Tick-borne Encephalitis in a 29-Year-Old Returning Traveller

Abstract

Tick-borne encephalitis (TBE) is a central nervous system (CNS) disease with high morbidity and mortality caused by a flavivirus and usually transmitted to humans via the bite of an infected Ixodes ricinus tick. It is endemic to central Europe, Germany inclusive. Until 2019, the causative agent, TBE virus, was not considered to occur in the UK. However, with the increase in tourism TBE is becoming a problem also outside endemic regions. It has a varied clinical manifestation ranging from mild symptoms to potentially life-threatening meningoencephalitis or meningoencephalomyelitis. Its diagnosis relies on high index of clinical suspicion and supported by the demonstration of specific IgM- and IgG-serum antibodies by ELISA. Management is largely supportive. We present a unique case of tick-borne encephalitis in a young traveller returning from an endemic region to the UK, managed appropriately with no residual complications.