TBE (Tick-borne-encephalitis)

Tick-borne-encephalitis (TBE) is an important cause of viral infections of the central nervous system. The vast majority of infections with the virus result from infected ticks, which often remain firmly attached to the skin for days. (source)

For further information please contact your physician or pharmacist.

Key facts

  • The TBE virus is transmitted to humans through the bite of an infected tick.(1,2) TBE can also be acquired by ingesting unpasteurized dairy products (such as milk and cheese) from infected goats, sheep, or cows.(1,2) Direct person-to-person spread of TBE virus occurs only rarely.(1,2)
  • Vaccines against the TBE virus exists and is recommended for people who live or work in, or travel to TBE risk areas.(3)
  • Austria is a high-risk area for TBE. No region is free of TBE and therefore a vaccination is recommended to all Austrian citizens.(4)
  • Most cases occur from April to November, with peaks in early and late summer when ticks are active.(2)
  • Immunization offers the most effective protection against TBE and furthermore the risk of tick-borne infections is reduced by avoiding tick bites.(3)
  • There is no specific antiviral treatment for TBE.(2) Most patients with TBE encephalitis will recover but up to one third will suffer long-term complications of the disease.(3)

What is TBE?

  • TBE is an infectious disease caused by the TBE virus.(1,2) It is mainly transmitted through the bite of an infected tick.(1,2) In addition, the virus can also be transmitted by the consumption of raw milk products (e.g. goat or sheep milk).(1,2)
  • Transmission from person to person only occurs very rarely, through blood transfusion, solid organ transplantation, or breastfeeding.(1,2)
  • Ticks live on the ground and climb 20-70 cm onto grasses and bushes where they wait for hosts. The tick bite is painless and it is often impossible to sense a tick moving on the skin.(3)
  • Ticks can also transmit the Lyme disease.(2) While TBE is caused by a virus, Lyme disease is caused by bacteria and cannot be prevented by the TBE vaccination.(2,4)
Video TBE

Where does TBE occur?

  • TBE is endemic to focal areas of Europe and Asia, extending from eastern France to northern Japan and from northern Russia to Albania.(2)
  • Approximately 5,000–10,000 TBE cases are reported each year, with large annual fluctuations.(2)
  • Russia (and Sibiria) has the largest number of reported cases.(2)
    The highest disease incidences has been reported from western Siberia, Slovenia, and the Baltic States (Estonia, Latvia, Lithuania).(2)
  • Austria is a high-risk area for TBE.(4) No region is free of TBE.(4)

Who is at risk of contracting TBE?

  • Most TBE virus infections result from tick bites acquired in forested areas through activities such as camping, hiking, fishing, bicycling, collecting mushrooms, berries, or flowers, and outdoor occupations such as forestry or military training.(2)
  • In disease endemic areas, people with recreational or occupational exposure to rural or outdoor settings (e.g., hunters, campers, forest workers, farmers) are potentially at risk for infection by contact with the infected ticks.(1)

What are the symptoms and lasting effects of TBE?

The incubation period for TBE is 7 days on average, but can last up to 28 days and is asymptomatic in around two thirds of cases.(1) Symptoms during the first phase of clinical TBE are nonspecific and may include fever, malaise, anorexia, muscle aches, headache, nausea, and/or vomiting.(1) After about 8 days of remission, a second phase of disease occurs in 20% to 30% of patients.(1) These patients may experience a clinical illness that involves the central nervous system with symptoms of meningitis (e.g., fever, headache, and a stiff neck), encephalitis (e.g., drowsiness, confusion, sensory disturbances, and/or motor abnormalities such as paralysis), or meningoencephalitis.(1) Even though the mortality rate for the European subtype is comparatively low at 0.5-2%, it can take a long time to fully recover and complications can occur.(1) Severe neurological sequelae have been observed in up to 10% of patients.(1)

How can TBE be treated?

There is no specific antiviral treatment for TBE and therapy consists of supportive care and management of complications.(1,2)

How to reduce the risk of being infected?

Vaccines against the TBE virus exist and are recommended for people who live or work in, or travel to, TBE endemic areas.(3) The risk of tick-borne infections is reduced by avoiding tick bites. Infection can be prevented by taking appropriate measures to avoid tick bites:

  • vaccination against TBE (inactivated vaccine) is considered as an effective means of preventing disease in endemic countries;
  • use of tick repellents;
  • wearing protective clothing, with long sleeves and long trousers in socks treated with a suitable insecticide
  • checking the body for ticks after outdoor activities and removing them with tweezers or forceps; and
  • avoiding the consumption of unpasteurised dairy products.(1)


  1. European Centers for Disease Control and Prevention. tick-borne-encephalitis.geographic distribution. März 2022. Online available: (Last accessed December 2023)
  2. Centers for Disease Control and Prevention. Yellow Book 2024. Mosquitoes, Ticks, & Other Arthropods. Online available: Tick-borne-encephalitis | CDC Yellow Book 2024 (Last accessed December 2023)
  3. World Health Organization. Health topics. Tick-borne-encephalitis. Online available: (Last accessed December 2023)
  4. Bundesministerium Soziales, Gesundheit, Pflege und Konsumentenschutz: Impfplan 2023/24, online verfügbar: Impfplan Österreich ( (Last accessed December 2023)


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