Spring fever is in the air and as temperatures start to rise, we aren't the only ones coming out of hibernation. Spring also lends itself to the return of ticks and tick-borne illnesses.

Ticks can carry several potentially deadly diseases. Two of the most common are Lyme disease and tick-borne encephalitis. According to Public Health Command Europe officials, these diseases are very common throughout Europe and in countries to the east and are contracted when a person it bit by a tick.

PHCE says that prevention is the best defense against both Lyme disease and TBE

"If you are going to be in grassy or woodland areas during tick season, to wear long sleeves and pants, preferably clothing that is permethrin-treated. They also suggest wearing insect repellent containing DEET on exposed skin," said Col. Rodney Coldren, PHCE Chief of Preventive Medicine

You should also check yourself, your loved ones and your pets for ticks after a trek through the outdoors.

If you do happen to locate a feeding tick, prompt and proper removal is important, Coldren said.

"Ticks should be removed using tweezers, pulling back slowly and steadily with firm force in the reverse direction from which the mouthparts are inserted, similar to removing a splinter. Once the tick is removed, cleanse the bite area with alcohol and apply antibiotic ointment."

Ticks that have been removed should be saved for identification and testing. Military personnel and DOD civilians should place the tick in a sealed ziplock bag and take it to their local military medical treatment facility which will then send it to PHCE to be tested for TBE and Lyme disease.

PHCE says that a person with Lyme disease may develop fever, headache, fatigue and a skin rash. This rash is sometimes referred to as a "bulls-eye" rash because it is red and circular in appearance.

If the disease is left untreated, it can worsen and cause swelling of the brain, facial paralysis and pain and numbness in the hands and feet. It also can cause enlargement and inflammation of the heart; intermittent bouts of arthritis in large joints (commonly the knees); and problems with sleeping, concentration and short-term memory.

In most cases, Lyme disease can be treated with antibiotics. But, in a small percentage of patients, problems with joint and muscle pain, fatigue and memory defects can persist for months to years after treatment.
Early treatment with antibiotics can usually cure the disease, but left untreated it can cause persistent chronic problems and physical disability.

Tick-borne encephalitis can affect the central nervous system and causes symptoms similar to Lyme disease, headache, fatigue and muscle pain, but can be much more serious.

"Tick-borne encephalitis is a serious disease that affects the central nervous system. It can result in permanent disability," said Coldren.

TBE progresses in a two-phase pattern with symptoms starting seven-14 days after the tick bite, Coldren said. "The initial, mild phase lasts two-four days and is marked by non-specific flu-like symptoms. After a symptom-free period of about eight days, the second phase of the disease occurs in 20-30 percent of patients and involves the central nervous system."

These symptoms are more severe including high fever, severe headache, stiff neck, drowsiness, confusion, sensory disturbances, and motor abnormalities such as paralysis. There is no known treatment or cure for TBE.

"Last year, in U.S. European Command, two service members required hospital admissions for TBE likely acquired from off-duty activities, so we know that our population is at risk," Coldren said.

An effective vaccine for tick-borne encephalitis is available, and consists of a series of three shots given over a six-month period.

"Since TBE does not exist in the United States, there is no US Food and Drug Administration licensed vaccination against TBE available," Coldren said. "However, there are vaccines that have been determined by the European Medicines Agency to be very safe and effective against TBE. These are available in Europe and require three shots over a period of time."

Because the vaccine is not FDA-licensed, it is not stocked or provided at U.S. MTFs. But Coldren said the TBE vaccine is a covered TRICARE benefit for individuals living in Europe.

"Individuals who wish to protect themselves and their families can contact their Primary Care Team to receive a referral to a Host Nation Provider who will then evaluate them and potentially prescribe the vaccination."

For more information on tick-borne illnesses and how to protect yourself and family, please talk with your primary care manager.