In short: Tick-borne encephalitis (TBE) is a viral infection of the brain and nervous system spread mainly by the bite of infected ticks, and occasionally by unpasteurised dairy products. It is found across central, northern and eastern Europe and parts of Asia, and in 2026 UKHSA reported a small number of cases acquired in the UK, although the risk here remains very low. Vaccination is advised for people whose travel, work or leisure activities put them at risk, alongside tick-bite prevention.

This guide, written by a Ready Health prescribing pharmacist and based on UKHSA, NaTHNaC (TravelHealthPro) and NHS guidance, explains where TBE occurs, the symptoms to look out for and who should consider the vaccine.

What is tick-borne encephalitis?

TBE is caused by a flavivirus carried by certain ticks. When an infected tick bites, the virus can pass into the bloodstream and, in some people, spread to the brain and its lining. Less commonly, people are infected by drinking raw (unpasteurised) milk or eating unpasteurised dairy products, particularly from goats, sheep or cows in risk areas. TBE does not spread from person to person.

Where is TBE found?

Central, northern and eastern Europe, including popular destinations such as Austria, Germany (especially the south), Czechia, Switzerland, Scandinavia and the Baltic states
Russia and Siberia
Parts of Asia, including China and Japan

Ticks live in forests and forest edges, grassland, meadows, marshland and even parks and gardens. In Europe the risk is generally highest from early spring to late autumn.

Is tick-borne encephalitis in the UK?

The virus has been detected in ticks in parts of the UK since 2019. In August 2026, UKHSA reported ten locally acquired cases (three confirmed and seven probable) linked to areas including Devon, Hampshire, Yorkshire, the Scottish Highlands and the Outer Hebrides. UKHSA describes the risk to the general public as very low. Lyme disease remains the more common tick-borne infection in the UK.

What are the symptoms of TBE?

Many infections cause no symptoms. When illness does occur, it typically starts about one to two weeks after a bite (up to 28 days) and often follows two stages:

First stage: a flu-like illness with fever, headache, tiredness and aching muscles, lasting a few days.
Second stage (in some people): after a short period of feeling better, symptoms of meningitis or encephalitis develop, such as severe headache, stiff neck, confusion, drowsiness, weakness or seizures.

TBE is rarely fatal in Europe, but long-term problems such as fatigue, memory and concentration difficulties or weakness are common after neurological illness. The Far Eastern form of the virus in Asia can be much more severe. There is no specific antiviral treatment.

If you become unwell within 28 days of a tick bite, seek medical advice promptly and mention the bite and your travel.

How can I prevent tick bites?

Stick to paths and avoid brushing through long grass and undergrowth.
Wear long sleeves and trousers, tucked into socks, and light colours so ticks are easier to spot.
Use an effective insect repellent on skin (for example DEET-based) and consider permethrin-treated clothing.
Check your whole body, including the scalp, armpits and groin, after time outdoors, and check children and pets.
Remove any tick promptly with fine-tipped tweezers or a tick-removal tool, gripping close to the skin and pulling steadily.
Avoid unpasteurised milk and dairy products in risk areas.

Who should consider the TBE vaccine?

The TBE vaccine is not part of the NHS routine schedule. UK guidance suggests considering it for:

travellers to risk areas who will walk, camp, cycle, hunt, fish or work in forests, woodland or rural areas, particularly in spring to autumn
people living or working in risk areas, such as forestry and farm workers or military personnel
laboratory staff who may be exposed to the virus

Short city breaks with no time in the countryside carry very little risk.

How is the TBE vaccine given?

Dose	Usual timing
First dose	Day 0
Second dose	1 to 3 months later (can be given 2 weeks later if protection is needed quickly)
Third dose	5 to 12 months after the second dose
First booster	Within 3 years of the third dose, if still at risk
Later boosters	Every 5 years (every 3 years from age 60), if still at risk

An adult vaccine is used from age 16 and a junior strength for children aged 1 to 15. Good protection is expected after the second dose, so ideally start at least a month before travel. The Green Book TBE chapter was updated in August 2026; one change is that severe egg allergy is no longer a reason to avoid this vaccine.

The UK has had temporary shortages of TBE vaccine. When supply is limited, doses are prioritised for people at highest risk, and delayed doses do not usually mean restarting the course. Booking early helps.

Frequently asked questions

Do I need the TBE vaccine for a trip to Austria or Germany?

It depends on where you are going and what you will do. Hiking, camping or working in forested rural areas in spring to autumn increases risk; a city stay does not usually justify vaccination.

How quickly does the TBE vaccine work?

Most people are well protected about two weeks after the second dose. The third dose provides longer-lasting protection.

Should I be vaccinated against TBE for walking in the UK?

Not routinely. UKHSA considers the UK risk very low, so tick-bite prevention and prompt tick removal are the main measures.

Can TBE be treated?

There is no specific antiviral treatment. Hospital care supports the body while it recovers.

Key takeaways

TBE is mainly spread by tick bites in parts of Europe and Asia, and occasionally by unpasteurised dairy.
The UK reported a small number of locally acquired cases in 2026, but the risk here remains very low.
Vaccination involves three doses plus boosters if you remain at risk.
Tick-bite prevention is essential whether or not you are vaccinated.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

Heading to forests, mountains or lakes in Europe? Ready Health in Standish offers travel health consultations for people across Wigan, Chorley, Horwich and Bolton. Our clinicians will look at your destination and plans and advise whether vaccination is appropriate. Book a travel health consultation or call 01257 676001.