Tick-borne encephalitis (TBE) in France 2026: +53% cases, spread to the South and food risk — the prevention guide

Tick-borne encephalitis (TBE, also called FSME in German) is the most underestimated viral disease in France. Unlike Lyme borreliosis (bacterial) which 82% of French people know about, TBE is identified by only 12% of the population according to the OpinionWay / Pfizer poll of June 2026 — while it can leave lasting neurological sequelae in 40% of symptomatic adults and a vaccine exists. The Santé publique France bulletin of 12 May 2026 documents 98 cases notified in 2025, a 53% increase over 2024 (62 cases in 2024, 39 cases in 2023) — a trajectory that worries health authorities at a time when the virus is spreading to the South of France (first case in Lozère, progression in PACA and Occitanie) and when 45 of the 98 cases in 2025 are linked to the consumption of raw milk cheese. Here is what you need to understand, recognise, prevent, and what ProDeratisation can do for owners, building managers and managers of exposed sites.

TBE: what it is, and why it differs from Lyme

Tick-borne encephalitis is a viral disease caused by a flavivirus transmitted by the saliva of the Ixodes ricinus tick (the same species that transmits Lyme borreliosis). The virus circulates in the tick and is injected within the first minutes of the bite — whereas Borrelia (Lyme) takes 36 to 48 hours to migrate from the tick's gut to its salivary glands. In other words: you don't have time to remove the tick in time for TBE as you may for Lyme. This is the first major difference to grasp.

The TBE virus is also resistant to moderate cooking heat and survives in raw milk from infected goats, sheep or cows. This is the second route of contamination, identified in France since 2020 (Ain department). In 2025, 45 cases out of 98 involved consumption of raw milk cheese, in particular artisanal goat cheeses from Auvergne-Rhône-Alpes.

To remember: for Lyme, prevention relies on rapid tick removal. For TBE, prevention relies on vaccination (for exposed people), avoiding risk areas, cooking food and clothing protection.

Tick-borne encephalitis is also a notifiable disease in France since 2021, which has allowed a finer mapping of its progression.

The 2025-2026 figures that worry the authorities

The 2025 review published by Santé publique France on 12 May 2026 confirms the heavy trend:

| Year | Cases notified | Change | |---|---|---| | 2022 | 35 cases | low baseline | | 2023 | 39 cases | +11% | | 2024 | 62 cases | +59% | | 2025 | 98 cases | +53% |

• 84 patients out of 98 were hospitalised in 2025.
• 80% of patients developed a neurological form (meningitis, meningoencephalitis, encephalitis).
• 40% of symptomatic adults retain lasting neurological sequelae (cognitive disorders, chronic fatigue, partial paralysis, balance disorders).
• No deaths were reported in 2025, but lethality in severe forms is documented at 0.5 to 2% in the European literature.

Key ANSES 2025 figure: the annual cost of TBE in France is estimated at 3 million euros (hospitalisation, rehabilitation, work stoppages), while vaccination coverage is almost nil in the general population.

Map of TBE virus circulation areas in France, progressive extension to the South since 2020

Why the TBE virus is spreading: the triple conjunction of 2026

1. Climate change extends the tick's range

The Ixodes ricinus tick was historically confined to the eastern half of France and the North (Alsace, Lorraine, Franche-Comté, Auvergne-Rhône-Alpes, Jura, Alps). Heatwaves and rising average temperatures since 2020 now allow it to colonise the South:

• First indigenous case in Lozère (Occitanie) recorded in 2025.
• Detection of the virus in ticks captured in PACA (Bouches-du-Rhône, Var, Alpes-de-Haute-Provence).
• Climb in altitude: infected ticks have been found up to 1,700 m in the Alps, the Pyrenees and the Cévennes.
• Colonisation of the Massif Central, previously considered a buffer zone.

ANSES, in its opinion of 8 July 2025, warns that the area of TBE virus circulation will extend by a further 30 to 50% by 2035 if the current climate trajectory is confirmed.

2. The food route amplifies the spread

Transmission via raw milk and raw milk cheeses is a phenomenon identified in France since the first cluster of 2020 in the Ain. The mechanism:

• Goats, sheep or cows are bitten by infected ticks.
• The virus passes into the milk in the days that follow.
• Consumption of raw milk or raw milk cheeses that are not heat-treated (fresh goat, tomme, picodon, reblochon, farmhouse saint-nectaire) transmits the virus to humans.
• Contrary to popular belief, the virus resists acidification (vinegar, marinade) and domestic freezing. Only heating to 70°C for 2 minutes or industrial pasteurisation inactivates the virus.

In 2025, 45 cases out of 98 (46%) involved consumption of raw milk cheese, mainly in farms, producer markets and guest tables in Auvergne-Rhône-Alpes (Ain, Savoie, Haute-Savoie, Isère, Ardèche, Drôme).

