In the majority of cases, tick bites are harmless, but they can sometimes cause certain diseases in humans, including tick-borne encephalitis. To date, this disease has not yet been diagnosed in humans in Belgium, but the virus has been shown to circulate in animals and exposure is possible in several European countries, such as Austria and Germany. A vaccine is recommended when traveling to one of these at-risk countries.
Tick-borne encephalitis is a disease caused by a virus, which is transmitted when bitten by a tick. In Europe, ticks involved in transmission are mainly of the genus Ixodes, which are found in shaded areas covered with thick litter or densely invaded by brush, ferns, and tall grasses. Small rodents are the natural reservoir of the virus.
Transmission of the virus is also possible through ingestion of unpasteurized milk and milk products from infected cattle, sheep and goats.
In about two thirds of cases, infection in humans will not cause symptoms and will therefore go unnoticed. When the disease develops, two symptomatic phases are usually separated by a symptom-free period: one phase of influenza syndrome and another characterized by damage to the central nervous system (meningoencephalitis). In this case, the disease can be severe, with a mortality rate of 0.5% to 2%.
The risk of infection varies according to the seasons and is highest from June to October, i.e. during the period of tick activity.
The disease is present in Asia and Europe, with a higher risk in Central Europe (Austria, Switzerland, Germany) and in Eastern Europe (Czech Republic, Hungary, Poland, etc.), in the Baltic republics (Estonia, Latvia, Lithuania), as well as in certain regions in Sweden and Finland. In Belgium, studies on animals (deer, wild boar, cows) have shown that the virus also circulates in Belgium. But to date, the disease has not been diagnosed in a person who has not traveled to an at-risk country.
There is a vaccine that is recommended in Belgium for people who travel to an area or country at risk and engage in outdoor activities (bivouacking, hiking, etc.).
Information for health professionals
As the vector for the transmission of TBEV virus is present in Belgium, and because animal surveillance has detected antibodies against the virus in different species of animals at different locations, tick-borne encephalitis should be included in the differential diagnosis of encephalitis.
Vaccination should also be recommended for people planning a trip with outdoor activities to a country where the disease is endemic.