Tick-borne Meningoencephalitis

In Central and Eastern Europe, tick-borne meningoencephalitis is a common viral infection caused by the Flavivirus RNA virus.

Most cases of this disease occur following infection through a tick bite. The infection onset is quick due to the fact that the source of the infection is present in the biting mechanism of a tick. In rare cases, the infection can be passed on to humans through animal milk that has not been heat treated.

The Czech Republic ranks high in case numbers with the occurrence standing at 5 cases in a population of 100,000. The severity of the infection varies based on health and age. It is estimated that anywhere between 4-38% of ticks in the Czech Republic are infected.

Southern Bohemia and the areas around Brno and Pilsen are considered high-risk. However, ticks are found everywhere across the country, especially in forests and grassy areas.

This tick-borne disease is characterized by two phases. The first phase occurs 1-2 weeks following being bitten and is associated with symptoms including soar-throat, headaches, muscle ache and an increased body temperature. All this lasts only for a couple days. The second phase is more serious and affects the central nervous system. These problems include meningitis, meningoencephalitis or meningoencephalomyelitis. Further symptoms include nausea, vomiting, headaches as well as neck stiffness or nerve paralysis. In severe cases, breathing and heart complications can cause death. The result often means that patients experience persisting problems such as memory and concentration problems, headaches, and limb or nerve paralysis.

Treatment of this infection is only supportive. Treatment focuses on ensuring minimal impact on the central nervous system while diagnosis in early stages as well as sufficient rest are major factors that play a significant role in a positive outcome for patients.

Vaccination is the best protection available. Austria for example vaccinates over 90% of the population as opposed to a very low 20% in the Czech Republic. The number of cases is directly related to this situation with Czech Republic amounting to 500 cases each year.

Children over one year of age and adults are eligible for vaccination. Suitable time to vaccinate as well as overall health should be considered prior to being vaccinated. Spring is usually the most recommended time for vaccination. Three initial doses are administered (1, 2 and 6-12 months). Follow-up booster doses are usually applied every 3-5 years to maintain immunity. Sometimes, pain, swelling as well as nausea, mild fever and headaches could be a potential side-effect.

Here are a couple common tick-related myths:

1. A tick must be suffocated prior to removal:
Do not try to suffocate a tick as it will release infectious material into the skin. Disinfect the area, use tweezers to remove it in back and forth movement or by turning. Do not pull it out and disinfect it following removal.

2. Ticks can jump down from trees:
Ticks do not jump. They climb up on bushes and grasses up to 1 meter in height and attach themselves to those who pass by.

3. Ticks are only found in forested areas:
Ticks like grass, river banks, lakes and forests as well.

4. Ticks avoid clothing that is colorful:
You are more likely to spot ticks on light-colored clothing, which makes it easier to see them.

Ticks do not differentiate between Czechs, expats or tourists. To enjoy this beautiful country, the only way to prevent tick-borne meningoencephalitis is to undergo vaccination in order prevent any possible undesirable consequences.

Travel medicine and vaccination

Canadian Medical Care - Prague