PUBLIC health experts in Scotland have urged people to be "tick aware" after a probable case of tick-borne encephalitis was reported in Scotland for the first time.
Public Health Scotland issued the warning after it emerged that a man in Yorkshire fell ill following a tick bite, with a second case also believed to have occurred in the Loch Earn area of Scotland.
They cautioned that the risk remains "very low" and is currently believed to be "restricted to this small geographic area in Scotland".
PHS is working with health boards to increase awareness of ticks and tick bite prevention, and enhance the surveillance of tick-borne encephalitis in Scotland.
It is the first time that a domestically acquired case of tick-borne encephalitis (TBE) has been confirmed in the UK.
READ MORE: Lyme disease warning as NHS calls surge
The infection, which mainly causes flu-like symptoms but can lead to brain inflammation and is fatal in around one in 100 cases, is more commonly found in Europe and Asia.
The UK cases are being reported by scientists in Copenhagen as part of the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), which will take place from April 15 to 18.
The study has been led by Dr Helen Callaby from the UK Health Security Agency (UKHSA), with colleagues from the Rare and Imported Pathogens Laboratory (RIPL) at Porton Down.
Scientists at the RIPL - only diagnostic laboratory in the UK with the sequencing technology capable of identifying the TBE virus - were alerted by clinicians caring for the man in Yorkshire after he displayed possible symptoms following a tick bite.
In relation to the "probable human case", which is considered likely to have been acquired in the Loch Earn area in Perthshire in 2022, the scientists says it is "not possible to determine conclusively" whether this was caused by the TBE virus or the Louping III virus, which is also spread by tick bites.
READ MORE: Scots scientists unravel probable cause of hepatitis outbreak in children
Dr Callaby said: “This study confirms the tick-borne encephalitis virus is present in parts of the UK where there are relevant tick and wildlife populations and may occasionally cause disease in humans.
“Physicians should consider the possibility of tick-borne encephalitis virus when patients present with unexplained encephalitis and a history of tick exposure, even if they have not travelled outside the UK, as the clinicians did in these cases.”
Ticks are becoming more common in parts of the UK, mainly due to increasing deer numbers. They live in undergrowth and latch on to humans when they walk through long grass.
Infections with the TBE virus cause a range of disease, from completely asymptomatic infection or mild flu-like illness, to severe infection in the central nervous system such as meningitis or brain swelling.
Symptoms can include a high fever with headache, neck stiffness, confusion or reduced consciousness.
Two probable cases of TBE infections have been reported twice before in the UK, in 2019 in 2020, but there was no molecular isolation of the virus to confirm a diagnosis.
TBE virus cases are on the rise in Europe with some 3,800 reported in 2020.
The European subtype is associated with milder disease than its Asian counterpart, with around 20-30 per cent of patients experiencing clinical disease.
It is assumed that the UK cases are the European subtype, but this has not been proven to date.
READ MORE: Disease X, Covid surveillance, and stopping the next pandemic
Dr Nick Phin, Director of Public Health Science and Medical Director at Public Health Scotland, said: “While the risk of acquiring tick-borne encephalitis in Scotland is very low, we know that ticks can cause other infections, such as Lyme disease.
“We would encourage everyone to familiarise themselves with the steps we can all take to avoid bugs and germs outdoors.
"This is particularly important as Spring approaches, and we begin to spend more time outdoors.
"Being tick aware, trying to avoid being bitten by ticks and removing any ticks that do bite as quickly as possible, are all important precautions.”
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules here