We still know too little about TBE

Proven content

We are afraid of ticks and our knowledge of tick-borne diseases is still insufficient. From the latest study “What Poles know about ticks and KZM”, carried out as part of the campaign “Don’t play with ticks. Win with tick-borne encephalitis ”shows that every third person has never heard of TBE.

KZM, what is it?

In recent years, an alarming increase in the number of ticks and the incidence of dangerous tick-borne diseases has been observed in Poland and Europe. One of them is tick-borne encephalitis, which is an infection of the central nervous system caused by a virus of the flavivirus type. The most common route of infection is a tick bite, but the virus can also enter the body through the ingestion of raw, unpasteurized milk from sick animals. * Even one in six ticks can be a carrier of the TBE virus and it takes just a few moments after the bite to become infected. This can lead to meningitis, encephalitis and / or myelitis. The greatest number of cases is observed in the so-called the tick season, i.e. in the period from April to November. Regions in which there is a particular risk of TBE and Lyme disease are located in north-eastern Poland and in Masuria, but cases of these diseases are reported throughout Poland. Any outdoor activity exposes us to a tick bite – camping, cycling, walking in the woods, picking mushrooms, jogging or hiking.

Tick-borne encephalitis is like the flu

Tick-borne encephalitis usually occurs in two phases. The incubation period of the disease is approximately one week. As many as 1/3 of patients do not remember the tick bite and often do not associate the symptoms with it.

1. In the first phase, the disease usually resembles the flu or other viral disease of the upper respiratory tract. Patients may complain of weakness, headaches, pains in the eyes and muscles, malaise. Nausea and vomiting may also occur. The fever, if any, does not usually exceed 38 ° C. In some patients, the symptoms of TBE end in the first stage. Unfortunately, symptoms recur much more often.
2. The second phase of the disease is usually meningitis with high fever, nausea, vomiting and aches and pains, and dizziness. There is also the stiff neck characteristic of meningitis. Central nervous system infection can also take the form of encephalitis. The characteristic symptoms of inflammation are disturbances in consciousness: increasing drowsiness, confusion, problems with concentration and memory, as well as symptoms indicating damage to specialized brain structures – nerve palsy, disturbances in sensation, swallowing, speech, paresis. In the most severe cases, the disease can affect the spinal cord and lead to coma and even death.

Tick-borne encephalitis and Lyme disease

Lyme disease and TBE are linked by a vector that transmits diseases, i.e. a tick. However, both diseases differ in terms of their causes, health consequences, treatment and prevention options. Lyme disease is a bacterial disease caused by Borrelia burgdorferi spirochete that develops in stages. Most of the infections with the mentioned bacteria are limited to the skin – they run as erythema migrans, which can be effectively treated with an antibiotic at home. Prevention of Lyme disease is to avoid being bitten by ticks. In turn, TBE is a viral disease that proceeds rapidly and requires admission to hospital and for which there is no effective treatment. Unlike Lyme disease, tick-borne encephalitis can be effectively prevented by means of protective vaccinations.

Relief of symptoms

Unfortunately, modern medicine has not yet found a cure for TBEand treatment is limited to relieving the symptoms of the disease, that is, relieving pain and lowering fever. Patients receive intravenous replacement of water and electrolyte deficiencies caused by fever and vomiting. In addition, drugs are used to relieve pain and reduce brain swelling, which alleviates the course of the disease and reduces the risk of complications. Enteral or parenteral nutrition is used as needed. If TBE infection was the mildest neurological form, i.e. meningitis, recovery requires only a sparing lifestyle, limiting sun exposure and exercise for several weeks. On the other hand, in the case of encephalitis and myelitis, patients need many months of hospitalization, usually combined with rehabilitation.

Prevention instead of risk

Vaccination is the only effective form of TBE prophylaxis. All adults and children over 1 year of age can be vaccinated against TBE. This vaccination is recommended in Poland, but it is not reimbursed. Three doses of the vaccine will be given a year, and then booster doses will need to be given every three to five years. As emphasized by professor Joanna Zajkowska from the Department of Infectious Diseases and Neuroinfections at the Medical University of Bialystok –The effectiveness of vaccination against TBE performed on a regular basis is excellent, amounting to 99-100 percent. This is evidenced by the fact that Polish foresters, who have been vaccinated regularly since 1994, do not suffer from TBE. To prevent tick bites, wear appropriate clothing, high boots and a head covering that cover the skin. When visiting forests or city parks, it is advisable to use repellants, i.e. tick repellants, preferably containing DEET, which should be sprayed on clothing and exposed skin, except for the face, or permethrin, which is used only on clothing. After returning from walks, the skin should be carefully inspected, especially the places most often selected by ticks, such as: groin, armpits, the inside of the arms, the area behind the auricles.

Real threat

In Poland, 150-350 cases of TBE are registered every year, but experts argue that the number of patients is greatly underestimated. Research conducted by the National Institute of Hygiene (NIZP-PZH) has shown that in most regions in Poland, doctors do not confirm the cause of meningitis due to the cost of serological tests and the need to send samples tested to only three laboratories in Poland. ** Although tick-borne encephalitis (TBE) is a real threat to all of us – both children and adults, the knowledge of Poles about tick-borne diseases is still insufficient. According to the study conducted as part of the social campaign “Do not play with the tick”, 1/3 of respondents do not know that tick-borne encephalitis can be prevented thanks to preventive vaccination, and every third person has never heard of this dangerous disease. ***

In response to this growing health problem, on the initiative of patient organizations, research centers and institutions dealing with public health, a declaration was signed to establish the National KZM Awareness Day (Tick Brain Inflammation), which will be celebrated each year on March 30. As part of the campaign “Don’t play with ticks. Win with tick-borne encephalitis ”organized by the Institute of Patient Rights and Health Education, Foundation To Live and Pfizer, educational and information activities will be carried out all over Poland on the virus and prevention options.

Źródła:

* Süss J. Tick-borne encephalitis 2010: Epidemiology, risk areas, and virus strains in Europe and Asia-An overview. Ticks Tick Borne Dis 2011; 2: 2-15.

** National Institute of Public Health. National Institute of Hygiene, Most cases of tick-borne encephalitis are not detected in Poland, accessed on 24.01.2019/XNUMX/XNUMX in Poland/

*** Research WHAT POLES KNOW ABOUT TICKS AND TBE carried out as part of the campaign “Don’t play with a tick” by the SW Research Institute in 2018 N = 1430