Perceptions of tick-borne encephalitis risk: a survey of travellers and travel clinics from Canada, Germany, Sweden and the UK

• Published in: Journal of travel medicine Vol. 26; no. Supplement_1; pp. S10 - S16
• Main Authors: Marano, Cinzia, Moodley, Melissa, Melander, Elaine, De Moerlooze, Laurence, Nothdurft, Hans D
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-02-2019
• Subjects: Clinics; Encephalitis; Hiking; Immunization; Internet; Original; Physicians; Polls & surveys; Prevention; Questionnaires; Risk perception; Tick-borne encephalitis; Travel; Travellers; Vaccination; Vaccines; Canada; Sweden; United Kingdom > UK; Germany; travel clinic; traveller; TBE; endemic; vaccination
• ISSN: 1708-8305; 1195-1982; 1708-8305
• DOI: 10.1093/jtm/tay063

Abstract
Background
While the worldwide endemicity of tick-borne encephalitis (TBE) has been increasing, a lack of awareness of the risks of this life-threatening disease may be leading to an underutilization of preventive measures among travellers to TBE-endemic regions. This study’s objectives were to assess travellers’ awareness of TBE and advice-seeking attitudes, and to evaluate practices of travel clinics regarding pre-travel advice.
Methods
We used an online questionnaire to identify individuals aged 18–65 years residing in the UK, Germany, Canada and Sweden, who had travelled to TBE-endemic countries between 2013 and 2016. This sample was defined as the visit-risk sample. Of these, the first 375 respondents who reported that they had engaged in pre-defined at-risk activities (e.g. hiking in forests) were asked to complete an additional online survey and were included in the activity-risk sub-sample. We also used an online/phone questionnaire to interview travel clinic personnel.
Results
The TBE visit-risk sample included 4375 individuals; 69% had heard of the disease and 32% had heard of a TBE vaccine. Before travelling, travellers most commonly sought information online (26%); fewer travellers consulted family doctors (8%) or travel clinics (5%). In the activity-risk sample, 79% of the travellers were aware of at least one correct TBE prevention measure; however, only 15% reported being vaccinated within the past 3 years, with 11% of vaccinated travellers doing so following a clinic’s recommendation. One hundred and eighty travel clinic representatives responded and reported that TBE vaccination was recommended to an average of 61% of travellers to endemic regions. Vaccination-reminder services such as follow-up appointments, e-mail and text reminders were offered by 50% of the clinics.
Conclusions
There is a need to increase awareness of the risk and prevention of TBE among travellers to endemic countries, and travel clinics could play an important role in this process.
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