Spread of ticks TBE risk areas in Germany are increasing rapidly

RKI defines new risk areas for FSME

The Robert Koch Institute (RKI) recently published a review of areas in Germany where there is an increased risk of infection with tick-borne encephalitis (TBE). According to RKI data, the risk areas in Germany increased to 156 districts.

The risk assessment data have been published in the current Epidemiological Bulletin. The purpose of this information is to help those concerned to initiate targeted preventive measures such as vaccinations or warnings. A freely accessible map shows the affected areas.

In a recent evaluation by the Robert Koch Institute, ten new TBE risk areas have been defined. Currently there is an increased risk of infection in 156 circles. (Image: Smileus / fotolia.com)

Where is the risk especially high??

Particularly in the south of Germany, the risk of FSME infection is high, especially in Bavaria and Baden-Württemberg, in southern Hesse and in southeastern Thuringia. According to RKI, there are other individual risk areas in the following regions:

• Central Hesse (Marburg-Biedenkopf district),
• Saarland (district Saar-Pfalz-Kreis),
• Rhineland-Palatinate (Birkenfeld district),
• Saxony (Counties Vogtlandkreis, Erzgebirgskreis, Bautzen and Zwickau),
• Thuringia (districts Ilm-Kreis and the city district Suhl),
• Bavaria (Munich district, Günzburg, Augsburg, Weilheim-Schongau and Starnberg).

Ten new risk areas

Overall, the defined TBE risk areas increase to a total of 156 counties. In previous years, only zero to three new areas were added. In 2017, a large accumulation of tick-borne encephalitis was noted. As a result, the RKI declared a total of ten new risk areas in the current valuation. All new risk areas are adjacent to existing risk areas in Germany or the Czech Republic.

TBE can occur throughout Germany

In the risk areas there is an increased risk of infection. However, the RKI reports a potential nationwide tick-risk. Even in states outside of the risk areas, TBE disorders can occasionally occur. Therefore, during the tick season with appropriate symptoms throughout Germany a TBE infection should be considered.

Declining vaccination rates

The Standing Vaccination Commission (STIKO) recommends a TBE vaccine for people who are in the risk areas and can come into contact with ticks. Vaccination rates have shown a downward trend in recent years. According to STIKO, 97 percent of TBE sufferers reported in 2017 were not or insufficiently vaccinated. A high proportion of cases could therefore be prevented by an increase in vaccination rates, especially in the risk areas, says the RKI.

About FSME

The pathogen virus, the so-called flavi virus, can be transmitted to humans via a tick bite. A TBE infection usually runs in two phases. The first phase occurs after an incubation period of up to 14 days after the tick bite and lasts for two to seven days. Flu-like symptoms such as body aches and headaches, fever and fatigue occur during this phase. This may be accompanied by complaints in the digestive tract such as nausea and vomiting and loss of appetite.

The second phase is more dangerous

After the first phase, there is often a symptom-free period of up to 20 days. Then the second, much more dangerous phase comes into force. In addition to the symptoms of the first phase is now an infestation of the neural system added. This can lead to symptoms of meningitis and encephalitis, including dizziness, sleeplessness and light-shyness. The neuronal infestation can also show speech, feeling and walking disorders, paralysis of the cranial nerves and changes in the personality of those affected.

Late effects due to FSME

As a rule, a TBE can be treated without long-term consequences. In rare cases, however, paralysis of the limbs, the face and the diaphragm as well as respiratory paralysis occur as a late consequence. In addition, permanent damage may occur to the spinal cord, liver or heart. In rare extreme cases, FSME can lead to death. (Vb)