TICK-BORNE ENCEPHALITIS
What you should know before visiting Siberia
By Pat Ormsby
If you are planning to visit Siberia you need to be warned of a growing danger of contracting
encephalitis via the bite of certain ticks. There is much misinformation on this subject. For example,
everyone will tell you the ticks live only in the woods. That is not true. Your chances of getting
bitten in the big cities are slim, but if you should step outside for a short walk in the countryside,
you are at risk.
Tick-borne encephalitis can kill you. Or it can leave you permanently paralyzed. Knowing about it can
save you and your loved ones a lot of misery. Precautions can minimize your risk, and knowing about the
symptoms and getting early treatment can help a lot.
Description
Tick-borne encephalitis is a viral disease which primarily infects certain warm-blooded animals,
including domesticated animals, without making them seriously ill. When certain species of Ixodes ticks
bite these animals, they acquire the virus. The female passes the virus on to her offspring, who become
infective, and when they find a host, they pass it on to the host. If the host is human, serious disease
can result. According to the Siberian BAM Guide, by Athol Yates and Nicholas Zvegintzov, the symptoms
are fever, excruciating headache, vomiting and central nervous system disorders, and the victims die or
remain crippled for life with neck, leg and arm muscles paralyzed. The onset of the disease may occur
anytime from within hours of the bite to as late as ten days afterwards.
Dorland's Illustrated Medical Dictionary, 27th Edition, calls it Russian spring-summer encephalitis, and
says it is acquired in forests from infected ticks, but also transmitted other ways such as ingestion of
flesh of infected birds and mammals or milk of infected goats. Aside from Dorland's, I have not heard of
it being transmitted via food, so that may be rare. Nonetheless, it is worth remembering.
As its name implies, it is most frequently seen in spring and summer when the ticks are most prevalent.
People, however, have contracted it as late as September.
Japanese B encephalitis (Nihon noen) is a completely different disease, which is typically transmitted
by mosquitoes from livestock. If you ask a doctor in Japan for inoculation against the encephalitis
occurring in Russia, they will give you a set of injections against Nihon noen. This is not fraudulent,
because Nihon noen does occur in Russia (and is also called Russian autumnal encephalitis). Nihon noen,
however, is not a big concern in Russia at this time, and furthermore, inoculation against Nihon noen
will not guard you against tick-borne encephalitis, the serum for which is difficult to obtain outside of
Europe or Russia.
Precautions
If you're going to be spending time in the boondocks of Russia, go to a pharmacist and get what is
called "Yodantipirin." Keep that on hand, because you will want to start taking it immediately if a tick
does bite you.
The most important precaution is to avoid getting bitten by ticks. They occur not only in forests, but
anywhere they can find their animal hosts. Many of the locals avoid spending time in the taiga in May or
June when the ticks are most prevalent. They also cultivate a strong awareness of anything crawling on
their skin, especially under their clothing.
If you're going to spend time outdoors in the countryside, always wear long trousers and good socks and
tuck your pant bottoms into your socks. I know it looks awful. Wear a t-shirt and tuck it inside your
pants. The fashion shows are in big cities indoors. Ticks drop from shrubbery onto you or the ground
and crawl upwards looking for soft skin. Some suggest wearing a rubber band around your socks as well in
case a tick gets the idea to crawl down them, and it is probably even more helpful in keeping your socks
up over your pant legs. Check yourself frequently, especially your armpits and your neck. Wear a good
hat, but also have a friend check your hair and your back occasionally. Make every effort to catch the
ticks before they start burrowing into your skin. Some recommend using insect repellant on your
clothing, but I doubt that has much effect. Check your clothing frequently and your entire body when you
have an opportunity.
If you're going to be spending lots of time in outdoors in Siberia during the most dangerous periods,
there are special protective garments you can wear. If possible, it would also be good to get proper
inoculations. According to the Siberian BAM Guide, there is an immune globulin serum made by a Viennese
company, Immuno, one dose of which will protect you for up to four weeks, while two doses, two weeks
apart, will provide protection for a longer time. The Russian serum is hard to find, and must be started
about six months in advance of tick season. It involves three injections a few days apart with a booster
at six months and an annual booster thereafter.
If you do find that a tick has burrowed into your skin, remove it somehow. And save the tick for
analysis.
You can put paraffin or other suffocating substances on the tick or burn it with a match head and it
will back out, but in my case, I was always so surprised that I yanked it out before I realized what it
was. There is no pain at all, no itching, nothing. But look at the bite and you will see an
unmistakable big hole where the tick burrowed its head. If you've got that, you're in potential danger,
even if you've been immunized. Start taking the Yodantipirin immediately. The course is three tablets a
day for three days, then two tablets a day for the next two days. This is said to boost your immunity so
that if you do get sick you will avoid the most serious manifestations.
