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Registered Yellow Fever Centre, Cambridge
Planning a hiking, camping or cycling trip in central Europe or Scandinavia? Then tick-borne encephalitis (TBE) is worth knowing about. It is a viral infection passed on mainly by tick bites in forests and grassland across parts of Europe and Asia. Most travellers on city breaks or beach holidays are at very low risk, but walkers, campers, cyclists and people working outdoors in risk areas may benefit from vaccination. At Cambridge Travel Clinic we can look at your plans and advise whether the TBE vaccine is right for you. You can book a consultation online.
What is tick-borne encephalitis?
TBE is caused by a virus carried by ticks. Most people infected have no symptoms. Some get a flu-like illness about a week after the bite, and a smaller number go on to develop infection of the brain and its linings. This can cause a stiff neck with severe headache, sensitivity to light, confusion or seizures, and long-term neurological problems are common in people who become seriously ill. TravelHealthPro notes that TBE is rarely fatal in Europe but can be fatal in up to 20% of cases in Asia.
Less commonly, TBE can also be caught by eating or drinking unpasteurised dairy products from infected animals in risk areas.
Where is TBE a risk?
According to the UKHSA Green Book and TravelHealthPro, TBE is found in:
Parts of central, northern and eastern Europe
Russia, including the Urals, Siberia and the far east
Parts of China and Japan
Ticks live in forest edges, grassland next to woods, forest clearings, riverside meadows and marshland, and can also be found in parks and gardens.
Infected ticks have also been found in a few parts of the UK, and a small number of UK-acquired cases have been reported. UKHSA currently assesses the risk to the general UK population as very low, and the vaccine is mainly considered for travel.
When is the risk highest?
Ticks are most active from early spring through to late autumn, although seasons vary by location. The Green Book suggests that if you are at risk, winter is a good time to start your course so you are protected before the tick season begins.
Who should consider the TBE vaccine?
The vaccine is recommended for some travellers depending on itinerary, season and activities. It is worth discussing if you are:
Hiking, camping, orienteering or cycling in forests or rural areas in a risk country
Staying for a longer period, or living in a risk area
Working outdoors, for example in forestry, farming, deer management, field science or the military
A laboratory worker who may be exposed to the virus
TBE vaccine schedule
The TBE vaccine is an inactivated vaccine given as an injection into the arm. There is an adult dose for people aged 16 and over and a children’s dose for ages 1 to 15.
Standard schedule
Dose 1: day 0
Dose 2: 1 to 3 months after the first dose
Dose 3: 5 to 12 months after the second dose
Rapid schedule
If you are travelling soon, the second dose can be given just 2 weeks after the first. The third dose is then given 5 to 12 months later if you will remain at risk. The Green Book reports over 90% protection after the first two doses, which is expected to cover the current tick season. Ideally start at least a month before you travel, as NHS.uk advises.
Boosters
First booster: 3 years after the third dose
After that: every 5 years if you are still at risk
Aged 60 and over: boosters every 3 years if you are still at risk
If you had two doses some time ago and missed the third, you may only need a single dose to complete the course rather than starting again.
Who should not have the TBE vaccine?
Because it is not a live vaccine, the TBE vaccine can be used more widely than some travel vaccines. The Green Book says it may be given in pregnancy or while breastfeeding when clinically indicated. It should not be given to anyone who has had a confirmed severe allergic reaction to a previous dose or to any ingredient. Egg allergy is no longer considered a reason to avoid it.
Avoiding tick bites
Vaccination protects against TBE only, and ticks can carry other infections such as Lyme disease. TravelHealthPro recommends:
Sticking to paths and avoiding long grass and heavily tick-infested woodland where possible
Wearing long sleeves and long trousers tucked into socks, ideally in light colours so ticks are easier to spot
Using an insect repellent such as DEET on skin, and considering permethrin-treated clothing
Checking your body, children and pets for ticks after time outdoors, remembering young ticks can be tiny
Removing ticks promptly with fine-tipped tweezers or a tick remover, gripping close to the skin and pulling steadily upwards without crushing, then cleaning the bite
Avoiding unpasteurised milk, cheese and other dairy products in risk areas
Seek medical advice if you develop flu-like symptoms or a rash within a month of a tick bite or of visiting a tick area. Call 999 or go to A&E for a stiff neck with severe headache, a seizure or sudden confusion.
Book your TBE vaccine in Cambridge
The TBE vaccine is not free on the NHS for travel. See our pricing page for fees. We’ll check stock when you book so it’s ready for your appointment, and we can review your other travel vaccines, including tetanus.
Every appointment is with one of our pharmacists. We check your whole itinerary against current UK guidance and go through every vaccine and travel medicine you might need in one visit.
We have two branches, and both are registered Yellow Fever Vaccination Centres. Cambridge Travel Clinic at Petersfield Pharmacy, 56 Mill Road, Cambridge CB1 2AS (01223 354383), is open Monday to Friday, 9am to 6pm. Book at Mill Road online. Cambridge Travel Clinic at Waterbeach Pharmacy, 5 Greenside, Waterbeach, Cambridge CB25 9HW (01223 564422), is open Monday to Friday, 9am to 1pm and 1:30pm to 5:45pm. Book at Waterbeach online.
We see travellers from Cambridge, Cherry Hinton, Trumpington, Chesterton, Histon, Milton, Cottenham, Waterbeach and nearby villages. We’re happy to talk through your plans, however close your departure.