Tickborne Diseases Abroad

• Crimean-Congo hemorrhagic fever is found in Eastern Europe, particularly in the former Soviet Union; in northwestern China, central Asia; southern Europe; Africa; the Middle East; and the Indian subcontinent.
• Imported tickborne spotted fevers (rickettsial infections) have caused infection in returning travelers. In the U.S., the most frequently diagnosed rickettsial infection associated with international travel is caused by Rickettsia africae (the agent of African spotted fever).
• Lyme disease can be contracted in temperate forested regions throughout Europe and northern Asia although it is more common in eastern and central Europe than western Europe. In contrast to North America, Lyme disease can be caused by several different species of Borrelia burgdorferi and may have somewhat different symptoms. For example, the initial rash, or erythema migrans (EM), may last longer but have less associated inflammation than the EM produced by U.S. infections. Additionally, tests in the U.S. will not necessarily detect European strains of Lyme disease. Additional information is available from the group, European Concerted Action on Lyme Borreliosis (EUCALB), regarding European Lyme disease serologic tests.
• Tickborne encephalitis (TBE) is found in many parts of Europe, the former Soviet Union, and Asia. Three virus sub-types include: European or Western tickborne encephalitis virus, Siberian tickborne encephalitis virus, and Far eastern tickborne encephalitis virus (formerly known as Russian Spring Summer encephalitis virus).