Presentation
Affirming that in patients presenting as FWLS also cases of TBE are contained, this disease is underreported. [ncbi.nlm.nih.gov]
2 We present an unusual TBE case with an isolated myelitis without signs of meningitis or meningoencephalitis. [dx.doi.org]
Entire Body System
- Fever
In these cases, fever can be the only leading manifestation. We report on four hospitalised children who had TBE and presented as fever without localising signs (FWLS) between 2000 and 2008 in an endemic area in Switzerland. [ncbi.nlm.nih.gov]
In approximately two-thirds of patients infected with the European TBE virus, only an early (viremic) phase is experienced; symptoms are nonspecific and may include fever, malaise, anorexia, muscle aches, headache, nausea, and/or vomiting. [cdc.gov]
It may manifest as meningoencephalitis or a mild illness with fever. [patient.info]
- Fatigue
In addition, the answers concerning tiredness/fatigue, poor concentration/attention, reduced initiative/motivation, balance disturbances, coordination problems, difficulties with short- and long-term memory, learning difficulties and problems with fine [ncbi.nlm.nih.gov]
Symptoms can last up to 8 days and include fever, headache, fatigue, muscle pain, nausea, and loss of appetite. [iamat.org]
Symptoms Fever, headache, fatigue, and malaise tend to occur and last for about five days. Following a short period of symptom-free time, more severe manifestations may develop including meningitis, encephalitis, myelitis, and cranial neuritis. [columbia-lyme.org]
TBE can for instance cause long-term memory issues, severe fatigue and loss of mobility. Symptoms The incubation period is usually 4 – 14 days, but can be up to a month. The first symptoms are typically fever, headache, muscle-ache and fatigue. [vaccination.org.uk]
Tick-borne encephalitis can affect the central nervous system and causes symptoms similar to Lyme disease: headache, fatigue and muscle pain. [stuttgartcitizen.com]
- Asymptomatic
Seroepidemiological studies on TBE virus infection in endemic areas of various European countries have demonstrated that asymptomatic infections are common. [ncbi.nlm.nih.gov]
This phase is followed by an asymptomatic interval lasting seven (range 1–33) days that precedes the second phase, when the central nervous system is involved (meningitis, meningoencephalitis, myelitis, paralysis, radiculitis). [ecdc.europa.eu]
The incubation period of TBE is usually between 7 and 14 days and is asymptomatic. Shorter incubation times have been reported after milk-borne exposure. [cdc.gov]
Usually lasts for several days and may be followed by an afebrile and relatively asymptomatic period. Up to two-thirds of patients recover without any further illness. [wwwnc.cdc.gov]
- Malaise
In approximately two-thirds of patients infected with the European TBE virus, only an early (viremic) phase is experienced; symptoms are nonspecific and may include fever, malaise, anorexia, muscle aches, headache, nausea, and/or vomiting. [cdc.gov]
Symptoms Fever, headache, fatigue, and malaise tend to occur and last for about five days. Following a short period of symptom-free time, more severe manifestations may develop including meningitis, encephalitis, myelitis, and cranial neuritis. [columbia-lyme.org]
The earliest symptom of Lyme disease is a rash that looks like a bull’s-eye at the site of the tick bite, and can progress to flu-like symptoms, including muscle soreness, headache, fever and malaise. [stuttgartcitizen.com]
This phase is characterized by aggravated headaches, ophtalmoplegia, vomiting, malaise, meningeal symptoms, cranial nerve paralysis and paresis of the limbs. An acute stage of tick-borne encephalitis lasts 1 to 3 weeks. [diesse.it]
The incubation period of 7-14 days is followed by a phase in which a patient suffers from fever, fatigue, general malaise and headache. [rivm.nl]
- Disability
Neurological status was ascertained by protocol at admission and discharge and the degree of disability was scored using the modified RANKIN Scale (mRS; clinical score addressing neurological disability, range from 0, healthy to 6, dead) at admission [ncbi.nlm.nih.gov]
Gastrointestinal
- Vomiting
Case report A 43-year-old man from the Black Forest area, Germany, who had not had TBE vaccination developed symptoms of gastroenteritis with fever (diarrhoea, nausea and vomiting) lasting for approximately 1 week. [dx.doi.org]
