The twelve-year-old girl and the 67-year-old man who ended up in hospital in Treviso with TBE, tick-borne encephalitis, are not isolated cases. In fact, this infection is very common among mountain visitors, even occasional ones, to the point that the Usl Dolomiti vaccinates thousands of people, both adults and children, every year (free of charge). According to the latest bulletin on arboviruses released by the Region,the cases of TBE detected so far are 18: eight in the less invasive form, tick-borne viral infection, and ten of encephalitis.
Encephalitis: the situation in Veneto
«We have just discharged three patients in their fifties — reveals Dr. Renzo Scaggiante, head of Infectious Diseases at the San Martino Hospital in Belluno, a regional reference centre for the diagnosis and treatment of tick-borne diseases — another, aged sixty, has just been transferred from Intensive Care to the ward. But the prognosis is serious; he still cannot breathe on his own. Unfortunately, there are no targeted therapies for TBE; we have to resort tocortisone and anti-inflammatory medicationand between 1% and 2% of patients experience respiratory failure. On the other hand,the vaccine works very well,it has no side effects, so we recommend it.» It requires three doses, plus boosters, and since 2019 it has been free for residents in the province of Belluno and can be booked on the websitewww.aulss1.veneto.it. From 2016 to 2022, Usl Dolomiti administered 85,193 doses of anti-TBE vaccine, but the vaccine is also available at the other eight Usl in Veneto, for a fee of 25 euros.Last year, in the rest of Veneto, 30,359 doses were administered.It can be taken from the age of one. Prevention in domestic animals is also important.
How is the disease transmitted?
The disease is transmitted to humans and animals by the bite of infected ticks; there is no transmission between humans.The virus 'reservoirs' are rodents, deer, sheep, cattle, goats, birds, and dogs.. "In 70% of cases, the infection presents with mild symptoms — states the regional bulletin —. In the remaining cases, after an incubation period of between three and 28 days, flu-like symptoms appear, such as high fever, headache, sore throat, fatigue, myalgia, and arthralgia. In 20%-30% of infected individuals, after a symptom-free interval of 8-20 days, central nervous system disorders (meningoencephalitis) emerge. The infection complicates with long-term neurological consequences in up to 30% of cases and causes death in 1%-2% of patients. The course is milder in children and young people, becoming progressively more severe with age."
Mountains crowded with ticks.
"Tick-borne meningoencephalitis was first diagnosed in the Belluno area in 1994, so quite recently — adds Dr. Scaggiante —. Unfortunately, our mountains are the most crowded places with ticks, followed by the hills of Vicenza, Trentino, and Friuli. Fortunately, not all transmit TBE, only a small percentage, but one must be very careful when going to the mountains. They are parasites as small as a pinhead, therefore hardly visible, but they cause thousands of bites."To transmit the infection, they must remain attached to the host for hours or days.and often a shower is enough to get rid of them, but sometimes it isn't. If they are spotted, they should be removed immediately. Thanks to the vaccine, the cases we see are significantly lower than the potential."
How to defend yourself
But how to protect yourself if you are not vaccinated and decide to go on holiday or simply take a trip to the mountains? "You need to walk on paths without tall grass, where ticks nest — explains the head of Infectious Diseases —they do not fly and do not jump, so the transfer to humans or animals occurs through contact.And then it is necessary to cover up as much as possible and use repellents, the simple Autan, just as you do to protect yourself from mosquitoes. After mosquitoes, ticks are indeed the most widespread parasites in the world and can also be found in the plains, always in the grass, but they are usually not infected."