In nearly all patients, IgM and IgG antibodies can be detected at the time of presentation for medical care; the antibody titer may reach its maximum level by the first blood test. Thus, the administration of IgG concentrates is unlikely to be of benefit to the patient’s immune defence at that time and is limited to administration for up to 48 hours after the tick bite. Therefore, IgG is not available any more in European countries. Especially in children the benefit-risk ratio may be negative and therefore, TBE immunoglobulin must not be used for post-exposure prophylaxis in children and adolescents up to the age of 14 years.

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