[Viral encephalitis after tick bite].

Ugeskr Laeger

Aalborg Sygehus, medicinsk gastroenterologisk afdeling.

Published: October 1994

TBE is caused by a Flavivirus and is endemic in certain areas of Central and Eastern Europe, such as Austria, the south of Germany, Hungary, Czechoslovakia, Poland, the former Yugoslavia and SNG and certain areas of Sweden and Finland. Recent developments in the Eastern European countries have made them popular with Danish travellers, who are thus exposed to infection. Until now TBE has been a very rare disease in Denmark. The clinical course is biphasic being preceded by an incubation period of ten days. After the initial phase with uncharacteristic symptoms, a period af about five days follows where the patient has no symptoms. About one-third of the patients develop meningo-encephalitis where paresis can be seen. The course of the disease is often prolonged. The prognosis is good in terms of full recovery and low mortality. The diagnosis is made serologically with haemagglutination-inhibition test or ELISA-technique. Differential diagnosis includes other causes of viral encephalitis and Lyme disease with neurological manifestations, when there is a history of tick-bites. Vaccination provides good protection and is recommended for certain travellers with trips of some duration in endemic areas.

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