For example: Meningitis: high fever, headache, nausea, vomiting, photophobia, vertigo. [patient.info]
All infected patients had similar clinical and laboratory symptoms and signs, including fever, headache, generalized body aches, arthralgia, anorexia, vomiting, leucopenia, thrombocytopenia, elevated liver enzymes (serum glutamic oxalacetic and serum [ncbi.nlm.nih.gov]
In approximately two-thirds of patients infected with the European TBE virus, only an early (viremic) phase is experienced; symptoms are nonspecific and may include fever, malaise, anorexia, muscle aches, headache, nausea, and/or vomiting. [cdc.gov]
- Nausea
Sufferers may also complain of nausea, muscle pain, lethargy and general discomfort. Some patients may go on to develop encephalitis, which can cause paralysis and can be fatal in some cases. [heathrowmedical.com]
Sufferers may also complain of nausea, muscle pain, lethargy and general discomfort. Some patients may go on to develop Encephalitis, which can cause paralysis and can be fatal in some cases. [londontravelclinic.co.uk]
Case report A 43-year-old man from the Black Forest area, Germany, who had not had TBE vaccination developed symptoms of gastroenteritis with fever (diarrhoea, nausea and vomiting) lasting for approximately 1 week. [dx.doi.org]
For example: Meningitis: high fever, headache, nausea, vomiting, photophobia, vertigo. [patient.info]
Musculoskeletal
- Muscle Weakness
Irritability, memory loss and concentration problems are common, along with hearing difficulties, muscle weakness and partial paralysis. [yle.fi]
Neurologic damage may be permanent, causing chronic headaches, difficulty concentrating, muscle weakness or loss of balance. A small percentage of cases are fatal. The disease is rarely severe in children less than four years old. [redplanet.travel]
- Arthralgia
All infected patients had similar clinical and laboratory symptoms and signs, including fever, headache, generalized body aches, arthralgia, anorexia, vomiting, leucopenia, thrombocytopenia, elevated liver enzymes (serum glutamic oxalacetic and serum [ncbi.nlm.nih.gov]
Neurologic
- Headache
In approximately two-thirds of patients infected with the European TBE virus, only an early (viremic) phase is experienced; symptoms are nonspecific and may include fever, malaise, anorexia, muscle aches, headache, nausea, and/or vomiting. [cdc.gov]
Foremost, FWLS characterised by a biphasic fever course and accompanied by headache in patients in a reduced general condition. Affirming that in patients presenting as FWLS also cases of TBE are contained, this disease is underreported. [ncbi.nlm.nih.gov]
Many people experience prolonged convalescence with headache, concentration difficulties and sleep disorders. [fhi.no]
Signs and symptoms The initial symptoms of Tick-borne Encephalitis usually occur one to two weeks after a tick bite and include fever, headache and general flu-like illness. [heathrowmedical.com]
- Seizure
Seizures should be treated as any other symptomatic epileptic seizures. CONCLUSIONS: Tick-borne encephalitis is a viral CNS infection that may result in long-term neurological sequelae. [ncbi.nlm.nih.gov]
In certain individuals the infection can spread to the brain leading to seizures, confusion and paralysis. [ealingtravelclinic.co.uk]
Clinical Signs Dogs Dogs exhibit neurological signs including tremors, stupor, tetraparesis, bunny hopping, seizures, blindness, delirium, hyperaesthesia aggression, circling, head pressing, dullness and mortalities. [en.wikivet.net]
Tick-borne encephalitis is a rare infection that can cause fever, headache, vomiting, weakness, confusion, seizures, and memory loss. Long-term neurologic problems may occur. [hpepublichealth.ca]
Go to hospital if you or someone else: gets a stiff neck and a severe headache gets pain when looking at bright lights has a seizure (fit) has a change in behaviour – such as sudden confusion develops weakness or loss of movement in part of the body Page [nhs.uk]
- Ataxia
The long-term prognosis is unfavorable in about 40% to 50% of patients who sustain sequelae for months to years, mainly in terms of pareses, ataxia, and other gait disturbances. No specific treatment for TBE is known. [ncbi.nlm.nih.gov]
In all other patients, facial palsy was associated with paresis of additional cranial nerves (dysarthria, dysphagia, double vision) or ataxia. [omicsonline.org]