Concrete case cited by ANSES: in July 2025, a family cluster of 4 cases was identified in Haute-Savoie after consumption of a farmhouse goat cheese bought directly from the farm. Three of the four patients developed meningoencephalitis with 10 to 21 days of hospitalisation.

3. Tourist mobility spreads exposure

Summer holidays take millions of French people every year to endemic areas (Alsace, Vosges, Jura, Alps, Massif Central, Auvergne, Ardèche). International mobility (German-speaking Switzerland, Austria, southern Germany, northern Italy — all high-endemicity TBE countries) adds an extra layer of exposure. France also attracts tourists from these areas, and some "travelling" ticks are found in luggage or clothing.

Symptoms: a two-phase disease

TBE typically progresses in two phases, which sometimes makes diagnosis difficult at the start.

Phase 1 (days 2 to 7 after the bite): flu-like syndrome

• Sudden fever (38.5 to 40°C)
• Intense headaches
• Aches, fatigue, general malaise
• Sometimes nausea, vomiting

This phase lasts 2 to 7 days and heals spontaneously in 70 to 80% of cases. The patient thinks they have a flu or a summer heat stroke — hence the massive under-diagnosis.

Phase 2 (days 7 to 14): neurological involvement

In 20 to 30% of cases, after a few days of improvement, a second febrile wave occurs with involvement of the central nervous system:

• Meningitis (50% of neurological forms): neck stiffness, photophobia, headaches
• Meningoencephalitis (40%): consciousness disorders, disorientation, convulsions
• Encephalomyelitis (10%): paralyses, swallowing disorders, respiratory involvement

This phase requires hospitalisation with lumbar puncture, brain MRI and symptomatic treatment. There is no curative antiviral treatment: only prevention (vaccine) is effective.

Documented sequelae: out of 100 adults who had a neurological form of TBE, 40 will retain sequelae at 12 months: chronic fatigue, cognitive disorders (memory, attention), recurrent headaches, balance disorders, partial paralyses. 20% report a lasting alteration in their quality of life.

The TBE vaccine: why France is behind

Two vaccines are available in France:

• TICOVAC (Pfizer) — adult and paediatric form (from 1 year old)
• ENCEPUR (Bavarian Nordic / Valneva)

The standard vaccination schedule is 3 doses (M0, M1 to M3, M5 to M12) with a booster every 3 to 5 years depending on age.

The French situation in 2026

• Vaccination coverage is estimated at less than 1% of the French population, against 80 to 90% in Austria (a country that generalised vaccination in the 1980s and today observes fewer than 100 cases/year).
• The vaccine is recommended in France by the Haut Conseil de la santé publique (HCSP) only for exposed professionals (foresters, livestock farmers, game keepers, veterinarians) and travellers going to endemic areas.
• The HAS is evaluating in 2026 the opportunity to extend the recommendation to regular hikers, walkers, owners residing in endemic areas, and children living in rural areas — similar to what has been done in German-speaking Switzerland.

Frequently asked question: "If I am bitten by a tick in the Forest of Fontainebleau and I don't have the vaccine, what should I do?" Answer: monitor for 4 weeks (as for Lyme), consult a doctor for any flu-like or neurological symptoms within 14 days of the bite, and report the bite on signalement-tique.fr (CiTIQUE / INRAE programme).

The particular case of Île-de-France: to be closely monitored

Île-de-France is not yet considered a TBE endemic area, but surveillance is intensifying:

• Ixodes ricinus ticks are present in all the forested massifs of Île-de-France (Fontainebleau, Rambouillet, Sénart, Chevreuse, Meudon, Carnelle, Notre-Dame).
• The CiTIQUE / INRAE programme regularly receives reports of bites in Île-de-France forests.
• No TBE viral circulation has yet been detected in ticks from Île-de-France (2024-2025 data), but the virus is present in the neighbouring Ardennes and the upward progression to the Paris Basin is not excluded by 2030.
• Consumption of raw milk cheeses from Île-de-France (farms in Brie, Gâtinais, Chevreuse valley) remains a point of vigilance: raw milk sourcing from outside the region is possible all year round.

For Île-de-France residents who hike in endemic areas (Vosges, Alsace, Jura, Alps, Massif Central) during summer 2026, TBE vaccination is recommended: talk to your doctor or to an international vaccination centre before departure.

