Each year as we move into the warm months and make plans to spend extended amounts of time outdoors — camping, gardening, hiking and more, it is likely that one item is missing from our list of anticipated activities: Getting vaccinated against ticks.
Ticks are the most frequent carriers of tick-borne encephalitis (TBE), a debilitating and potentially deadly human viral infection that attacks the central nervous system. Ticks are common to Central Europe; within the Czech Republic the risk of tick infection is highest in Šumava, Prague and its surroundings, Bruntál, Brno, Plzeňsko, Opavsko, and Podyje. Local health officials and the media have reported a dramatic increase in cases of tick-borne encephalitis in recent years. Despite campaigns to educate the public about ticks and the severe diseases associated with their bite, the vaccination rate in the Czech Republic is a low 17 percent. In contrast, neighboring Austria boasts an 80 percent-plus rate and cases of tick-borne diseases in the double digits.

Symptoms

Ticks can be found in forests, parks, gardens, and near bodies of water. As small as a pin-head, a tick attaches itself to a passing human or animal host without notice. When an infected tick bites its human host, the encephalitis virus spreads into the cells of the affected area. There’s an incubation period that lasts from seven to 14 days. (In some case, incubation can also take a month.) The disease has a two-phase cycle: After the incubation, the host experiences flu-like symptoms — headaches, fatigue, fever, nausea, and joint and muscle pain — that lasts several days. In some patients, the disease runs it course only in this first phase.
For others, the second phase is marked by severe headaches and fever, increased sensitivity to light and possible nausea and vomiting. If the nerve system has been affected, patients experience stiffness in the neck muscles, amyostasia (trembling muscles), nerve paralysis, dizziness, dyssomnia (sleeping disorder), memory disruption, and disorientation. This very acute phase can linger for two to three weeks.
Approximately one-third of infected patients are asymptomatic for the disease’s first phase, but exhibit symptoms of the second. One quarter of those infected suffer irreversible neurological and muscular damage, such as paralysis in the upper limbs, chronic headaches, poor concentration, mood or sleep disorder, decreased performance, and depression. Death is rare.

Prevention

Firm shoes, long socks, long-sleeved shirts, and trousers (preferably tucked into socks) are a must if you plan to spend plenty of time outdoors. Ticks are highly sensitive to dehydration; proper clothing creates a barrier that prevents a tick from getting to the intended host’s blood supply. In time, the tick falls off or dies. Repellents should be used on skin; clothing (the shirt sleeves, for example) can be rubbed with insecticides. Ticks are not high climbers — they lurk at a maximum height of 60 centimeters. Contrary to popular belief, they don’t fall off trees or jump onto passing hosts. You are more likely to be bitten while laying down on grass; therefore picnicking or relaxing in an open field with a blanket is highly recommended.

After a Tick Bite

To remove a tick, put on single-use rubber gloves. The infected area and the tick should be lightly doused with rubbing alcohol or a disinfecting solution and left untouched for about five minutes. Do not oil the tick. After the disinfection, use tongs or tweezers designed for tick removal. (They can be purchased at a pharmacy.) Gently grab the tick as close to the skin as possible and carefully extract it with a swinging motion. Do not rotate the insect during removal. Apply the disinfecting solution to the infected area again. Soak the tick in a drop of the solution and then flush down a toilet. The tick should not be burnt with a lighter or thrown into a bin. Under no circumstance should the tick be crushed by fingernails. If extracting the insect proves difficult, it is best to visit a doctor.

Vaccination

Vaccination is the best prevention against tick-borne encephalitis, not only at the start of the tick season, traditionally in March, but for year round protection. Be careful though about vaccines received in the summer: immunity only kicks in 14 days after the second dose.
The vaccination consists of three applications: a first dose; the second dose one to three months later; and a third dose five to 12 months after the second. Re-vaccination should take place three years after the first regimen, and then every five years.