Ruminants Ruminants exhibit neurological signs, usually head tilt, facial paralysis, listlessness, blindness, hypermetria, opisthotonus, excess salivation and ataxia. They may bunny hop if weakness is severe. [en.wikivet.net]
On the next day, he began to have dysarthria, diplopia, gait ataxia, and clumsiness in both hands. On day 3 he was admitted to hospital. [jnnp.bmj.com]
Findings include meningeal signs, altered mental status, cognitive dysfunction, ataxia, rigidity, seizures, tremors, cranial nerve palsies, and limb paresis. Disease severity increases with age. [wwwnc.cdc.gov]
- Confusion
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 [cdc.gov]
In certain individuals the infection can spread to the brain leading to seizures, confusion and paralysis. [ealingtravelclinic.co.uk]
TBE should not be confused with Lyme disease (Lyme borreliosis), which is also transmitted by tick bites. Vaccination People who spend a lot of time in areas with a known risk of TBE infection should consider vaccination against TBE. [fhi.no]
Tick-borne encephalitis is a rare infection that can cause fever, headache, vomiting, weakness, confusion, seizures, and memory loss. Long-term neurologic problems may occur. [hpepublichealth.ca]
- Paresis
Paresis persisted in six patients, and 8/28 patients recovered (28%). Paresis of the extremities Paresis of only one extremity and with a low grade (4/5) had the best prognosis: All five patients with this kind of paresis recovered within one year. [omicsonline.org]
Meningoencephalomyelitis: muscle pains, flaccid paresis, respiratory paralysis. Rates of serious neurological deficit are estimated to be around 10% and death occurs in less than 2%. [patient.info]
This phase is characterized by aggravated headaches, ophtalmoplegia, vomiting, malaise, meningeal symptoms, cranial nerve paralysis and paresis of the limbs. An acute stage of tick-borne encephalitis lasts 1 to 3 weeks. [diesse.it]
Treatment
No specific antiviral treatment is currently available for TBE; indeed, supportive treatment as well as intensive care and assisted ventilation in severe forms may be needed. [ncbi.nlm.nih.gov]
The medicines will usually be tested against another treatment called a control. This will either be a dummy treatment (a placebo) or a standard treatment already in use. [nhs.uk]
Prognosis
The long-term prognosis is unfavorable in about 40% to 50% of patients who sustain sequelae for months to years, mainly in terms of pareses, ataxia, and other gait disturbances. No specific treatment for TBE is known. [ncbi.nlm.nih.gov]
The severity of clinical symptoms at the first presentation correlated well with long-term prognosis. Patients with only “mild” symptoms at the onset mostly had a good prognosis and vice versa. [omicsonline.org]
Etiology
A systematic study was carried out in cooperation between the Department of Neurology of the University of Florence and the Istituto Superiore di Sanità (Rome), in order to understand a possible role of arboviruses as etiologic agents of meningoencephalitis [ncbi.nlm.nih.gov]
Günther G, Haglund M, Lindquist L, Forsgren M, Sköldenberg B (1997) Tick-bone encephalitis in Sweden in relation to aseptic meningo-encephalitis of other etiology: a prospective study of clinical course and outcome. J Neurol 244: 230-238. [omicsonline.org]
Epidemiology
The conference agenda was divided into six sessions: 'National Implementation of EU notifiable disease status', 'Virology', 'Epidemiology and Risk areas & Poster Walk Epidemiological Update', 'Clinic', 'Environmental Factors' and 'New Findings and Diagnosis [ncbi.nlm.nih.gov]
Pathophysiology
BACKGROUND: Magnetic resonance imaging (MRI) changes in tick-borne encephalitis (TBE) are non-specific and the pathophysiological mechanisms leading to their formation remain unclear. [ncbi.nlm.nih.gov]
Prevention
Enhanced surveillance and intervention for human TBE in the high-risk regions, particularly on the forest areas in north-eastern China, is necessary to prevent human infections. Copyright © 2017 The Authors. Published by Elsevier GmbH.. [ncbi.nlm.nih.gov]
View preventive measures Communication toolkit on tick-borne disease Communication materials to support awareness campaigns on tick-borne diseases and their prevention. [ecdc.europa.eu]