TBE protection

If you don’t get the TBE vaccination shots there are several rather easy things you can do to protect yourself are in an at risk area. These include:

1. Wear protective clothing – the more exposed skin, the more skin to bite.
2. Wear insect repellant with DEET. This is a repulsive chemical that has a burning sensation when initially applied, but really does work.
3. Check your body over after being outdoors. If you’re out for long periods of time, check yourself thoroughly several times a day. Strip off all your clothes and stand in front of a mirror if the house you are staying at has one. Ticks tend to like places with hair (scalp, pubic area), creases (arm pits, crotch) and thin skin (behind the ears, ankles). Men should note that the scrotum fits all of these descriptions and is actually a frequent and tricky place to find ticks. Check your scrotum thoroughly. If you have a partner who doesn’t mind, or even likes to, get naked and check each other!
4. Ticks can look like moles, so feel moles and make sure they aren’t ticks and pay attention to “new moles.” If you find a tick that hasn’t bitten, just flush it down the toilet. If the tick has bitten you and found on the first day, it should be easy to remove. The recommendation is to take a pair of tweezers, grab it as close to your skin as you can and pull it off, then flush it. If you get it early, it will be less likely to transmit a virus to you. The more time it is on you, the deeper it bites and the better the chances are that it could transmit the disease.

So, without telling you what to do, this is what I would do if I had to make a choice:

1. If I was going for only a week or two and didn’t have time to get the shots, I would probably just depend on the above steps.
2. If I was going for a month or longer or was going to be out camping, I think it would be worth looking into an accelerated vaccination regimen.

I’m going to complete this with a description of TBE I got off the internet. Remember, not all ticks, a minority in fact, will transmit this disease.

Tick-borne encephalitis is a viral infection of the central nervous system transmitted by tick bites, usually after travel to rural or forested areas. The disease may also be acquired by ingesting unpasteurized dairy products. Two subtypes have been identified, sometimes known as Russian spring/summer encephalitis and Central European encephalitis, but there is little difference between them. The disease is reported from Scandinavia, Western Europe, Central Europe, the former Soviet Union, and East Asia. The peak incidence is from April through August. The incubation period is usually from one to two weeks, but may vary. The disease typically begins as a flu-like illness, including fever, headache, and vomiting, followed by the development of neurologic symptoms, including neck stiffness, dizziness, tremors, drowsiness, delirium, and coma. Neurologic damage may be permanent, causing chronic headaches, difficulty concentrating, muscle weakness or loss of balance. A small percentage of cases are fatal. The disease is rarely severe in children less than four years old.
Three vaccines have been developed for tick-borne encephalitis. The first, called FSME Immun (Baxter AG), consists of inactivated, purified whole virus. The vaccine is manufactured in Austria and approved for use in a number of European countries, but is not available in the United States. A full series consists of three doses over a one-year period (at times 0, 1, and 12 months), so complete immunization is not practical for most travelers. Because a previous version of this vaccine caused high fevers in infants and young children (probably due to the absence of albumin, which has been included in the current product), FSME Immun is recommended only for those over 16 years old. Serious reactions have not been documented in older children and adults. The vaccine has been suspected of causing an exacerbation of autoimmune diseases, but a cause-and-effect relationship has not been confirmed.
Another vaccine is Encepur (Chiron Behring), which is manufactured in Germany and available in several European countries. Like FSME Immun, the usual schedule consists of three doses over a one-year period. However, limited data indicate that an accelerated schedule, consisting of two doses separated by one week, may confer immunity in most people. A third dose should be given three-to-four weeks later, followed by a fourth dose in one year’s time.
A third vaccine for tick-borne encephalitis is produced in Russia.
There are no proven treatments for tick-borne encephalitis. Gamma globulin is sometimes used, but the effectiveness is unproven and there is evidence that it might actually lead to a more severe infection.