Tick-borne encephalitis detection in England

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. A case in 2022 is the first confirmed case in England. The virus has also been detected previously in Hampshire, Dorset, and the 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 symptoms, 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.

Dr Meera Chand, Deputy Director at the UK Health Security Agency (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.”

Tick removal tools are available from vets, some chemists and online and are the safest way of dealing with ticks on human and pet skin. Ticks should not be simply pulled out, as this risks leaving the head behind. The large numbers of deer in East Anglia – which are important sources of blood for ticks and contribute to tick survival and movement to new areas – mean that ticks are present in woodland, bracken and damp grassland across the region. Tick bites are painless, and until the tick has fed, it is small and unobtrusive.

UKHSA suggests that the public should get advice from a GP 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

Tick-borne Lyme Disease can also cause long-term health issues. It can be identified by a circular target-like rash around a tick bite and flu-like symptoms.