Tick-borne encephalitis detected in England

TICK-BORNE encephalitis is now likely to be present in England, according to the UK Health Security Agency (UKHSA).

A new risk assessment has been published by a multi-agency cross-government committee based on both human cases and detection of the virus in ticks in several areas of the country. It states that the risk to the general public in the UK remains very low.

Three cases of probable or confirmed tick-borne encephalitis have been reported in England since 2019, including one linked to the Yorkshire area in 2022 (which is the first confirmed case). The report states that the virus has also been detected previously in the Hampshire and Dorset, and Norfolk and Suffolk border areas but may also be present elsewhere as the tick species that carries the virus is widespread in the UK.

Tick-borne encephalitis virus (TBEV) is common in many parts of the world, including Europe. It causes a range of disease from completely asymptomatic infection to mild flu-like illness, to severe infection in the central nervous system such as meningitis or encephalitis. Symptoms of this are similar to other causes of meningitis, and can include a high fever with headache, neck stiffness, confusion or reduced consciousness.

Researchers are investigating why the virus has been found in ticks more frequently in recent years but believe it is likely due to a number of factors.

UK Health Security Agency (UKHSA) says risk to the general public in the UK remains very low but has recommended changes to testing in hospitals so that any further cases can be detected promptly. It will be enhancing surveillance – including asymptomatic surveillance in people in the areas where TBEV has been detected.

Dr Meera Chand, Deputy Director at UKHSA, said: "Our surveillance suggests that tick-borne encephalitis virus is very uncommon in the UK and that the risk to the general population is very low. Ticks also carry various other infections, including Lyme disease, so take steps to reduce your chances of being bitten when outdoors in areas where ticks thrive, such as moorlands and woodlands, and remember to check for ticks and remove them promptly.”

UKHAS is reminding the public to seek GP advice if they are unwell after a tick bite, and to seek urgent medical attention if they or someone they know has symptoms of meningitis and/or develops neurological symptoms, such as non-epileptic seizure, sudden confusion or behaviour change, limb weakness or loss of movement, facial dropping, or change in vision or slurred speech.