weeks. If the tick bite has occurred earlier, it is too late to implement passive immunization. If tick-borne encephalitis is suspected, immediate medical attention and possible hospitalization is required.
It should be remembered that not every tick transmits the virus of tick-borne encephalitis, Lyme disease or other types of pathogenic germs. For this reason, not every tick bite must lead to the ailments described above.
Where are the most ticks?
High tick activity occurs with increasing temperature (March to November). In Poland, the pasture tick is the most common. Ticks are widespread all over the globe. Their occurrence is observed to a different intensity in individual geographic regions. Compared to other European countries, Poland has the largest number of them.
So far, as many as 20 different varieties of ticks have been recognized in Poland and are transferred to Poland from other countries.
Find out more about ticks and Lyme disease:
- Why are ticks dangerous?
- Five common myths about ticks
- Tick nymphs – what are they?
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