Tick-borne encephalitis detection in England
A new risk assessment, published by a multi-agency cross-government committee, reports that tick borne encephalitis is now likely to be present in England.
The risk assessment is based on both human cases and the detection of the virus in ticks in several areas of the country. The risk to the general public in the UK remains very low.
There have been 3 cases of probable or confirmed tick-borne encephalitis acquired in England since 2019, including one linked to the Yorkshire area in 2022. This case in 2022 is the first confirmed case in England. The virus has also been detected previously in the Hampshire and Dorset, and Norfolk and Suffolk border areas but may also be present elsewhere as the tick species that carries the virus is widespread in the UK.
The tick-borne encephalitis virus (TBEV) is a virus carried by ticks and is common in many parts of the world, including many countries in Europe. It causes a range of disease, from completely asymptomatic infection, to mild flu-like illness, to severe infection in the central nervous system such as meningitis or encephalitis. Symptoms of this are similar to other causes of meningitis, and can include a high fever with headache, neck stiffness, confusion or reduced consciousness.
Investigations into why the virus has been found in ticks more frequently in recent years are under way, but is likely due to a number of factors.
The risk to the general public in the UK remains very low from TBEV, but the UK Health Security Agency (UKHSA) has recommended changes to testing in hospitals so that any further cases can be detected promptly and will be enhancing surveillance – including asymptomatic surveillance in people in the areas where TBEV has been detected.
Ticks can carry other diseases such as Lyme disease – a bacterial infection which can be treated with antibiotics – so UKHSA is reminding the public to check themselves for ticks after they have been outdoors and remove them promptly and correctly if they are found.
Dr Meera Chand, Deputy Director at UKHSA, said:
Our surveillance suggests that tick-borne encephalitis virus is very uncommon in the UK and that the risk to the general population is very low. Ticks also carry various other infections, including Lyme disease, so take steps to reduce your chances of being bitten when outdoors in areas where ticks thrive, such as moorlands and woodlands, and remember to check for ticks and remove them promptly.
UKHSA carries out surveillance of vector-borne disease in the UK, closely monitoring sentinel animals, tick and mosquito species and their distribution, and the infections that they carry, to understand more about emerging infections in this country.
The public are reminded that they should seek GP advice if they are unwell after a tick bite, and should seek urgent medical attention if they or someone they know:
- has symptoms of meningitis:
- severe headache
- stiff neck
- pain looking at bright lights
- develops neurological symptoms:
- a fit (seizure), if not known to be epileptic
- sudden confusion or change in behaviour
- weakness or loss of movement in arms and legs
- facial dropping, change in vision or slurred speech