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Risk of ticks: “Only a vaccination helps against TBE!”

The tick season should also start regular searches of the body for aggressive little animals, advises senior physician Stefan Schlesinger from the Clinic for Acute Neurology / Stroke Unit and Neurological Intensive Care Medicine on the Bad Neustadt campus. The tick expert also recommends getting vaccinated against TBE at an early stage, because the consequences of a virus infection can be devastating.

The risk of tick infestation is particularly high in the months of June to September. Especially in the so-called high-risk areas, which mainly include the German low mountain range, it makes sense to check your child and partner for ticks every day during this time.

“The tick should not be killed before it has been removed from the skin,” says senior physician Stefan Schlesinger. As a neurologist, he has been working with ticks for many years – and also with the often serious consequences of an infection.

Basically, he says, one has to distinguish between two types of infections. In addition to the feared and aggressive early summer meningoencephalitis (TBE) virus, there is also borreliosis, bacteria-like spirochetes that are much less dangerous – and can also be combated well with antibiotics.

Against TBE, on the other hand, only a preventive vaccination helps, which is particularly beneficial for all those people whose place of residence is in a high-risk area (map). In Germany, these are mainly within the federal states of Bavaria and Baden-Württemberg.

Anyone who has been bitten and infected with the borreliosis bacterium will first see what is known as “wandering redness”, an infection in the skin. If this affects the human nervous system, experts speak of neuroborreliosis. In children this usually manifests itself in the form of meningitis, in adults it is often an inflammation of individual nerves.

If the infection progresses for years, it is called chronic neuroborreliosis. This could very rarely lead to symptoms similar to dementia. Long-term psychological complaints caused by a Borrelia infection have not yet been scientifically proven.

In addition, says Stefan Schlesinger, an infection of the nervous system is very rare. Statistically speaking, one speaks of 0.8 cases per 100,000 inhabitants. The doctor also advises that diseases should be narrowed down as precisely as possible by experts before they are treated: “Not every depression or springtime tiredness is a chronic neuroborreliosis”.

There is also the all-clear elsewhere. The immune system can also do a good job: “If a Borrelia appears in the blood, the immune system recognizes and destroys it, then that is a healthy immune reaction and positive for the patient.” However, the doctor says that the problem is that the immune system becomes one once the infection has taken place, I do not notice it. So you could be infected with Borrelia every year.

However, one should also bear in mind that not every tick bite automatically makes you sick. For this reason, doctors usually do not give antibiotics as prophylaxis. “The best prophylaxis we have is to thoroughly check your own child or partner for ticks once a day during the tick weddings, ie between June and September,” says Stefan Schlesinger.

Because the infection with the bacterium needs a certain duration of the sucking act. Only after 24 hours have enough Borrelia pathogens been transferred into the blood to cause inflammation. If you find a tick in the evening after the infestation and remove it, there will be no infection. “Within twelve hours a person is definitely not infected with Borrelia,” says the expert.

In addition to the Borrelia, there is also the dreaded TBE virus. If you live in a high-risk area when it comes to ticks, Stefan Schlesinger urgently recommends a suitable vaccination from your family doctor or pediatrician for effective prevention. For a basic immunization, three vaccinations are necessary at an interval of several months. Thereafter, a booster is required every three to five years in order to maintain the vaccination protection. The statutory health insurance companies usually cover the costs of TBE vaccinations in risk areas. However, they are not obliged to assume the costs for vacation trips.

One thing is certain: such a vaccination is definitely worth it. The consequences of an infection with the TBE virus can be devastating: Studies suggest that in the event of illness, brain or spinal cord inflammation, around half of all patients experience residual symptoms, one in ten suffer from permanent neurological damage, and every one Hundreds even to death.

It is particularly important to consider: In contrast to the transmission of Borrelia to humans, which only takes place 24 hours after the start of the act of sucking, TBE viruses get from the tick to the person as soon as the blood begins to suck. This is precisely why vaccination as early as possible – experts recommend age 5 – makes sense. “Anyone who has ever seen a TBE infection will never think of waiting for a preventive vaccination,” says Stefan Schlesinger. He advises the winter half-year as the optimal time for the TBE vaccination, but TBE basic immunization is also possible in spring.

Similar to influenza, signs of the disease are high fever, which after a certain period of time is suddenly associated with neurological symptoms of meningitis, such as severe headache, change in character, fatigue, symptoms of paralysis, but also epileptic seizures.

Although, ideally, a vaccination should take place before infection, it should also be carried out at the time of infection, says Stefan Schlesinger. Because once the virus has been detected in the blood, the course of the disease could possibly be alleviated. This is important because there is still no therapy against TBE. However, there is a bit of good news: TBE is not transmitted from person to person.

Anyone who has ever dealt with ticks knows: the small animals are tough. They can easily survive freezer temperatures of minus 20 degrees. If they have been frozen for a day, they wake up again as if nothing had happened. They also usually survive a wash cycle.

In order not to give them the opportunity to get stuck on human skin in the first place, long trousers can help, especially during walks in the countryside. When searching, you should keep in mind that ticks especially like to crawl where it is damp. In children, for example, they tend to get stuck behind the ear and under the armpits.

Once the tick has located itself, it should not be crushed under any circumstances, advises Stefan Schlesinger. If you press it carelessly, you will pump the bacteria in the tick directly into the bloodstream of the infected person.

Instead, the expert advises, it makes sense to put a fine, metal tick loop around the proboscis and pull the tick out in this way. This also works well with small ticks, the so-called nymphs.

Your expert for neurological diseases:

Stefan Schlesinger
Senior physician at the Clinic for Acute Neurology / Stroke Unit and Neurological Intensive Care Medicine
at the RHÖN-KLINIKUM Campus Bad Neustadt

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