Massive increase in TBE infections caused by ticks

New map on TBE risk areas published

05/29/2012

More and more people are suffering from tick-borne tick-borne encephalitis (TBE). The Robert Koch Institute (RKI) has presented in its current "Epidemiological Bulletin" the TBE risk areas and pointed to the health risk of tick bites.

„In 2011, a total of 423 cases of TBE were transmitted that met the reference definition of the RKI“, what a „significant increase over the previous year (260 TBE cases) by 63 percent“ The RKI reports in the Epidemiological Bulletin. The massive increase in the number of cases was limited mainly to Baden-Württemberg (47.5 percent of total FSME infections) and Bavaria (45.1 percent of TBE infections). But also regions in other federal states are marked on the current map of the RKI as TBE risk areas.

140 circles are TBE risk area
According to the definition of the RKI, endemic areas of the FSME are classified as „TBE risk areas“ declared if „there is a risk of disease for persons with tick exposure, which establishes preventive measures according to the agreement of experts.“ This is the case in case numbers of more than one TBE disease per 100,000 inhabitants, according to the statement in the Epidemiological Bulletin of the RKI. Overall, according to the definition of the RKI „currently 140 districts reported as TBE risk areas“: 43 districts in Baden-Wuerttemberg, 79 counties in Bavaria, nine counties in Hesse, seven districts in Thuringia, one district in Rhineland-Palatinate and one district in Saarland. Compared to the previous state, three districts have been added: the district of Ulm in Baden-Württemberg, the district of Kempten in Bavaria and the Saar-Pfalz district in the Saarland. The „Increase in TBE risk areas in recent years took place almost exclusively within the described southern German areas; Here, the LK Saar-Pfalz-Kreis is an exception“, commented the RKI the development.

TBE risk not only in the risk areas
Although no TBE risk areas have been determined in the other federal states, this does not mean that tick bites are harmless. Even in states such as Lower Saxony, Saxony-Anhalt, Saxony, Mecklenburg-Vorpommern or Schleswig-Holstein, the tiny bloodsuckers can trigger the dangerous meningitis. Besides, it is „It is likely that the TBE virus continues to latently endure in herds in the eastern states, where it was already endemic between the 1960s and the early 1980s“, reports the RKI. With appropriate symptoms should therefore always be thought of FSME and take a corresponding history and diagnostics, the statement in the Epidemiological Bulletin. Typical symptoms of TBE include flu-like symptoms such as fever, headache and pain in the limbs, which regress relatively quickly after a first appearance, but then increasingly return. In the later course of the disease massive headache, nausea and vomiting as well as possibly disturbances of consciousness and motor skills can be observed.

Risk of Lyme disease
In addition to the TBE risk, a tick bite is generally associated with the risk of a borreliosis infection in Germany, which, although not a comparably acute health risk, such as TBE, can also be a significant burden on the health of those affected. While TBE is caused by viruses and a corresponding vaccination is possible, Lyme disease is based on a bacterial infection that is treatable with antibiotics against which no vaccine protection can be established.

Protection against TBE
According to the Epidemiological Bulletin of the RKI, the risk of disease is so high in the TBE risk areas that this „ according to a risk-benefit assessment, a routine TBE vaccination of residents or tourists with tick exposure makes sense.“ The Standing Committee on Vaccination (STIKO) also recommends a TBE vaccination for persons who are exposed to ticks in the defined risk areas. There is also an obligation to reimburse the vaccine on the part of the health insurances. However, to ensure vaccination coverage, the vaccine must be refreshed every three to five years. Preventive protection by other means allows wearing appropriate clothing when staying outdoors. Long sleeves, long trousers with tight cuffs and sturdy footwear provide a relatively efficient way to defend ticks, which protects against both TBE and Lyme disease. In addition, after the excursion into nature, the body should be thoroughly screened for ticks and adherents should be removed as soon as possible with tweezers or ticks to minimize the transmission risk of pathogens. (Fp)

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