Hikers and mountain bikers have been urged to take precautions after health officials confirmed that a potentially deadly virus spread by ticks is present in the UK.
What is the virus?
Tick-borne encephalitis (TBEV) is now present in the UK, the UK Health Security Agency (UKHSA) has said, after the first domestically acquired case of the virus was confirmed in Yorkshire.
The virus can cause a range of illnesses from completely asymptomatic infection, to mild, flu-like illness, to severe infection in the central nervous system such as meningitis or encephalitis.
Encephalitis is an uncommon but potentially deadly condition in which the brain becomes swollen. It can be life-threatening and requires urgent treatment in hospital.
TBEV is a key cause of viral infections in the central nervous system, according to the World Health Organization.
How has it got into the UK?
TBEV is already common in many parts of Europe. Scientists do not know how it got into the UK, but some say that genetically the UK viruses are similar to European or Scandinavian variants, so they may have originally arrived from the near continent in ticks attached to birds.
How serious is the risk to the public?
The UKHSA says the risk is very low. However, the virus is potentially deadly, and the agency has taken the decision to issue advice to the public on how to reduce their risk.
The first confirmed domestically acquired case of TBEV was identified when a 50-year-old man who had been mountain biking in Yorkshire presented with fatigue, muscle pain and fever five days after being bitten by a tick.
After initially recovering, his fever returned a week later with a headache and loss of coordination. MRI scans showed changes in keeping with viral encephalitis. He has now recovered.
How can I protect myself?
The UKHSA is advising people to walk, run or cycle on clearly defined paths to avoid brushing against vegetation. It is also sensible to consider using repellants such as DEET and wear light-coloured clothes so ticks can be spotted and brushed off.
When and where should I check for ticks?
Make it a habit to check your clothes and body regularly for ticks when outdoors and again when you get home. Check your children and pets as well.
Areas that ticks may be found include skin folds, armpits, groin, the waistband area, back of the neck and hairline. Adults are commonly bitten on the legs, while children are commonly bitten on the head or neck area, according to data from UKHSA’s tick surveillance scheme.
It is important to remember, however, that bites can occur on any part of the body and more than one tick can be attached at one time.
What should I do if I have been bitten?
If you have been bitten, you should remove the tick or ticks as soon as possible.
The safest way to remove a tick is to use a pair of fine-tipped tweezers or a tick removal tool. Grasp the tick as close to the skin as possible, then pull upwards slowly and firmly, as mouthparts left in the skin can cause a local infection.
Next, you should clean the bite area with antibacterial wash or soap and water, and monitor it for several weeks for any changes.
Contact your GP promptly if you begin to feel unwell with flu-like symptoms or develop a spreading circular red rash. Tell them you were bitten by a tick or recently spent time outdoors.
When should I seek urgent medical attention?
If you have symptoms of meningitis – which include a severe headache, a stiff neck, or pain looking at bright lights – you need to seek urgent medical help.
Similarly, seek immediate help if you develop neurological symptoms. UKHSA says that includes experiencing a seizure, if not known to be epileptic, sudden confusion or a change in your behaviour, weakness or loss of movement in your arms and legs, facial dropping, or a change in your vision or slurred speech.
