Summer is fast approaching, and with it more and more opportunities to relax outside the home. When planning holiday trips to picturesque corners of Polish or European nature, do not forget to protect yourself against ticks. Regardless of where we intend to spend our time, an encounter with these tiny parasites is always possible, and with them the danger of dangerous diseases such as tick-borne encephalitis (TBE).
- Last year was a record year in terms of the number of reported cases of tick-borne encephalitis (TBE) infections in European countries[1].
- Nowadays, the whole area of Poland is considered endemic, practically everywhere you can come into contact with a tick and get infected with the disease it transmits[2].
- There is no cure for PMS, an effective form of protection is vaccination[3]which only needs to be started two weeks before the planned trip.[4]
Ticks, small and inconspicuous, can nevertheless pose a real threat to our health. The main cause for concern is the presence of bacteria and viruses in their bodies, which they can transmit to humans during a bite. TBE, one of the most serious tick-borne diseases, can lead to dangerous neurological complications and is a real threat to our health and even our lives[5]. There is much to fear, especially as the number of cases of TBE has been increasing alarmingly over the years. The problem affects the whole of Europe and Poland, where there has recently been a year-on-year increase in the number of infections with the SHB virus.[6]
For several years, an increase in cases of people developing serious complications of tick-borne encephalitis has been observed in European countries. In most European countries, including Poland, the number of recorded cases of TBE is higher than in previous years. This can be seen in statistics from Germany, Austria and Switzerland[7].
It is worth remembering that in some areas of our country, there may be more arachnids infected with the KZM virus. Most infections occur in north-eastern and eastern Poland: in Suwalszczyzna, Mazury, the vicinity of Lublin, eastern Mazovia, but it should be noted today arachnids infected with the KZM virus occur throughout Poland.[8]
contracting an illness caused by the canine distemper virus is always a risk, and the long-term consequences are difficult to predict. Of course, everyone is at risk of contracting the SHB virus. However, people are particularly at risk of coming into contact with ticks during the summer period, spending time in parks or green spaces and going on holiday, and are consequently at risk of contracting the disease.
Neurological complications are the most dangerous, with MCS being the most commonly reported cause of viral neuroinfections in Poland.[9],[10]. The disease can cause severe neurological complications and lead to severe brain damage, nerve palsy and disability, mood and memory disorders, sleep problems, balance and speech disorders, learning problems, hearing impairment[11],[12]. Infection leads to permanent neurological sequelae in 35-58% patients or death in 1-4% of them.[13] Not all patients return to full function even after prolonged rehab[14], [15], [16], [17].
We are seeing more and more infections and a higher number of severe cases. We are seeing patients with paralysis, meningitis, respiratory disorders, who require long-term rehabilitation and for whom it is virtually impossible to return to full function. - says Professor Joanna Zajkowska, MD, specialist in infectious diseases from the Department of Infectious Diseases and Neuroinfection at the Medical University of Białystok
Vaccination protects against infection. Tick-borne encephalitis is a disease for which there is no cure, but it can be prevented by vaccination.[18] As with other viruses, vaccination is the most effective form of prophylaxis, which in this case has been available for many years - the vaccine is one of the best studied vaccines in the world, and vaccination against TBE is recommended for people aged 1 year and over[19].
Children at risk. Over the next two months, many children will be taking part in summer camps and youth camps, which usually take place in the countryside, and which may involve an increased risk of tick-borne diseases. When sending a child on a summer camp, camp or trip, it is important to remember that this form of recreation will increase the risk of tick bites. Therefore, prepare your child well for such a trip. First of all, take care of appropriate clothing, i.e. pack clothes with long sleeves and legs, and shoes that cover the ankles. It is also a good idea to take some time before the trip to provide the child with basic knowledge about the dangers of ticks and to teach the child the basic principles of prevention, so that after each outdoor game they take a moment to check their body and report any worrying changes on their skin to the educator, who should know how to remove the tick quickly and safely. It is worth remembering that removing an infected tick can protect against Lyme disease but, unfortunately, does not guarantee protection against tick-borne encephalitis (TBE), because the virus is in the tick's saliva and infection with TBE occurs at the time of the bite. However, protection is provided by vaccination, which can be carried out up to two weeks before the planned trip. We can ask for an accelerated vaccination schedule, which will allow more than 90% immunity in 14 days[20].
Proven effectiveness. The efficacy of the vaccine against CCHM was determined during long-term clinical observations of the entire Austrian population (since 1984). As a result of these observations, it was calculated that more than 90% vaccinated were immunised after the second dose and more than 97% after the 3rd dose (basic vaccination schedule)[21]. The actual efficacy of the vaccines in the prevention of CRC was 99%, regardless of age group, provided that the vaccination was received according to the schedule[22].
What is also worth remembering is that the vaccination can be done up to 2 weeks before the planned trip. An accelerated vaccination schedule should then be requested, which will allow more than 90% immunity in 14 days[23].
***
The educational campaign "Don't play with a tick. Win against Tick-borne Encephalitis". was established to raise awareness of the TBE virus and to draw attention to the dangers of tick-borne diseases. On the initiative of the organisers of the campaign, 30 March was declared National Tick-Borne Encephalitis Awareness Day in Poland. The aim of the educational activities carried out is to provide reliable and credible information on ticks and TBE, as well as on the prevention of infections in the form of vaccination.
