Loch Earn: “Probable” case of tick-borne encephalitis

Public Health Scotland issued the alert after a man in Yorkshire was revealed to have fallen ill after a tick bite, with a second case believed to have also occurred in the Loch Earn area of ​​Scotland.

They warned the risk remains “very low” and is currently thought to be “limited to this small geographical area in Scotland”.

PHS is working with health authorities to raise awareness of ticks and tick bite prevention and improve surveillance of tick-borne encephalitis in Scotland.

It is the first time that a locally acquired case of tick-borne encephalitis (TBE) has been confirmed in the UK.

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The infection, which mainly causes flu-like symptoms but can lead to encephalitis and is fatal in about 1 in 100 cases, is more common in Europe and Asia.

The UK cases are being reported by scientists in Copenhagen as part of the European Congress on Clinical Microbiology and Infectious Diseases (ECCMID) taking place from April 15-18.

The study was conducted by Dr. Helen Callaby of the UK Health Security Agency (UKHSA) along with colleagues from the Rare and Imported Pathogens Laboratory (RIPL) at Porton Down.

Scientists at RIPL – the only diagnostic laboratory in the UK with the sequencing technology capable of identifying the TBE virus – were alerted by clinicians caring for the Yorkshire man after he showed possible symptoms after a tick bite.

Referring to the “probable human case” believed to have been acquired in 2022 in the Loch Earn area of ​​Perthshire, the scientists say it is “not possible to say conclusively” whether this is caused by the TBE virus or that became Louping III virus, which is also transmitted by tick bites.

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dr Callaby said: “This study confirms that tick-borne encephalitis virus is present in parts of the UK where there are relevant tick and wildlife populations and can occasionally cause disease in humans.

“Physicians should consider the possibility of tick-borne encephalitis virus when presenting patients with unexplained encephalitis and a history of tick exposure, even if they have not traveled outside the UK, as clinicians have done in these cases .”

Ticks are becoming increasingly common in parts of the UK, largely due to increasing numbers of deer. They live in the undergrowth and will cling to humans as they walk through tall grass.

Infections with the TBE virus cause a range of diseases, from a completely asymptomatic infection or a mild flu-like illness to severe infections of the central nervous system such as meningitis or brain swelling.

Symptoms may include a high fever with a headache, stiff neck, confusion, or loss of consciousness.

Two probable cases of TBE infection have already been reported twice in the UK, in 2019 in 2020, but there has been no molecular isolation of the virus to confirm a diagnosis.

TBE virus cases are increasing in Europe, with around 3,800 reported in 2020.

The European subtype is associated with milder disease than its Asian counterpart, with approximately 20-30 percent of patients experiencing clinical disease.

The UK cases are believed to be of the European subtype, but this has not been proven.

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dr Nick Phin, Director of Public Health Science and Medical Director at Public Health Scotland, said: “Although the risk of contracting tick-borne encephalitis is very low in Scotland, we do know that ticks can carry other infections such as Lyme disease can cause.

“We want to encourage everyone to become familiar with the steps we can all take to avoid bugs and germs outdoors.

“This is especially important as spring approaches and we start spending more time outdoors.

“Watching for ticks, avoiding being bitten by ticks, and removing any ticks that bite as soon as possible are important precautions.”