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RKI defines new risk areas for TBE
The Robert Koch Institute (RKI) recently published an assessment of areas in Germany where there is an increased risk of infection with early summer meningoencephalitis (TBE). According to RKI, the risk areas across Germany have increased to 156 districts.
The risk assessment data was published in the current Epidemiological Bulletin. The information available is intended to help the affected circles to take targeted preventive measures such as vaccinations or warnings. A freely accessible map shows the affected areas.
Where is the risk particularly high?
The TBE infection risk is particularly high in southern Germany, especially in Bavaria and Baden-Württemberg, in southern Hesse and in southeastern Thuringia. According to the RKI, there are further individual risk areas in the following regions:
- Mittelhessen (district of Marburg-Biedenkopf),
- Saarland (district of Saar-Pfalz-Kreis),
- Rhineland-Palatinate (Birkenfeld district),
- Saxony (rural districts of Vogtlandkreis, Erzgebirgskreis, Bautzen and Zwickau),
- Thuringia (Ilm district and Suhl district),
- Bavaria (district of Munich, Günzburg, Augsburg, Weilheim-Schongau and Starnberg).
Ten new risk areas
The defined TBE risk areas increase to a total of 156 districts. In previous years, only zero to three new areas were added. In 2017 there was a strong accumulation of early summer meningoencephalitis. As a result, the RKI declared ten new risk areas in the current assessment. All new risk areas are adjacent to existing risk areas in Germany or the Czech Republic.
TBE can occur throughout Germany
There is an increased risk of infection in the risk areas. However, the RKI reports a potential Germany-wide risk of ticks. TBE diseases can also occasionally occur in federal states outside the risk areas. Therefore, a TBE infection must be considered throughout Germany during the tick season if symptoms are appropriate.
Falling vaccination rates
The Standing Vaccination Commission (STIKO) recommends TBE vaccination for people who are in the risk areas and who can come into contact with ticks. There has been a downward trend in vaccination rates in recent years. According to STIKO, 97 percent of people with TBE who were reported in 2017 were not vaccinated at all or insufficiently. A high proportion of cases could thus be prevented by increasing the vaccination rate, particularly in the risk areas, according to the RKI.
The pathogen virus, the so-called Flavi virus, can be transmitted to humans via a tick bite. A TBE infection usually has two phases. The first phase appears after an incubation period of up to 14 days after the tick bite and lasts for two to seven days. During this phase, flu-like symptoms such as body aches and headaches, fever and fatigue occur. In addition, complaints in the digestive tract such as nausea and vomiting as well as loss of appetite can be added.
The second phase is more dangerous
After the first phase there is often a symptom-free period of up to 20 days. Then the second, much more dangerous phase comes into force. In addition to the symptoms of the first phase, there is now an attack on the neural system. This can lead to symptoms of meningitis and encephalitis, which include dizziness, a tendency to sleep, and photophobia. Due to the neuronal involvement, speech, feeling and walking disorders, paralysis of the cranial nerves and changes in the nature of those affected can also appear.
Late effects from TBE
As a rule, a TBE can be treated without late effects. In rare cases, however, paralysis of the limbs, face and diaphragm and respiratory paralysis occur as a late consequence. Permanent damage to the spinal cord, liver or heart can also occur. In rare extreme cases, a TBE can lead to death. (vb)