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Epidemic Control Toolkit
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Tick-borne encephalities
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Tick-borne encephalities

Last update: 2025-07-04

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) 

Transmission: vector-borne (ticks)

  • 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. 

Most vulnerable to contracting the disease 

  • 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 

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?

Personal protection

  • 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.

Monitoring the community and identifying sick people  

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

Treatment and management

  • Rapidly detect and refer severe cases to health facilities early
  • Provide psychosocial support to the sick person and their family members  

Social mobilisation and behaviour change

  • 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  

Immunization

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

Mapping and community assessment

  • 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? 

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