Forest encephalitis (tick-borne) is a severe neurological infection caused by the forest encephalitis virus, primarily transmitted through bites from infected hard ticks. The treatment aims to alleviate symptoms, prevent complications, and block viral dissemination.
Current main treatment strategies include vaccination and supportive care, with vaccination being the only active immunization method proven to effectively prevent infection. Severe cases may require hospitalization for antiviral therapy and neurological protection measures.
1. Vaccination: Utilizes inactivated virus vaccines to induce the production of neutralizing antibodies, preventing the virus from binding to cellular receptors. The Encepur vaccine approved in Taiwan requires a three-dose primary series.
2. Antiviral Drugs: Nucleoside analogs such as ribavirin can interfere with viral RNA replication. It is recommended to use within 72 hours of symptom onset for maximum efficacy. Severe cases may also require passive immunity with immunoglobulin.
Applicable to high-risk groups:
Antiviral drugs can be used during the acute infection phase, but should be evaluated by a physician based on virus type and disease stage.
The vaccination schedule is:
Ribavirin is administered intravenously, with a common adult dose of 10 mg/kg every 8 hours, typically for 5-7 days.
Vaccination provides over 90% protection, with immunity lasting 5-10 years after the third dose. It reduces the risk of severe illness and sequelae.
Supportive care can improve respiratory failure and intracranial pressure. Early use of antiviral drugs can reduce mortality by up to 40%.
Common reactions to the vaccine include injection site redness and swelling (15-20%), fever (<5%), and rare allergic shock (<0.1%).
Antiviral drugs may cause leukopenia and elevated liver enzymes; blood monitoring is necessary during long-term use. Use during pregnancy may lead to fetal malformations and is contraindicated.
Contraindications include:
Important Warning: Observe for allergic reactions within 48 hours post-vaccination. Immunocompromised individuals should evaluate timing of vaccination. Administer at least 2 weeks apart from other injectable medications.
Ribavirin may increase bleeding risk when combined with anticoagulants and requires dose adjustment when used with corticosteroids.
Vaccines should not be administered simultaneously with other live vaccines; a minimum interval of 28 days is recommended. Concomitant use with immunosuppressants may reduce immune response.
Seroconversion rate after the third vaccine dose reaches 99%. Epidemiological studies across multiple European countries show an over 85% reduction in disease incidence among vaccinated populations.
Clinical trials with antiviral drugs demonstrate a 40% reduction in coma duration and a decrease in neurological sequelae from 35% to 12%.
Unapproved alternative drugs include:
Unvaccinated individuals should enhance personal protection, including using DEET insect repellent and wearing long-sleeved clothing.
Localized redness or mild fever post-vaccination are normal reactions. Applying cold compresses to the injection site can relieve discomfort, and avoid rubbing the area. If body temperature exceeds 38.5°C or symptoms persist over 48 hours, consult a healthcare professional promptly for assessment and possible use of antipyretics or further examination.
Should I avoid water contact or vigorous exercise after vaccination?It is recommended to avoid exposing the injection site to water streams within 24 hours post-vaccination to prevent infection. There are no absolute restrictions on vigorous exercise, but if muscle soreness occurs, reduce intensity accordingly. Rest and observe for any adverse reactions on the day of vaccination.
How long does the protection from the forest encephalitis vaccine last? Is a booster needed periodically?The primary vaccination provides protection for about 3 to 5 years, though this may vary based on individual immune response. Health authorities recommend a booster at the 3rd year post-vaccination and re-evaluation of immunity every 5 to 10 years, especially for those residing in high-risk areas, with regular consultation with a healthcare provider.
Do people who have previously been infected with forest encephalitis still need vaccination?Previous infection usually confers antibodies, but virus strains may vary by region. Physicians will assess based on infection history and circulating virus types whether additional vaccination with specific strains is necessary to fill immune gaps. Providing a complete medical history before vaccination is advised to avoid unnecessary repeat doses.
What are the risks and benefits of vaccination for pregnant women or immunocompromised patients?Vaccination for pregnant women and immunocompromised individuals should be evaluated by a physician. Although inactivated vaccines are generally safer, individual differences may affect immune response or side effects. Physicians will provide personalized advice based on exposure risk (such as residence or travel history) and health status, and monitor post-vaccination reactions accordingly.
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