Primary prevention

People living in disease-endemic areas should be educated about modes of spread and control of tick-borne encephalitis (TBE) virus.[13]

Travellers in disease-endemic areas should:

  • Wear protective clothing against tick bites, and should use a skin-applied acaricide, such as DEET (N,N-diethyl-3-methylbenzamide)[1][17]

  • Inspect themselves and their roommates for attached ticks when undressing at night, and should remove these using tweezers; however, transmission occurs from the saliva of an infected tick and may occur early, hence removing a tick may not prevent transmission[1]

  • Avoid consuming unpasteurised milk or dairy products.[3]

Currently, there are 4 widely used vaccines available for use in paediatric and adult populations:​[18]

  • FSME-Immun® (TicoVac®) and Encepur® (based on European strains of the virus)

  • TBE-Moscow® and EnceVir® (based on Far Eastern strains).

All four vaccines are considered to be safe, efficacious, and immunogenic.[19][20]​​

A vaccine is approved in the US (TICOVAC®) to prevent TBE in people aged 1 year and older. It is administered as a three-dose series, and is recommended for people who are travelling to endemic areas who will have extensive exposure to ticks, or who may participate in outdoor activities in areas where ticks are likely to be found.[21][22]​​ CDC: tick-borne encephalitis - vaccine Opens in new window

​The World Health Organization recommends that vaccination be offered to all age groups, including children, in areas where the disease is highly endemic (i.e., where the average pre-vaccination incidence of clinical disease is ≥5 cases per 100,000 population per year), implying that there is a high individual risk of infection. People travelling from non-endemic areas to endemic areas should be offered vaccination if their visits will include extensive outdoor activities.[18]​​

Secondary prevention

Pasteurisation of milk, tick population control measures, and individual protective measures should be followed. The population of ticks can be reduced by, for example, regular cutting of the grass around the house, using acaricides, and controlling the deer population.

Direct person-to-person transmission of the infection is rare, occurring through blood transfusion, solid organ transplantation, or breastfeeding.[3]

TBE is a notifiable disease in some countries.[1]

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