Key facts

Tick-borne Encephalitis (TBE) is a viral infection of the central nervous system caused by the Tick-borne Encephalitis Virus (TBEV).
It is transmitted through the bite of infected Ixodes ticks, which are commonly found in forested and grassy areas of Europe and Asia.
The disease can range from mild flu-like symptoms to severe neurological conditions and long-term complications.
There are three subtypes of TBEV, each associated with different geographical regions.
- European (TBEV-Eur)
- Siberian (TBEV-Sib)
- Far Eastern (TBEV-FE)

It is primarily transmitted through the bite of infected Ixodes ticks during their blood-feeding.
However, in some regions, particularly in Europe, unpasteurized milk from infected livestock can also transmit the virus when consumed.

Individuals living in or traveling to regions where TBE is common, particularly in parts of Europe and Asia.
Those who frequently spend time in tick-infested areas, such as forested or grassy environments.
In regions where the virus can be transmitted through unpasteurized milk, consumers of such milt are at increased risk.

Symptoms can vary, ranging from mild to severe:

Early Symptoms
- Fever
- Headache
- Muscle aches
- Fatigue
Neurological Symptoms
- Confusion
- Neck stiffness
- Seizures
- Ataxia (lack of muscle coordination).
Long-term Effects
- Cognitive difficulties
- Motor impairments.

What can you do to prevent and control an epidemic?

Encourage the community members to stay away from wooded and grassy areas where ticks are commonly found, especially during peak seasons.
Encourage them to apply tick repellents containing DEET or other approved chemicals to exposed skin and clothing.
Encourage them to wear long sleeves, long pants, and tick-resistant clothing when in tick habitats.
Encourage them to regularly check for ticks on the body and remove them promptly with fine-tipped tweezers.

Identify community members who have suspected TBE based on the community case definition

Find out the specific advice being given by health and other relevant authorities
Model following this advice and inform community members of current health practice advice
Offer support and encouragement to follow the advice
Try to gain understanding about if and why health practice advice is not being followed
With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices

In some endemic regions, vaccines are available and recommended for people at high risk of exposure.

Make a map of the community.
Mark the following information on the map:
- How many people have fallen sick with Tick-borne encephalitis? Where?
- How many people have died? Where? When?
- Who and where are the vulnerable people?
- Where are the local health facilities and services? (include traditional healers)
Record the following information on the back of the map:
- When did people start to fall sick with tick-borne encephalitis?
- How many people live in the affected community?
  - How many are children are under five years old?
- What are the usual ways of disposing of rubbish and solid waste in the community?
- How common is it for people to live in houses with insect screens on windows and doors?
- What are the community’s habits, practices and beliefs about repellents and sprays?
- What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between men and women.
  - When babies and infants are sick, do women continue to breastfeed them?
- Are children badly affected by tick-borne encephalitis? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected?
- Is a social mobilization or health promotion programme in place?
- Which sources do people use/trust the most for information?
- Are there rumours or misinformation about tick-borne encephalitis? What are the rumours?

01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 36. Vector and reservoir control 43. Social mobilization and behaviour change 44. Dealing with rumors 45. Psychological First Aid (PFA)