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(TBE) Tick-Borne-Encephalitis

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TBE (Tick-Borne-Encephalitis) or CEE (Central European Encephalitis) occurs in many European and Asian countries. The most significant infection areas in Germany are in Bavaria and Baden-Württemberg, as well as individual risk areas in Hessen and the Rhineland-Palatinate. There are additional areas inside Germany where individual TBE infections have occurred, and because of this sporadic occurrence, they have not been declared TBE risk zones. Larger TBE risk zones can be found in Austria, Russia, Poland, the Baltic countries, the Czech Republic, Slovakia, Hungary, southern Sweden and Albania. There is a small risk in France, Italy and Greece. The United Kingdom, Denmark, the Iberian peninsula and the Benelux countries are believed to be free of TBE. The first signs of the disease are flu-like symptoms and fever. In the further course of the illness some 10% of the patients develop an inflammation of the meninges with fever and vomiting, which in the continued course can lead to neurological problems all the way to coma and death. In most cases, a complete cure occurs (often this takes months). The disease only ends fatally in 1 to 2% of the cases.


The disease is generally transmitted by tick bite. In rare cases the virus can also be transmitted by goat´s, sheep´s or cow´s milk. An infection from one human to another does not exist; this means infected individuals are not contagious. Ticks can generally be found living in woods, high grass, shrubs, bushes and leaves. There are no ticks in altitudes above 1,000 mtrs. In the southeastern and southwestern parts of Germany it is estimated that TBE-virus are transmitted with each 25th to 1,000th tick bite (depending on the TBE risk zone). Once infected, 30 to 50% of the affected individuals in Germany die


You should get information well in advance as to whether the area where you are planning to vacation is located in an TBE risk zone. Discuss with your doctor whether you should have an TBE vaccination as a preventive precautionary measure. The protective vaccination consists of three individual vaccinations and provides three years of protection. At present the STIKO (Permanent Vaccination Commission) in Germany recommends that only young people from the age of 12 or adults should be vaccinated. A general protection from ticks is always advisable. This includes avoiding hikes through shrubbery or high grass. Tick infections also come about occasionally in cases of persons picking berries. If you wear light-colored clothing - especially if it covers your skin - you can best recognize the little ticks. You should apply insect repellent lotions or creams (also used for mosquito protection) to the free areas of your body. After every "day in the country", the entire body, especially in the case of children, should be checked. In case of tick attacks, the tick must be immediately removed, at best with tick tweezers. Avoid squashing and squeezing the tick´s body, as this increases the possibility of infectious matter entering the human body. For the same reason, you should avoid using glue, oil, etc. After removal of the tick, the site of the bite should be disinfected with alcohol and should be observed for several weeks. Should symptoms occur, especially a spreading redness of the skin, pains in the limbs, headaches and other signs of illness, a physician should be immediately consulted.