The project includes educational meetings, research projects and outreach events in collaboration with the media and partners. An educational website is also available www.kleszcze.info.pl, containing a compendium of knowledge about ticks and their dangers. The campaign is organised by the Institute for Patients' Rights and Health Education, the To Live Foundation and Pfizer. Medicover is a partner of the campaign.
[1] European Centre for Disease Prevention and Control (ECDC). Tick-borne encephalitis Annual Epidemiological Report for 2019. https://www.ecdc.europa.eu/sites/default/files/documents/AER-TBE-2019.pdf (accessed 02.2023).
[2] Ibid
[3] Kuchar, E., Zajkowska, J., Flisiak, R., Mastalerz-Migas, A., Rosińska, M., Szenborn, L., Wdówik, P., & Walusiak-Skorupa, J. (2021). Epidemiology, diagnosis and prevention of tick-borne encephalitis in Poland and selected European countries op.cit.
[4] Heinz FX et al.:Field effectiveness of vaccination against tick-borne encephalitis. Vaccine. 2007 Oct 23;25(43):7559-67
[5] Zajkowska J, Czupryna P. Tick-borne encephalitis - epidemiology, pathogenesis, clinical picture, diagnosis, prevention and treatment. Infection Forum 2013; 4(1):21-27.
[6] Beauté Julien, Spiteri Gianfranco, Warns-Petit Eva, Zeller Hervé. Tick-borne encephalitis in Europe, 2012 to 2016.Euro Surveill. 2018;23(45):pii=1800201
[7] Practical Medicine. The number of infections with the virus causing tick-borne encephalitis is increasing. The number of infections with the virus causing tick-borne encephalitis is increasing | Infectious diseases - mp.pl https://www.mp.pl/pacjent/choroby-zakazne/aktualnosci/263587,rosnie-liczba-zakazen-wirusem-wywolujacym-kleszczowe-zapalenie-mozgu (accessed 02. 2023)
[8] National Institute of Public Health PZH - National Research Institute. Tick-borne encephalitis in Poland and worldwide. Assessment of the epidemiological situation of TBE in Poland in 2015-2019 based on epidemiological surveillance data. https://www.pzh.gov.pl/wp-content/uploads/2021/03/KleszczoweZapalenieMozgu-raport-PZH_2021.pdf (accessed: 02.2023)
[9] Practical Neurology. Viral encephalitis. https://neurologia-praktyczna.pl/a1322/Wirusowe-zapalenie-mozgu.html (accessed 02.2023)
[10] National Institute of Public Health PZH - National Research Institute. Tick-borne encephalitis in Poland and worldwide. Assessment of the epidemiological situation of TBE in Poland in 2015-2019 based on epidemiological surveillance data. Op.cit.
[11] Kuchar, E., Zajkowska, J., Flisiak, R., Mastalerz-Migas, A., Rosińska, M., Szenborn, L., Wdówik, P., & Walusiak-Skorupa, J. (2021). Epidemiology, diagnosis and prevention op.cit
[12] P. Stefanoff, M. Rosińska, S. Samuels, D. White, D.L. Morse, S. Randolph. A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland. op.cit
[13] Zajkowska J, Czupryna P. Tick-borne encephalitis - epidemiology, pathogenesis, clinical picture, diagnosis, prevention and treatment. Infection Forum 2013; 4(1):21-27.
[14] Kuchar, E., Zajkowska, J., Flisiak, R., Mastalerz-Migas, A., Rosińska, M., Szenborn, L., Wdówik, P., & Walusiak-Skorupa, J. (2021). Epidemiology, diagnosis and prevention op.cit
[15] National Institute of Public Health PZH - National Research Institute. Ticks in local parks. Op.cit
[16] Zajkowska J, Czupryna P. Tick-borne encephalitis, op cit.
[17] Zajkowska J. Tick-borne encephalitis - risk and consequences of the disease in children. Pediatr. Dipl. 2014; 18(suppl. 2):1-7.
[18] Kuchar, E., Zajkowska, J., Flisiak, R., Mastalerz-Migas, A., Rosińska, M., Szenborn, L., Wdówik, P., & Walusiak-Skorupa, J. (2021). Epidemiology, diagnosis and prevention of tick-borne encephalitis in Poland and selected European countries op.cit.
[19] Communication of the Chief Sanitary Inspector of 28 October 2022 on the 2023 Immunization Programme: https://dziennikmz.mz.gov.pl/DUM_MZ/2022/113/oryginal/akt.pdf (accessed 02.2023)
[20] Heinz FX et al.:Field effectiveness of vaccination against tick-borne encephalitis. Vaccine. 2007 Oct 23;25(43):7559-67
[21] Summary of product characteristics FSME-Immun 0.5mL
[22] National Institute of Public Health PZH - National Research Institute. Portal Szczepienia.info. Summary - Tick-borne encephalitis vaccine. https://szczepienia.pzh.gov.pl/szczepionki/kleszczowe-zapalenie-mozgu/ (accessed 02.2023)
[23] Heinz FX et al.:Field effectiveness of vaccination against tick-borne encephalitis. Vaccine. 2007 Oct 23;25(43):7559-67