wanderlust.co.uk April 2020 143HEALTH DISCOVER
Travel
Clinic
Whilesymptomsoftick-borneencephalitis can be as mild as a headache, they can also be deadly,
so make sure you’re tick aware if enjoying the countryside, says Dr Jane Wilson-Howarthwith D Jane
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T
ick-borne encephalitis
(TBE) is a disease
known in continental
Europe, Siberia and
northern Asia, but
until 2019 no confi rmed cases had
been recorded in the UK. Towards
the end of last year though, British
national newspapers ran headlines
including, “Deadly brain disease
passed on by ticks now in Britain.”
Then, a visitor from Europe became
ill after a tick bite in the New Forest
and it is possible that he acquired
the infection in England.
The virus is transmitted by way of
a tick, most likely one that has fi rst
bitten a deer. In 66% of human
cases, the person notices no
symptoms whatsoever. In the third
who do become ill, the victim feels
as if they have a touch of fl u 3-14
days after the tick bite. There is
seven days of improvement before
neurological symptoms begin.
These can be mild (such as
a headache) but can include
meningitis and paralysis. In half of
those with confi rmed disease due to
TBE there are long-term symptoms,
including weakness and headache
and 1-2% die. The Siberian and
Far-Eastern forms of the disease are
even nastier, with 8% and 20%
mortality respectively.Spreading disease
New cases of TBE are being found
in the Netherlands, which had been
TBE-free before: the disease is
spreading and global warming ismigrating birds, bringing it across
the North Sea or The Channel.
The good news is that there is
a very eff ective vaccine against TBE,
and this is actually part of the routine
immunisation schedule in Austria.Be tick aware
The other way to avoid infection is of
course to avoid tick bites. People who
enjoy walking in the woods and in
scrubby country, or like orienteering
or wild camping in northern Europe
and Asia should arrange the vaccine,
but make sure they cover their skin
and use plenty of insect repellent.
Spraying EX-4 on your clothes will
make you even more repellent.
At the end of each day, adventurers
should check for ticks by running
their hands over their skin, paying
special attention to genitals, groins,
armpits and beneath the breasts.
Any ticks found should be pulled
off promptly by applying fi nger and
thumb to the tick as close to your
skin as possible and pulling steadily
away. If the tick has been feeding
for a while, removal hurts a bit
because the creature cements its
mouthparts in place.
Being tick aware is sensible for all
travellers who love the countryside
as ticks transmit an array of
infections including Lyme disease
and, beyond the UK, several
horrendous haemorrhagic fevers. In
Africa, tick-bite fever is common
and leaves victims feeling unwell for
some days, but that infection is
treatable with doxycycline.probably improving conditions
for ticks. Researchers from
Liverpool decided to look for
evidence of the virus in English deer
and ticks. Just 4% of the deer tested
positive for TBE but, surprisingly,
nearly half the deer sampled in
Thetford Forest in East Anglia
showed evidence of the virus and
2.6% of the ticks were infected.
This level of TBE infection is
similar to regions in mainland
Europe where the disease is known
to infect people. It is thought that
infected ticks might hitch lifts onAvoiding bites
People who like walking in
scrubby countryside
should wear cover all
clothes and consider
applying EX4 to trousers.Dr Jane Wilson-Howarth lives in
Nepal; you can read her blog at
http://www.wilson-howarth.com