What should be done if the tick is encephalitic, and how should it be treated? - briefly
Remove the tick immediately and obtain urgent medical evaluation for tick‑borne encephalitis; initiate supportive care, consider antiviral therapy (e.g., ribavirin) or specific immunoglobulin, and manage neurological symptoms with close monitoring. Prevent recurrence through vaccination and strict tick‑avoidance practices.
What should be done if the tick is encephalitic, and how should it be treated? - in detail
If a bite is suspected to involve a tick that transmits encephalitis, immediate removal of the arthropod is essential. Grasp the tick with fine‑point tweezers as close to the skin as possible, pull upward with steady pressure, and disinfect the site afterward.
After extraction, seek medical assessment without delay. The clinician should:
- Record the date of the bite, geographic location, and any recent travel to endemic regions.
- Perform a thorough neurological examination to identify early signs such as headache, fever, neck stiffness, or altered mental status.
- Order laboratory tests, including complete blood count, liver enzymes, and inflammatory markers.
- Request serological testing for tick‑borne encephalitis virus (TBEV) IgM and IgG, and, if available, polymerase chain reaction (PCR) on blood or cerebrospinal fluid (CSF).
If infection is confirmed or strongly suspected, hospital admission is recommended. Management focuses on supportive care:
- Fluid and electrolyte balance – maintain adequate hydration and correct electrolyte disturbances.
- Fever control – administer antipyretics such as paracetamol; avoid non‑steroidal anti‑inflammatory drugs that may increase bleeding risk.
- Neurological monitoring – perform regular assessments of consciousness level, cranial nerve function, and motor strength; obtain repeat imaging (CT or MRI) if deterioration occurs.
- Antiviral therapy – specific antivirals are unavailable; some protocols consider ribavirin in severe cases, although evidence is limited.
- Corticosteroids – may be used to reduce cerebral edema in selected patients, guided by neurologist judgment.
- Seizure prophylaxis – initiate antiepileptic medication if seizures develop or EEG shows epileptiform activity.
Recovery often requires rehabilitation to address residual motor or cognitive deficits. Follow‑up visits should include repeat serology to document seroconversion and assessment of long‑term neurological outcome.
Prevention remains critical. Individuals residing in or traveling to endemic zones should receive the licensed tick‑borne encephalitis vaccine series, observe protective clothing, apply repellents containing DEET or picaridin, and conduct daily body checks to remove ticks before pathogen transmission can occur.