Expert: Tick-borne encephalitis risk may be higher in towns than forests
While the scourge of ticks is often associated with summer in Estonia's countryside, the towns aren't tick-free either and may even pose greater risk, one expert said.
Last year, over 3,300 people in Estonia contracted either of the two main tick-borne diseases seen in Estonia: Lyme disease and tick-borne encephalitis (TBE). Ticks are also common in the towns, for instance in parks, and infection risks may be even higher there than in the countryside.
Health Board (Terviseamet) chief specialist Julia Geller told "Ringvaade" tick populations depend largely on environmental conditions.
"Whether there are more ticks arriving or emerging depends on climate. It depends on where they are located. This is not something static. If an area gets overgrown, there will be more ticks. If there is logging or anything else going on that disrupts the environment where they live, they move away," Geller said.
The nature of urban development can make certain areas much more tick-dense, with plenty of scope for the mites to find a human or animal host, compared with rural areas where perhaps not a soul passes by all day.
"In the cities, these green areas are usually small and confined. Once something gets into them, it starts multiplying there, and the concentration is usually quite high. And again, in an urban environment, this poses a risk to people: We move around there, we walk our dogs, sometimes have picnics, stroll with our children, and sit on the grass. The risks are simply higher. In the forest, we do not usually do those types of things right in the middle of the woods," she explained.
Tick populations in home gardens and public green spaces can be reduced through mowing, Geller went on, stressing ticks do not tolerate direct sunlight and prefer places where they can be concealed.
"When the grass gets mowed, they have nowhere to escape to or hide. And this is not only mowing. If there are thickets or dense shrubs, it is worth raking thoroughly and using mulch so that there is no debris. Again, if they have nowhere to hide, so much the better," Geller went on.
While paid vaccination is available against TBE, there is currently no such protection against Lyme disease. Ticks do carry several other pathogens in addition to these diseases, though most of those infections tend to be milder, Geller noted. "Perhaps you will get a fever, and that is all. If a person's immune system is not otherwise compromised, nothing more serious is likely to happen."
The other problem with tick bites, even ticks getting attached, is people may not initially notice. For that reason, Geller advises paying attention to symptoms that may appear after spending time outdoors. The first symptoms of TBE usually develop within one to two weeks after infection, Geller went on.
"Within about one to two weeks, a fever develops. That is the most characteristic symptom which could point to it, if I have been out in nature, in the forest, in a field, or in the garden. The first phase is referred to as flu-like symptoms: fever, feeling unwell, muscle aches, and headache. This subsides on its own after a few days, but then a few days later it comes back, and with a higher fever of 39–40 degrees Celsius. This already indicates that the situation is serious—off to the doctor right away," she cautioned.
Geller recommends seeing a doctor as soon as the first signs of potential illness appear and not waiting till this phase in any case. "At least get checked to see whether it could be tick-borne encephalitis. If it is not, then that is great," she said.
Lyme disease differs from TBE in that it can develop much more slowly. Although one of the best-known signs of Lyme disease is an expanding red rash around the bite zone, this is not seen in all infected individuals. Symptoms may also appear only several months after the tick bite.
To prevent tick-borne diseases, Geller recommends using insect repellents and carefully checking both clothing and the body after spending time outdoors.
"We should use every available means to prevent and minimize the risk. If you are allowed to use repellents and have no allergies or other contraindications, then use them. Check yourself two, three, four, even five times. When you come back from the forest, take off your clothes and put them in the wash. After washing, check again to make sure the ticks are not still alive. They are crafty little creatures," Geller concluded.
A couple of summers ago, mainstream pharmacy chains in Estonia were quoting vaccination charges around the €40-mark for TBE jabs.
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Editor: Andrew Whyte, Karmen Rebane
Source: "Ringvaade"
