Sweden. Risk is concentrated along coastal areas and the archipelago, particularly in the Stockholm and Kalmar regions. Sweden has expanded its at-risk zone designation in recent years. Recommended for kayaking, cabin stays, and coastal hiking in endemic areas during tick season.
Finland. Risk is present in the southwestern archipelago and coastal regions, particularly the Aland Islands and Turku archipelago. Recommended for travelers to these areas between April and November.
Norway. Lower risk than Sweden or Finland but documented cases in southern coastal zones. Worth discussing for extended outdoor itineraries in southern Norway.
Russia. Widespread risk across Siberia and the Russian Far East, where the Siberian and Far Eastern subtypes circulate and carry higher mortality than the European subtype. Risk is also present in European Russia. Strongly recommended for any rural travel, Trans-Siberian rail journeys with stops in forested towns, or nature tourism anywhere in Russia.
China. The Far Eastern subtype is present in northeastern China, particularly Heilongjiang, Jilin, and Inner Mongolia provinces. Recommended for travelers to forested rural areas in these regions.
Japan. The Far Eastern subtype has been reported from Hokkaido. Risk is low but present for hikers and outdoor workers in forested areas of northern Japan. Recommended for extended outdoor travel in Hokkaido.
Mongolia. TBE risk is documented, particularly in forested northern and central Mongolia. Recommended for travelers venturing outside Ulaanbaatar into rural steppe or forested areas.
Kazakhstan and Central Asia. TBE activity is documented in parts of Kazakhstan and neighboring Central Asian countries, particularly in forested or semi-forested zones. Risk is geographically focal. Discuss with your travel medicine provider based on your specific itinerary.
TBE is not present in Southeast Asia, South Asia, Africa, the Americas, or the Middle East. If your travel is limited to these regions, TBE vaccination is not indicated. Risk maps shift as surveillance improves and climate changes expand tick ranges. We review current CDC and ECDC guidance for your specific itinerary at your appointment.