TBE – Tick-Borne Brain Inflammation

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TBE is a viral disease that is spread by ticks that can cause inflammation of the brain, meninges or both places. Most people who are infected get mild problems with fever and headaches and get healthy after a few days, but up to third-get brain inflammation or meningitis.

The virus is found mainly in Stockholm County, Södermanland County, Uppsala County coastal areas. and the central and eastern parts of the Lake Region. However, over the past ten years, more and more people have been infected and the geographical spread of TBE viruses has increased. Examples include areas around Vänern and Vättern, the Gothenburg area and areas in eastern Skåne. 

You can protect yourself against the disease through vaccination.  Children can receive the vaccination from the age of one year. 

Borrelia is another disease that is spread by ticks.

The risk of being infected is small

Even in the risk areas, no more than two out of a hundred ticks are carriers of the virus. Therefore, there is little risk of being infected after single tick bites. around 200 to 250 people get sick in TBE every year.

Since the beginning of the 2000s, the number of reported cases of TBE has more than doubled. Disease cases also occur outside the traditional risk areas. This indicates increased prevalence, and in order for the  Public Health Authority to be able to monitor the spread of TBE, the treating physician must report all cases of TBE.

Symptoms of tick-borne brain inflammation

It usually takes between four and ten days from the time of infection until you get sick, but it can take up to a month.

The first signs are vague and general problems such as headache, muscle pain, fatigue, and fever. These symptoms last only for a few days to a week. In most people, the infection heals itself and they are completely restored.

In about one-third of all infected, the virus is spread to the brain. About a week after the first symptoms of tick-borne brain inflammation have disappeared, the following new symptoms usually appear:

  • High fever.
  • Severe headache
  • Vomiting.
  • Light sensitivity and sound sensitivity.
  • Confusion.
  • Concentration difficulties.

Seek care

 If you have a fever, headache, are unusually tired, have pain in your muscles or joints, contact a  health center or on-call hospital for a while after a tick bite. The symptoms usually come 1-4 weeks after the tick bite.

If it’s in a hurry

If you experience severe headaches, neck stiffness, or symptoms of paralysis, contact a health care center or emergency room immediately. If closed, seek medical attention at an emergency room.

Only the symptoms can be treated

Today, there is no way to cure TBE once it has erupted, but the body must heal the infection itself. However, you can receive care for the various signs of illness that appear. If you get brain inflammation or meningitis, you usually need hospital care, but not always. It can take several months before you recover. After a severe illness, you can have lasting problems.

If you have had TBE once, you are immune to the rest of your life.

How can I protect myself against TBE?

Vaccination is the best way to protect yourself against TBE. You can vaccinate yourself at health centers, vaccination centers, and some pharmacies. Vaccination is especially important if you are a permanent resident or a summer residence in a risk area or if you often live in forests and land in areas with a risk of infection. Children from one year of age can receive TBE vaccination. The vaccines that are available provide good protection and have few side effects.

You can to some extent protect yourself from tick bites. For example, to

  • wear boots, long pants and long-sleeved sweaters in areas where ticks are located.
  • wear dark-colored clothing, as they attract fewer ticks. However, ticks may be easier to spot on light clothing.

Read more about how the vaccination is done.

Investigations

A blood test shows whether the body has started producing antibodies to TBE. If the central nervous system is affected, it may be a sign of cerebral inflammation or meningitis. Then a sample is also taken of the fluid that surrounds the brain and spinal cord.

Complications and sequelae

In about one-third of all those infected, the virus is spread to the brain and cornea. It can affect the central nervous system and cause walking difficulties, speech disorders, and concentration or memory disorders. Every tenth infected gets different paralysis symptoms.

Deaths in TBE occur, but the risk is very small. In children under the age of seven, the course of the disease is usually milder. More men than women receive TBE.

TBE and pregnancy and breastfeeding

There are no known cases showing that the infection can be transmitted from the mother to the fetus or the newborn baby. Nor does it indicate that TBE affects the pregnancy or the fetus.

All experience shows that you can be vaccinated against TBE both during pregnancy and while breastfeeding. The vaccine poses neither risk to you nor the child.

What happens in the body?

TBE means tick-borne brain inflammation and is caused by a virus spread by ticks. In most people infected, the body’s own immune system is able to fight the virus before it spreads and causes inflammation in the central nervous system. They, therefore, have no or insignificant problems. More than a quarter of all infected people have symptoms of meningitis or meningitis.

How do I get infected?

You get infected if you get bitten by a tick that carries the virus. Ticks need blood to develop, and they get blood by biting on birds and mammals. Through the blood, the ticks can be infected with various infectious agents and pass them on. The ticks are active when the temperature rises above four to five degrees. This usually means that the season for ticks lasts from the earliest March to the latest November.

The virus is found in the tick’s salivary glands and can be transmitted quickly by a bite. Therefore, you can be infected by TBE even if you quickly remove the tick.

Risk areas

TBE is mainly located in the coastal areas of Stockholm, Södermanland, and Uppsala. Around three-quarters of all reported cases of TBE come from here. Special areas of risk are the coasts around Södertörn and some islands in eastern Lake Mälaren.

The virus is also found elsewhere in the country. The risk area includes the coastal areas from Roslagen to northern Kalmar County as well as the central and eastern parts of the Lake Mälar region.

On Gotland’s main island, only one person has become infected. However, several have become infected on the surrounding islands of Stora Karlsö and Gotska sandön.

Areas around and between Vänern and Vättern, Gothenburg and eastern Skåne are new areas.

In Västra Götaland County, people have become infected west of Kungälv, in the Lidköping area, in the Mariestad area and along the western shore of Vänern.

In recent years, some have also been infected by TBE in southeastern August, in the Fjällbacka-Grebbestad area, and in Skredsvik. A few cases have also been reported from the southern Dalarna. Individuals are infected every year in Jönköping, Östergötland, Kalmar County, Skåne and Blekinge.

Abroad, there is a risk of infection in large parts of Central Europe, in the Baltic countries, in Russia, and in Åland.

On the website of the Public Health Authority, you can see a map showing the number of cases of TBE in different parts of the country.

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