Take the tick into town into the clinic and have them analyze it. Each major town should be able to
help you. Within a few days they can tell you whether or not the tick was infective and how infective if
it was. If there is a chance of infection, you must remain under observation for at least ten days
because that is how long it could possibly take for symptoms to develop. If the clinic has found the
tick to be infective, they will probably give you a big dose of gamma globulin. This also helps your
body fight off the infection. By some accounts, these large doses of gamma globulin can be very hard on
the body (one ampoule per 10kg body weight is given) and it is an experience you'll never want to repeat.
It is, however, better than the disease.
Infection rates are high and growing. Twenty years ago, this disease was practically unknown. Now, I'm
hearing figures like 10% in general and considerably higher in some areas. No word on what areas are at
most risk. There are lost of stories of young, healthy men suddenly dying of it, but no information on
what part of the population is most vulnerable.
Myths to Beware of
1. The ticks are only in the forests. As I've said twice above already, not true! Yet all kinds of
authoritative sources, including Dorland's, will tell you they re only in the forests. The ticks are apt
to be found around settlements because that is where their hosts live-dogs, rats, etc., often attracted
by garbage. They frequent pathways, and in fact, it is said to be better to cross untrammeled forest
than to follow paths. I have found ticks in deep woods, but mostly near houses in the woods or in
sparsely wooded areas. In June, I found a swarm of ticks on a lightly wooded pathway to a lake very
close to houses. They crawled from the ground up my shoes and socks. They were quick and aggressive,
like ants. Nearby, one of our tour members found a tick burrowed into the skin of his armpit. The dogs
running through the bushes picked up ticks and transferred them to people playing with the dogs. That
was pretty extreme. Usually, dogs don't transfer ticks directly!
to people because the ticks are after the dog. Usually, you pick up just one tick somewhere and he
gets you unaware.
2. I got immunized, so I'm fine. Not true. That was me, incidentally, about three years ago. I got
three tick bites and thought how lucky it was I was immunized. It was pure dumb luck that saved me, and
probably less prevalence of the disease at that time. Nihon noen is a completely different disease from
tick-borne encephalitis, and the proper serum is probably unavailable in Japan. Moreover, even if you
have obtained the proper serum, be aware it is not 100% effective. It only reduces your risk. Avoid
being bitten.
3. It's summer/autumn, so the ticks are gone. Not true. They are less numerous, but infection has
occurred as late as September. Be aware of the possibility of ticks from May to September.
4. I'm only here for a couple of weeks. There is very little risk of my catching it in such a short
time. No. If a tick bites you, you've got a high risk of infection. Your ignorance will more than make
up for the shortness of your stay.
5. I caught the tick pretty quickly, so I think I am okay. Maybe. Did it burrow into your skin? If
so, you are in danger. Start taking Yodantipirin and take the tick to a clinic for analysis. See the
precautions.
6. This is fate. Yes, for some people. Do you have to make it yours? This nasty disease is hitting
Siberia when it is down economically. There is so little money and so many other, bigger problems. The
money you are bringing over when you visit is helping some of the people avoid it. Your awareness can
save you and others.
7. The ten days are over, there are no symptoms, I'm fine. Maybe. But you'd better be on the lookout
for Lyme Disease, which is also transferred by Ixodes ticks. Dorland's says it is a recurrent
multisystemic disorder caused by a spirochete, beginning with chronic migrating erythema lesions,
followed by arthritis of the large joints, myalgia, malaise, and neurological and cardiac manifestations.
I hear it gets mistaken for other things, including psychosomatic disorders, so let your doctor know if
you think you may have it. There is also a tick-borne Siberian typhus, which Dorland's says is a
relatively mild spotted fever caused by a Rickettsia bacterium transferred from infected rodents, with an
initial lesion at the site of the bite. And while rare, apparently, there is also Omsk hemorrhagic
fever, a severe viral disease of western Siberia, transmitted by a different kind of tick (Dermacentor).
It is best to avoid getting bitten. And if bitten, tell your doctor.
At the end of the Friends of the Earth tour to Baikal in June this year, we were shocked to learn that
one of our hosts had contracted tick-borne encephalitis. In fact, unbeknownst to everyone including
himself, he came down with it right in front of us, with fever, a bad headache, prostration, complaints
about the food not agreeing with him, a sudden trip to the john, interspersed with remissions where he
was his usual sociable self. We hear they discovered what it was quickly enough to help him. We pray he
will be okay. He probably had received the inoculation.
Incidentally, don't worry about the mosquitoes. The Russians swear their bites are good for you. They
boost your immunity. So far so good, anyway.
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