Tick-borne encephalitis - Preventing tick-borne encephalitis

You can reduce your risk of tick-borne encephalitis (TBE) by getting vaccinated and by taking precautions to avoid tick bites when in risk areas.

TBE vaccination

Vaccination against TBE is recommended for anyone who may be at risk of TBE through their work or travels. It provides protection for more than nine out of every 10 people who have it.

The vaccination is not available on the NHS, so you will need to pay for it privately. The cost of the vaccination course can vary, but it is usually around £50-70 per dose.

The vaccination is given as an injection and requires a course of three doses for full protection. The second dose is given one to three months after the first, and a third dose is given five to 12 months after the second.

If necessary, the course can be accelerated, with the first and second doses given two weeks apart. This shorter course offers rapid short-term protection for at least nine in every 10 people who have it. If you have this accelerated schedule, you should have the third dose five to 12 months after the second as usual if you continue to be at risk.

Booster doses are recommended every three years if you continue to be at risk.

Side effects and precautions

Any reactions to the TBE vaccination are usually mild and do not last long, such as temporary swelling, redness and pain at the site of the injection. You may also experience a high temperature (fever) for a day or two after the first dose.

Most people can have the TBE vaccination safely, but you should tell the doctor or nurse before being vaccinated if:

• you have a fever
• you have a condition, or are receiving treatment, that affects your immune system
• you have a condition affecting your brain or central nervous system
• you are pregnant or breastfeeding

In these circumstances you may still be able to have the vaccine, but your doctor or nurse will need to check your risk with a travel medicine specialist before giving it to you.

You should not have the vaccine if you have had an allergic reaction to eggs (as the vaccine contains egg protein) or any of the other vaccine components in the past.

Read more about the TBE vaccine.

Preventing tick bites

Even if you have been vaccinated, it is still important to take steps to reduce your risk of being bitten by a tick as the vaccine is not 100% effective. Tick bites can also spread other illnesses, such as lyme disease.

The best way to reduce your risk of TBE is to avoid tick bites as much as possible when in risk areas:

• Wear long-sleeved tops and long trousers tucked into your socks. You can also treat your clothes with insecticides such as permethrin.
• Wear light-coloured clothes so ticks are easier to spot and brush off.
• Apply insect repellent containing DEET to exposed skin.
• Check your body for ticks regularly – common places to find them are the hair line, behind the ears, in the elbows, the backs of the knees, the groin and the armpits.

There is also a risk of being infected if you drink milk or eat dairy products from an infected animal, so you should avoid eating and drinking all unpasteurised milk and dairy products in countries where there is a high risk of TBE.

What to do if you find a tick

After a tick has attached itself to you, it may not start feeding for several hours. Adult ticks, once they have fed, can be up to the size of a coffee bean, but tick larvae can be tiny.

If you find a tick on your body, remove it as quickly as possible:

• Use tweezers or a tick remover and wear gloves or cover your fingers with tissue to avoid touching the tick.
• Grab the tick as close to the skin as you can, and gently pull straight up until all parts are removed.
• Do not twist or jerk the tick as you are removing it because this may cause the mouthparts to break off and remain in your skin once the tick has been removed.
• Avoid squeezing the body of the tick and the contents of its stomach into the site of your bite.

After the tick has been removed, wash your hands with soap and water and clean the tick bite with soap and water or an antiseptic – such as an iodine scrub.

You should seek medical advice as soon as possible if you have been bitten by a tick in a TBE risk area and you haven't been vaccinated against TBE, or if you develop a rash or fever after being bitten.