Prevent, detect, and treat early summer meningoencephalitis (TBE)

Tick-borne encephalitis (TBE) is a tick-borne disease that can cause the meninges and brain to become inflamed. Protection is provided by a special vaccination. More about diagnosis and therapy

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TBE - in a nutshell

  • Early summer meningoencephalitis (TBE for short) is a viral infection that is usually transmitted by ticks.
  • The risk of infection is greatest from March to November, especially in the TBE risk areas (see below).
  • The first symptoms are similar to those of a cold, such as fever, headache and body aches. In severe cases, TBE can develop with meningoencephalitis, the inflammation of the meninges and brain.
  • With TBE, only the symptoms, not the disease itself, can be treated. In most cases, TBE heals without complications or consequential damage.
  • Protection against tick bites, for example by wearing long clothing, is the best preventive measure. There is also a vaccination against TBE.

Overview: What is Early Summer Meningoencephalitis?

Tick-borne encephalitis (TBE) is a viral infection that is mainly transmitted by infected ticks. If the tiny bloodsuckers sting, they can pass the pathogen on to the host's blood with their saliva.

The TBE virus belongs to the group of flaviviruses and is related to the pathogens of dengue and yellow fever. In addition to the central European TBE subtype that occurs in our latitudes, there are also other subtypes.

TBE risk areas in Germany

In certain regions of Germany an infection is more likely than in others - they are considered TBE risk areas. The reason: In these so-called "natural herds", there are more host animals (for example small rodents) and ticks, as conditions such as sufficiently high humidity or the soil temperature are right. In these areas, approximately one in 100 to 500 ticks carries the TBE virus. But even if one of these ticks stings, the person affected does not necessarily have to contract TBE. Getting infected with Borrelia after a tick bite is more likely.

The risk of infection is greatest in the tick season from March to November. At particularly mild temperatures, however, infections can also occur in winter.

Mostly flu-like symptoms

Most of those affected do not feel the infection at all. Every third person initially suffers from flu-like symptoms such as fever, headache and body aches. In some of the sick, the fever comes back after a temporary improvement. The meninges and brain can become inflamed, and in some cases the spinal cord is also affected. Depending on the severity of the disease, severe headache and neck pain, nausea, impaired consciousness, seizures or paralysis occur.

Since TBE is caused by viruses, antibiotics are ineffective. There are also no other drugs that target the virus at the moment. Therefore, only the symptoms, not the disease itself, can be treated.

In the majority of patients, the disease heals completely. However, if the central nervous system is affected, damage can remain. The disease even ends fatally in an average of one percent of cases. Older people over 50 years of age, especially men, are at risk of severe disease.

Every year in Germany an average of 300 people develop TBE each year. The number of unreported cases is probably higher, because if the symptoms are mild, they can easily be confused with the usual "summer flu", ie a flu-like infection.

Vaccination and protection is the best prevention

There is a vaccination against TBE, which is recommended for people in risk areas. The family doctor can advise on this.

It is also important to protect yourself from tick bites. In this way you also prevent other diseases that are transmitted by ticks - for example bacterial Lyme borreliosis.

Ticks live in tall grass, which is why joggers can quickly catch a tick bite.

© iStock / Halfpoint

How is TBE transmitted?

Ticks become infected with the TBE virus while they are sucking blood and pass it on via their salivary glands during the next blood meal. The viruses are transmitted to the host within the first few hours after the tick bite.

Ticks live in tall grass, bushes, hedges and forests. As a result, people often get a tick bite while doing activities such as jogging, hiking, horseback riding, or camping. But ticks are also on the prey in the home garden or in the park in the middle of the city.

The mini-vampires are mainly active from March to November, so the cases of illness increase during these times of the year. At temperatures below six degrees Celsius, ticks actually fall into winter rigor. However, if the winter months are mild, infections can also increase during this time. In addition, tick species from warmer climates can now also be found sporadically in Germany.

Once the tick has stung, it should be removed as quickly as possible. You can read here what you should pay attention to: