FSME IgG/IgM

FSME Virus IgG (FSMG serum) and FSME Virus IgM (FSMM serum)

Infection diagnosis tick bite

reference values:
<22.0 RU/mL method
ELISA (EIA)
Clinical indication for meningoencephalitis after residing in an endemic area, suspected early summer meningoencephalitis (TBE)

Tick-borne encephalitis is an inflammation of the brain (membrane) caused by the tick-borne encephalitis virus (TBE virus). Infected ticks transmit the TBE virus from animal to animal and sometimes to humans. Until recently, the virus only occurred abroad, but in the spring of 2016 evidence emerged that roe deer in the Netherlands have been infected with the virus and the virus has also been demonstrated in ticks in the Netherlands. A few patients are now known to have contracted the virus in the Netherlands. The virus is transmitted by tick bites.

There are several types of TBE viruses. In general, these types have a similar course of disease, although the subtype that occurs in eastern Russia often progresses more severely.
The likelihood of infection after a tick bite is very low, because very few ticks are infected with the TBE virus. Moreover, an infection after the bite of an infected tick usually passes without clinical symptoms. If someone does develop symptoms, the disease often progresses in 2 phases. After an incubation period of 7 to 14 days, there is a phase with fever, fatigue, general malaise and headache. This phase usually lasts 2 to 7 days and is followed by a period of about a week without symptoms. Then follows the 2nd phase of the disease with symptoms such as severe headache with fever and brain (membrane) inflammation. Then hospitalization is necessary. A portion of these patients develop neurological residual symptoms. Approximately 1-2% of patients with brain inflammation die. There are no specific drugs against tick-borne encephalitis.

The virus is transmitted to humans by infected ticks. There is a vaccine that gives 95% protection. People who stay for a long time in areas where tick-borne encephalitis is common can be vaccinated; this is recommended for parts of Central and Eastern Europe, for example. On the website of the National Coordination for Travel Advisory you can find out where vaccination is recommended. For the time being, there is no reason to vaccinate in the Netherlands.
Removing a tick as quickly as possible also reduces the risk of infection, although the virus is transmitted soon after the bite. A quick removal can therefore not always prevent this disease, but also reduces the risk of other diseases that can be transmitted by ticks, such as Lyme disease. Tick bites can be prevented by wearing protective clothing and smearing the uncovered skin with a product containing DEET. These measures do not provide 100% protection so tick bite control is always necessary after spending time in green space.
Another rare route of infection for humans is drinking contaminated raw milk or eating contaminated raw milk cheese. Farm animals such as sheep, goats and cows can also become infected. They then excrete the virus in the milk.

for more information see: https://www.tekenradar.nl/ziekte-van-lyme/andere-ziekten-door-teken-en-co-infecties/tekenencefalitis-tbe