I. ricinus is the primary vector for the TBEV-Eur transmission to humans, although foodborne transmission (mainly through contaminated unpasteurised milk) is occasionally reported ( 13 to 15). For zoonoses or vector-borne disease, is the animal host or vector present in the UK? Outcome We asked testers to use the product on at least five occasions and record their observations, including how long the effectiveness of the repellent seemed to last, if the tester experienced any bug bites, and if the scent or feel of the product on the skin was notable or unpleasant. Outcomes are specified with (Outcome) beside the appropriate answer. Question 1. Is this a recognised human disease? Yes

verifyErrors }}{{ message }}{{ /verifyErrors }}{{ This section of the assessment examines the likelihood of an infectious threat causing infection in the UK human population. Where a new agent is identified, there may be insufficient information to carry out a risk assessment and this should be clearly documented. The impact of infection in the UK population is considered very low. Question 5. Does it cause severe disease in humans? Yes The recently described TBEV-Bkl found in East Siberia and Him-TBEV has been found in the Qinghai-Tibet Plateau in China ( 4).In addition, PHE’s Rare and Imported Pathogens Laboratory is also evaluating different diagnostic tests and will be developing a specific set of guidance for the investigation and management of Lyme disease in the UK. Prevention of Lyme disease is one of the most effective ways of managing this infection. PHE is also working towards raising awareness of the signs and symptoms of Lyme disease among GPs and other healthcare professionals. It's not clear why this happens to some people and not others. This means there's also no agreed treatment. I. ricinus, both a reservoir and the vector of TBEV, is present and abundant throughout the UK ( 30).

Transmission of TBEV is highly reliant on co-feeding of nymphs and larvae, and a recent study has shown some evidence of co-infestation ( 27). The Advisory Committee on the Microbiological Safety of Food noted when assessing the above FSA risk assessment that it would be sensible to mark this subject for revisiting in the future when more data is available, potentially covering a broader geographical area and a longer time period. Following an asymptomatic interval of around 7 days, there is a second clinical phase involving the CNS with presentations such as meningitis, meningoencephalitis, myelitis, paralysis and radiculitis ( 4).note 2] Includes susceptibility to animal-derived variants Question 10. Is the disease highly infectious in humans? Yes

The FSA has assessed the risk of infection with TBEV to consumers in these areas ( 51), as follows: You may need to be retested if you still have Lyme disease symptoms after a negative result. Treatment from a GPThe probability of infection in the UK population is considered very low. Question 3. Is this disease endemic in humans within the UK? Yes [note 1] Approximately a third of patients experience the second phase, and up to 20% of those with severe disease experience neurological sequelae. According to a 10-year follow-up survey, 80% of patients with primary myelitic disease will remain with sequelae ( 44). Overall, the mortality rate is 0.5% to 2% ( 4). Would a significant number of people be affected? Outcome Dr Tim Brooks, Head of PHE’s Rare and Imported Pathogens Laboratory ( RIPL) which tests samples for Lyme disease, said: The antibiotics you're given will depend on your symptoms, but you may need to take them for up to 28 days. It's important to finish the course, even if you start to feel better. Most people with Lyme disease get better after antibiotic treatment. This can take months for some people, but the symptoms should improve over time.