Ticks cannot be avoided, even on Sněžka. More than 700 Czechs are afflicted with tick-borne encephalitis annually

Ticks start to be active at temperatures above 5°C. With the coming of spring, we should therefore be careful and check for ticks after coming home from the park or forest. The inconspicuous acarids are most commonly present on the edges of forests and along watercourses, but we may even encounter them in big cities, parks and gardens. “There is a risk of infection particularly in areas located up to 600 metres above sea level. However, this elevation is increasing due to the impact of climate change [6] and it is not unusual to encounter ticks even on the peaks of our highest mountains, for example, where people often underestimate the risk and don’t sufficiently protect themselves,” explains MUDr. László Wenchich, medical director, EUC Laboratories.

In terms of the occurrence of infection with the tick-borne encephalitis virus, we unfortunately rank among the most severely affected countries in Europe. Among the EU countries, Czechs account for almost a quarter (23%) of all cases. However, we also face a comparable risk of infection when visiting Slovenia or Slovakia. Conversely, if we visit our immediate neighbours to the west, it is probable that we will encounter ticks somewhat less frequently. [7] However, we must not forget that we can get infected with this virus not only through tick bites, but also by consuming poorly processed foods made from infected animals (e.g. fresh milk and cheeses from free-range animals).

The first phase is tricky, the second is insidious

“Infection with the tick-born encephalitis virus is typically of a two-phase character. It usually takes a week or two before the illness breaks out in full force. The first phase is often reminiscent of a flu-like infection – patients complain of fatigue, headaches and muscle pain. The disease may be accompanied by loss of appetite, nausea or fever. The insidious nature of the disease consists in the fact that the first phase subsides and is followed by a quiet period – a week or two without clinical symptoms. But we mustn’t let ourselves be placated by that. During that time, the virus multiplies and prepares for the next attack,” says MUDr. László Wenchich.

The second phase of the illness is even more severe – symptoms include vomiting, fever, stiffening of the neck, light sensitivity, sleep disorders, difficulty concentrating and confusion. The diagnosis can be confirmed by means of blood tests and examination of the cerebrospinal fluid. Treatment requires hospitalisation and often a long period of convalescence after being released from the hospital. In the most severe cases, tick-borne encephalitis attacks the central nervous system, which can lead to nerve palsy and even death.

There is no targeted treatment for tick-borne encephalitis. If an infection occurs, only the symptoms are treated, not the disease itself. Even after treatment, however, patients are far from being out of the woods. They are still at risk of chronic headaches, impaired hearing and sleep, difficulty concentration, tremors, depression and muscle palsy. After recovering from the disease, we gain immunity for up to 30 years. Other than that, the only possible form of prevention is vaccination, which is carried out in three doses. A booster is recommended every three to five years.

Laboratory testing indicates when to get a booster

Due to the long time interval between doses, we can easily lose track of when we last received a booster vaccination against tick-borne encephalitis. In such a case, it is appropriate to undergo a test for the level of tick-borne encephalitis antibodies. This test provides us with relevant information on our immunity. Thanks to the test, patients can also find out the right time to get a booster. After a tick bite it is necessary to also consider the possibility of Lyme disease, especially if after a few days the area of the bite reddens with a distinct red border and central discolouration.

Tick-borne encephalitis - antibodies

[1] https://www.solen.cz/pdfs/med/2022/04/01.pdf

[2] https://www.ecdc.europa.eu/en/tick-borne-encephalitis/facts/factsheet

[3] https://www.tribune.cz/specialy/e-reprinty/dulezitost-ockovani-proti-klistove-encefalitide_2/

[4] https://www.pozorkliste.cz/vse-o-klistove-encefalitide#vyskyt

[5] https://www.tribune.cz/specialy/e-reprinty/dulezitost-ockovani-proti-klistove-encefalitide_2/

[6] https://www.solen.cz/pdfs/med/2022/04/01.pdf

[7] https://www.solen.cz/pdfs/med/2022/04/01.pdf