Page 436 - TBE_Book_V2_2019

Chapter 13: TBE as a matter of public health

Today, most people (90%) who will ultimately TBE affects all age groups. The severity of the
develop TBE visit endemic areas in pursuit of disease increases with age. Older generations
recreational activities. In central Europe and and retired people are more active today and
the Baltic states, recent increases in TBE may especially at risk of acquiring TBE. This is
have arisen largely from changes in human especially true for elderly travelers (both
behavior that have brought more people into domestic as well as from other regions) since
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contact with infected ticks. Europe is generally considered a safe
Infection with TBEV may also happen at home destination requiring no specific preparation,
when infected ticks inadvertently are brought and that can meet the needs of elderly people
in with harvested items from the outdoors or those with chronic or underlying illnesses –
(e.g., wildflowers or Christmas trees) on including those that depend on “high-standard
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clothing, or by domestic animals (e.g., dogs). medical infrastructure".
Moreover, TBEV infections are increasingly
reported to occur in gardens – even in urban
areas.
Table 1: General primary and secondary preventive measures

Measure Comment
Behavior Avoid tick-infested areas

Avoid unpasteurized dairy products Whenever possible
Adhere to personal protection measures
when working with viable TBEV
Clothing Light-colored clothing that covers arm Dark clothing is proven to be more
and legs (long-sleeved shirts – tight at the
attractive for ticks (which in
wrists, long pants – tight at the ankles
addition are more difficult to
and tucked into the socks); shoes
identify on a dark background)
covering the entire foot
Use of e.g. DEET in higher concentrations,
repellents Apply adequate repellent (with proven (p)icaridine as well as permethrin /
action against ticks) to clothing and skin pyrethroids are proven to act
against ticks; allow clothing to dry
up before wearing
Early The checks should especially focus
detection Adults should be checked daily; children on waist bands, sock tops, under
arms, other moist areas (for
should be checked more frequently, i.e. children: head and especially
after some hours of exposure (could behind the ears); even adults may
result in 2 to 3 checks per day)
need the assistance of a second
person to check the whole body
Early Remove tick as soon as possible using
Don´t suffocate the tick (oil, cream,
removal of fine-tipped tweezers or special cards nail polish, water); don´t burn the
ticks (resembling carved credit cards); grasp tick; don´t apply “home remedies;”
the tick firmly as close to the skin as
don´t wait for medical services if
possible and simply tear it out without
not promptly available
squeezing or rotating the tick

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