Ready to explore? Learn more about avoiding tick-borne encephalitis while travelling

What is tick-borne encephalitis?

Tick-borne encephalitis (TBE) is a viral infection that’s spread by a type of tick, which looks a bit like a small spider. TBE is transmitted when an infected tick bites a human or animal.

Ticks that spread the infection are mainly found in rural areas such as:

• Forests

• Woods

• Grasslands

• Riverside meadows

• Marshes

• Brushwood

• Scrublands

They can also be found in some European and Asian countries including:

• Austria

• Estonia

• Croatia

• Russia

• China

• Japan

In rare cases, TBE can also be contracted through eating or drinking unpasteurised dairy products from an infected animal.

Signs & symptoms of tick-borne encephalitis

Tick-borne encephalitis symptoms occur in two stages. First signs of TBE include flu-like symptoms such as:

• Having a fever

• Headache

• Tiredness

• Muscle aches and pains

• Nausea

On average, these symptoms last around eight days and most people make a full recovery. In around 20-30 percent of cases, people go on to develop more serious symptoms.

This is when the virus has spread to the protective tissue that covers the brain and spinal cord (meningitis) and the brain itself (encephalitis).

More serious symptoms can include:

• Changes in mental state

• Feeling confused

• Feeling disorientated

• Feeling drowsy

• Seizures

• A sensitivity to bright light

• An inability to speak

• Paralysis

If you have any of the above symptoms, you’ll most likely be admitted to hospital for medical attention. These more severe symptoms will subside after a few weeks, but it could take several months or even years to fully recover. There is a risk of long-term complications and around one in 100 cases of TBE turns out fatal.

Make sure to ask for an urgent GP appointment or call NHS 111 if you’ve been bitten by a tick or visited a place where ticks are found and:

• You have flu-like symptoms like having a fever, feeling hot and shivery, having a headache, aching muscles or nausea

• You have a circular rash (this could be caused by Lyme disease, a different infection from ticks)

You should call 999 or go to A&E if you or someone else has:

• A severe headache

• A stiff neck

• Pain when looking at bright lights

• A fit (seizure)

• A change in behaviour

• Sudden confusion

• Slurred speech

• Weakness in part of the body (including the face drooping on one side)

• Loss of movement in part of the body

Treating tick-borne encephalitis

There is currently no available treatment, other than supportive treatment.

Preventing tick-borne encephalitis

Even if you’ve been vaccinated, it’s important to take precautions to reduce your risk of being bitten, particularly when you’re in high-risk areas.

To reduce the risk of being bitten by a tick when you’re outside:

• Check your clothes regularly for ticks that might be on you

• If you spot any ticks on you, brush them off before they can bite you

• Wear light-coloured clothes so ticks are easier to spot

• Wear long sleeves and trousers

• Tuck your trousers into your socks

• Treat your clothes with insecticides

• Use an insect repellent like DEET on your skin

• Walk on paths which are clearly defined to avoid brushing against plants that have ticks on them

• Check your skin regularly for ticks – especially your hair line, behind your ears, elbows, backs of knees, groins and armpits

You can also reduce your risk of contracting TBE by not eating or drinking unpasteurised dairy products.

Removing ticks

If you find a tick on your skin, it’s important to remove it as soon as possible. Once attached, ticks may not start feeding for several hours. Tick larvae can be very tiny, but once they start to feed they can reach the size of a coffee bean.

To remove ticks safely: 

• Use a pair of finely tipped tweezers or a tick removal tool which can be bought from some pharmacies, vets and pet shops

• Grasp the tick as close to the skin as possible

• Slowly pull upwards until all the parts of the tick are removed

• Try to avoid any sudden movements or twisting as this could make the tick leave mouthparts in the skin after the tick has been removed

• Don’t squeeze the body of the tick as the contents of its stomach could go back into the bite

Once the tick is removed, wash your hands and the tick bite with soap and water or an antiseptic like an iodine scrub.

If you haven’t been vaccinated and you’re in an area where there’s a risk of TBE and you develop a rash or fever, make sure to seek medical advice straight away.


The tick-borne encephalitis vaccination is given by an injection. The vaccination course consists of three doses, but protection for the ongoing tick season is to be expected after the first two doses. The second dose is usually given one to three months after the first. However, if time is short speak to a travel health pharmacist or another suitable healthcare professional.

How long does the tick-borne encephalitis vaccination last?

Following a course of three vaccinations, a first booster dose should be given after three years. For those aged between two and 60 years, subsequent boosters can be given every five years if you’re at continued risk.

For travellers over 60 years, boosters should be given every three years if at continued risk.

TBE vaccinations aren’t available on the NHS.

Our service​​​​​​​

For specialist health advice and vaccinations, book an appointment online with Boots Travel Vaccinations and Health Advice Service*. Ideally, this should be six to eight weeks before departure, but it’s never too late to seek advice if you're leaving sooner.

1. Book an appointment

Six to eight weeks before you travel you will need to have your travel health appointment to assess what vaccinations you need.

2. Attend a personalised risk assessment23

During the 40 minute travel health appointment our specially-trained pharmacist will advise on any vaccinations and antimalarials you need for your travelling.

3. Get any vaccinations & antimalarials you may need*

You'll also be given additional personalised advice to help you stay healthy on your trip

*Available in around 200 pharmacies. For people aged two and over. Eligibility criteria apply. Subject to availability. Charges apply.