Aug. 8 (Bloomberg) -- Swedish vacationers heading for the
country's thousands of coastal islands this summer are threatened
with something worse than sunburn: Bugs.
A record number of Swedes may be infected by encephalitis
and other potentially fatal diseases by the country's billions of
ticks, whose number is increasing because of milder winters.
Sweden had the highest rate of tick-borne encephalitis, or TBE,
in Western Europe last year. The illness affected about one in
every 20,000 residents, according to Eurosurveillance data. One
in every 1,000 patients dies from the illness, according to
doctors.
``They're disgusting and can be so dangerous,'' said Sara
Strindlund, 27, who spends summer in her family's cottage on an
island in Stockholm's archipelago, and won't lie in the grass
because of the bugs. ``The worst is that they are tiny and don't
hurt, so I won't notice them until they've fed on my blood.''
Ticks are found across Sweden's eastern coastline and the
country's 220,000 islands, the top holiday destination for
Sweden's nine million people, who use traditional deterrents
including garlic and sprays to ward off the insects. Demand for
vaccinations also means doctors are using new ways to reach
patients, including a tick clinic that's based on a boat.
``Considering that TBE causes lasting damage in 40 percent
of infected adults, there's a way to go,'' said General
Practitioner Ola Stroemstedt, a co-founder and skipper of an
Arcona 460 sailing boat christened Medica. ``We decided to take
the vaccine out to the islands where the Swedes spend their
holidays so they can get their booster in time.''
Smittskyddsinstitutet, the Swedish Institute for Infectious
Disease Control, based near Stockholm, recorded 184 cases of TBE
last year compared with between 50 and 100 cases in the 1990s.
There have already been 90 cases in Stockholm this year,
according to Bo Svenungsson, a doctor at Smittskyddsenheten, the
infectious disease unit for Stockholm.
Lyme Disease
A third of ticks in Sweden also carry bacteria that cause
Lyme disease, which as many as 10,000 people get every year in
Sweden. The disease is treatable with antibiotics such as
doxycycline, Roche Holding AG's Rocephin or GlaxoSmithKline Plc's
Ceftin. It can't be prevented with a vaccine.
Lyme disease can cause a red rash and fever. Some patients
suffer from inflammation of the brain and nerves, which may lead
to facial paralysis or personality changes. It's rarely fatal.
TBE causes fever and nausea. In 30 percent of TBE infections the
virus spreads to the brain. One in five never recover totally and
1 percent die, according to health authorities.
Stroemstedt, who has toured the islands for six years, gives
500 TBE shots a day and extended this year's trip to meet demand.
Garlic Deterrent
``We have been selling more TBE vaccines this year and
there's plenty of ticks around because their numbers are soaring
after two mild winters,'' said Rolf Gustafson, medical director
at Baxter International Inc., in a phone interview. ``The cold
makes them think it's winter.'' Baxter is the world's biggest
maker of blood-disease products.
``We've already been using a larger sailing boat this year
and there's also a motorboat, '' said Stroemstedt, sitting on his
boat in the Gustavsberg harbor. ``We stand outside a supermarket
and people get their shot as part of a shopping trip.''
In addition to vaccination, many people cover themselves in
anti-tick sprays, powders, roll-ons and creams and eat large
amounts of garlic, in a bid to put off the blind blood-sucking
parasites, which are active in Sweden from March until November.
Health Cost
Ticks like warm and slightly moist undergrowth, bushes and
meadows with long grass. Though they have few predators, 99
percent die because they sit in the wrong place or because of
high temperatures or low humidity. Ticks suck blood from deer,
birds, dogs or humans. In searching for a host, the tick displays
a behavior referred to as ``questing.''
``Ticks are cute and very sociable,'' said Gustafson.
``Ticks have been around for a hundred million years. They're so
old, they used to feed from dinosaur blood.''
In Europe, tick-born encephalitis is primarily found in
Sweden, Germany, Austria, the Baltic countries and Eastern
Europe, according to the World Health Organization.
A case of TBE costs Sweden as much as 500,000 kronor
($63,000). A TBE shot, which isn't reimbursed by the state, costs
250 kronor, said Gustafson, a 52-year-old who works for Baxter in
Sweden. Baxter, which is based in Deerfield, Illinois, controls
85 percent of the TBE vaccine market in Sweden.
