What is TBE, and how does it spread?
Tick-borne encephalitis (TBE) virus is spread through the bite of an infected tick. Occasionally, TBE virus can spread to people through eating or drinking raw milk or cheese from infected goats, sheep, or cows.
TBE virus can be found in parts of the region stretching from western and northern Europe through northern and eastern Asia. People who travel to these areas might be at risk for infection. TBE virus is not found in the United States. The ticks that spread TBE virus are most active in warmer months (April through November). People who spend time outdoors in or near forests are at highest risk of being bitten by a tick infected with TBE virus.
Many people infected with tick-borne encephalitis (TBE) virus do not have symptoms. For people with symptoms, the time from tick bite to feeling sick (incubation period) is usually about 7 to 14 days, but can range from about 4 to 28 days.
- Severe disease often occurs including infection of the brain (encephalitis) or the membranes around the brain and spinal cord (meningitis).
- Initial symptoms can include fever, headache, vomiting, and weakness.
- A few days later, severe symptoms can develop including confusion, loss of coordination, difficulty speaking, weakness of the arms or legs, and seizures.
- Sometimes initial symptoms last a few days and completely resolve, but then about a week later the more severe symptoms develop (known as “biphasic illness”).
If you think you or a family member might have TBE, see your healthcare provider.
- Healthcare providers diagnose TBE virus infection based on:
- Signs and symptoms
- Travel history and possible exposure to ticks while traveling
- Laboratory testing of blood or spinal fluid
- Your healthcare provider can order tests to look for TBE virus infection or other infections that can cause similar symptoms.
Who Should Get Vaccinated?
All travelers visiting countries with TBE should take steps to avoid tick bites. If you plan to travel during the warmer months of the year and participate in outdoor activities, you should discuss the need for vaccination with your healthcare provider. When discussing whether or not to be vaccinated against TBE, consider the following:
- What locations you will be visiting
- What activities you will participate in while traveling
- Likelihood of future travel to countries where TBE is found
- Potential severe outcomes of TBE disease
- Vaccine doses, cost, and possible side effects
The TBE vaccine is available for children aged 1 year and older and adults. Three doses are needed to complete the series so you should talk to your healthcare provider as early as possible before travel.
In 2021, the U.S. Food and Drug Administration approved a tick-borne encephalitis (TBE) vaccine for use in the United States, called TICOVAC. This vaccine has been used for over 20 years in Europe. U.S. travelers visiting parts of Europe and Asia where TBE is found who might participate in outdoor activities with risk of tick exposure should talk to their healthcare provider about vaccination.
- There is no medication to treat TBE virus infection. However, a vaccine is available to prevent infection; visit our TBE vaccine page for more information on who the vaccine is recommend for.
- Rest, fluids, and over-the-counter pain medications may relieve some symptoms.
- People with severe disease often need to be hospitalized to receive support for breathing, staying hydrated, or reducing swelling in the brain.