Key points
- There is no specific treatment for tick-borne encephalitis (TBE); clinical management is supportive.
- Monitor patients closely for severe complications.
- Counsel travelers about using personal protective measures to prevent tick bites and avoiding consumption of unpasteurized dairy products; a TBE vaccine is also available.
- Patients with TBE should not donate blood for 4 months after their illness.
Treatment
There is no specific treatment for TBE. Clinical management is supportive. Patients with severe meningeal symptoms often require pain control for headaches and antiemetic therapy and rehydration for associated nausea and vomiting. Patients with encephalitis require close monitoring for the development of elevated intracranial pressure, seizures, and inability to protect their airway.
Prevention
In August 2021, the FDA approved a TBE vaccine, TICOVAC (manufactured by Pfizer), for individuals aged 1 year or older. The primary vaccination schedule includes 3 doses, and a booster dose can be administered if a person will be at risk for being infected with TBE. TBE vaccines are also available in many countries overseas where TBE virus is present. Please visit the following vaccine information page for detailed information on vaccine recommendations, schedule, and dosing.
Travelers should be counseled on how to prevent tick bites. This includes:
- Avoiding wooded and brushy areas in places where TBE is endemic
- Applying insect repellents
- Treating clothing and gear with products containing 0.5% permethrin or buying permethrin-treated clothing and gear
- Finding and removing ticks before they have a chance to attach
More information about reducing exposure to ticks is available on the CDC Ticks website. Travelers also should be advised to avoid the consumption of unpasteurized dairy products.
TBE virus can rarely be transmitted through blood transfusion or solid organ transplantation. People with confirmed TBE virus infection should not donate blood for 120 days (4 months) after their illness. TBE virus infections temporally associated with blood transfusion or solid organ transplantation should be reported promptly to the appropriate state health department.
- Hudopisk N, Korva M, Janet E, Simetinger M, Grgiĉ-Vitek M, Gubenšek J, et al. Tick-borne encephalitis associated with consumption of raw goat milk, Slovenia, 2012. Emerg Infect Dis. 2013;19(5): 806-808. doi: 10.3201/eid1905.121442
- Holzmann H, Aberle SW, Stiasny K, Werner P, Mischak A, Zainer B, et al. Tick-borne encephalitis from eating goat cheese in a mountain region of Austria. Emerg Infect Dis. 2009;15(10):1671-1673. doi: 10.3201/eid1510.090743
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