How to protect yourself in 2026: the complete method

For walkers, hikers and trail runners

• TBE vaccination: recommended for anyone staying in an endemic area (Alsace, Lorraine, Franche-Comté, Auvergne-Rhône-Alpes, Alps, PACA, Switzerland, Austria, southern Germany, northern Italy). 3 doses over 6 to 12 months, booster every 3 to 5 years. Can be started on an accelerated schedule (3 doses over 3 weeks) in case of imminent departure.
• Covering and light clothing: trousers tucked into socks, long sleeves, closed shoes.
• Skin repellents based on DEET 30-50% or icaridin 20%.
• Mutual inspection on return (warm areas: armpits, elbow creases, behind the knees, scalp, navel, groin).
• Shower within 2 hours of the outing.
• Wash clothes at 60°C minimum, or tumble dryer 1 hour on high heat.
• Tick remover from the pharmacy: in case of an attached tick, immediate removal with gentle rotation (but does not replace the 4-week monitoring: for TBE, the virus is injected within the first minutes).

HAS 2025 note: permethrin on clothing is no longer recommended in the general population in France (toxicological risks). Prefer AMM skin repellents.

For consumers of raw milk cheese

• Cook raw milk to 70°C for at least 2 minutes before consumption.
• Avoid farm raw milk cheeses that are not heat-treated in endemic areas (Ain, Savoie, Haute-Savoie, Isère, Ardèche, Drôme) in the absence of pasteurisation attested by the producer.
• Ask the producer if the milk has been pasteurised or thermised.
• Prefer cooked pressed cheeses (comté, emmental, beaufort) whose manufacture includes heating to over 50°C.
• Children under 5, pregnant women, immunocompromised persons should not consume unpasteurised raw milk cheese, in accordance with ANSES recommendations.

For owners of wooded estates, managers of natural sites, local authorities

This is where ProDeratisation intervenes upstream of exposure, in addition to individual measures:

• Tick and TBE risk diagnosis: mapping of questing areas, identification of tick hotspots (edges, clearings, tall grass, deer areas), assessment of the risk of exposure for users.
• Integrated management plan: maintenance schedule (mowing, brush cutting, pruning), creation of dry barriers, management of rodent populations (reservoirs), treatment of domestic animals.
• Reasoned rodent control of areas where rodents maintain the Ixodes-Borrelia cycle (field mice, voles, rats).
• Communication protocol: multilingual signage, signposted trails, information for users and children.
• Veterinary and medical partnerships for tick reporting (CiTIQUE / INRAE) and the provision of tick first aid kits (tick remover, antiseptic) on sites open to the public.
• Training: awareness-raising of staff (forest rangers, sports educators, holiday camp leaders, teachers, municipal officers) in the removal method, post-bite monitoring, and referral of suspected cases for consultation.

When to call on ProDeratisation

Our job is parasitic and vector risk management. For the tick / TBE issue, we intervene mainly upstream of exposure, supporting owners of wooded estates, building managers, green space managers, farmers, golf courses, equestrian centres, leisure bases, holiday camps and local authorities:

For individuals, we provide advice on garden layout and management of rodent shelters. For the regulatory framework of pest control and the responsibility of owners, see our article on mandatory pest control in co-ownerships and restaurants and our guide to the cost of professional pest control in 2026.

To put the tick issue in the broader summer context of pest proliferation in summer 2026, see also our pest control and heat: why rodents are swarming this summer and our complete guide on ticks and Lyme disease in France in July 2026, which details the removal method, erythema migrans and post-bite monitoring.

For the other vector risks active in France at the same time, see our West Nile virus: first indigenous case in France, July 2026 and our analysis tiger mosquito and chikungunya: record of cases in July 2026.

In summary

• ✅ Tick-borne encephalitis (TBE) affected 98 people in France in 2025, up 53% on 2024 (Santé publique France data, May 2026).
• ✅ 80% of patients develop a neurological form; 40% of symptomatic adults retain lasting sequelae.
• ✅ The virus is spreading to the South: first case in Lozère (2025), progression in PACA and Occitanie, climbing to 1,700 m altitude.
• ✅ 45 cases out of 98 in 2025 are linked to consumption of raw milk cheese, mainly in Auvergne-Rhône-Alpes.
• ✅ The virus is injected within the first minutes of the bite: rapid tick removal is not enough as it can be for Lyme.
• ✅ Vaccine available (TICOVAC, ENCEPUR) — French vaccination coverage < 1%, against 80-90% in Austria.
• ✅ The HAS is evaluating in 2026 extending the vaccination recommendation to hikers and owners residing in endemic areas.
• ✅ Prevention: covering clothing, DEET 30-50% repellents, inspection on return, shower within 2 hours, cooking raw milk to 70°C, vaccination for exposed people.
• ✅ ANSES recommends strengthening surveillance, broad information and further research on circulating strains.

The TBE risk is not a subject for alarmism, but a subject of active vigilance that requires clear information (only 12% of French people know the disease) and wider access to vaccination. For owners, building managers, managers of natural or leisure sites who want to set up a tick management plan on their land, ProDeratisation operates throughout Île-de-France (Paris, Hauts-de-Seine, Seine-Saint-Denis, Val-de-Marne, Seine-et-Marne, Yvelines, Essonne, Val-d'Oise) for diagnosis, advice and risk management.

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