TBE Overview
TBE (Tick-Borne Encephalitis) is a viral disease transmitted by ticks. The virus attacks the nervous system and can result in long-term neurological symptoms and even death. TBE can cause both mild and severe illnesses, with permanent consequences such as disorders of the automatic nervous system, concentration problems, paralysis and depression. Approximately 2% of cases are fatal.
Vaccination against TBE is recommended for persons planning to travel to areas where the disease is endemic. You should consult a travel medicine clinic or physician for protective advice, including immunization with FSME - IMMUN®.
Tick Life Cycle and TBE Transmission
High Risk Areas
The TBE virus is prevalent in the Eurasian forest belt of Europe, China, North Africa, and Russia. Prevalence is particularly high in regions of Austria, Czech Republic, Slovakia, Germany, Switzerland, Hungary, Poland, Slovenia, Croatia, Sweden, Finland and Russia.
The prevalence of TBE in Europe has increased by 500-1000% in some regions over the last 30 years. Currently, there are more than 10,000 TBE cases reported in Europe each year.
Statistics for the incidence of TBE in Asia are limited. Over 2,000 cases have been reported in China and ticks carrying the TBE virus have been discovered in Japan, Mongolia, and South Korea.
For technical information about TBE risk areas, click here.
The following map shows where the TBE virus is found:
The following map shows the current endemic areas in Europe:
Current endemic countries include:
France |
Poland |
How is TBE transmitted?
TBE is transmitted through bites from infected ticks. The Ixodes ricinus tick (commonly referred to as the castor-bean tick) is prevalent across Europe. Not every tick transmits the dangerous TBE virus, but the rate of infestation in some elevated-risk areas can be high. Following a tick bite, transmission can occur in a matter of seconds.
Where do ticks hide?
Although many still believe that ticks fall from trees, they actually live in the soil and don't climb much higher than 20 to 70 centimeters onto grasses and bushes in their search for a blood host (people or animals).
Therefore, ticks generally get picked up off of vegetation when passing through grasses or by bushes along forest paths or when walking on lawns and in the garden. Ticks have temperature-geared olfactory senses that detect “prey.” Many infected people cannot remember ever being bitten because of the small size of the ticks.
Which individuals are at highest risk of contracting TBE?
Individuals at highest risk for contracting the disease are those planning to travel through areas where ticks are located, such as grasslands and wooded areas. So if you are planning on participating in outdoor activities in these types of areas, you are at risk and should consult a travel clinic or physician for protective advice, including immunization with FSME - Immun®.
In addition, non-pasteurized milk in endemic areas may also be The tick season lasts from approximately March until November, with peak activity occurring in the spring and summer months. In some locations, 2 peak periods have been observed, with maximal activity in May/June and again in September/October. The frequency of illness is subject to seasonal fluctuations and depends on the activity of ticks. Mild winters and humid springs promote the incidence of ticks. The risk of infection can begin as early as February and last until November, depending on the region.
The TBE illness progresses in 2 phases; in up to 66% of cases the first phase is not perceived by patients. During the 2-phase progression, the so-called first phase of the illness occurs after an incubation period of 7 to 14 days; this is when the virus enters the bloodstream. Patients complain about general symptoms such as temperature increase (usually under 39 °C), headaches, overall weakness, fatigue, intestinal problems, cough and sniffles. After a symptom-free interval of between 2 and up to a maximum of 8 days, symptoms indicating the infection of the nervous system appear. This happens when the virus succeeds in infecting the brain. The second phase, occuring 2-4 weeks from date of infection includes another temperature increase (usually over 39 °C) with additional symptoms including aggravated headaches, neck stiffness, impaired consciousness, delirium, cranial nerve paralysis, coordination problems, and paralysis of the arms and legs. Ultimately, paralysis of the respiratory musculature can occur. Intensive treatment, including artificial respiration, is then essential. There is currently no specific treatment for TBE. Therefore, therapy after infection can only be symptom-oriented, e.g. reducing fever, alleviating pain. For more information on TBE, including statements from global health authorities and fact sheets, see the following resources.
When is the tick season?
Seasonal TBE Variation
What are the signs & symptoms of TBE?
First Phase
Second Phase
Additional Resources
