A Fatal Tick Bite Occurring During the Course of Tick-Borne Encephalitis Vaccination

Abstract

In Western Europe tick-borne encephalitis virus infections with fatal outcome are rare, especially in children. We report the case of an adolescent who died of meningoencephalitis after a tick bite that occurred between the first 2 tick-borne encephalitis vaccinations. The case demonstrates the difficulty of differentiating possible adverse events associated with the immunization from symptoms of simultaneous infection with tick-borne encephalitis virus.

Tick‐borne encephalitis in patients vaccinated against this disease

“…The number of patients reported as developing vaccination breakthrough TBE is low [7][8][9][10][11][12][13][14][15][16][17][18][19], and information on this group is limited. The aim of this study was to determine the proportion of such patients and to compare the course and outcome in this group with findings in unvaccinated patients who developed TBE.…”

The neurovirulence and neuroinvasiveness of chimeric tick-borne encephalitis/dengue virus can be attenuated by introducing defined mutations into the envelope and NS5 protein genes and the 3′ non-coding region of the genome

“…Although TBEV vaccination in Austria has been highly successful, several practical concerns have arisen with use of the inactivated virus vaccines, including the long schedule of primary immunization, the need for repeated booster vaccinations due to the relatively short duration of immunity, and the high cost of manufacture, all of which contribute to the relatively high cost of immunization. Furthermore, the lower immune responsiveness in the elderly and the rare occurrence of severe TBE disease due to incomplete protection of vaccinees in endemic areas are also of concern with the inactivated virus vaccines (Andersson et al, 2010; Bender et al, 2004; Brauchli et al, 2008; Kleiter et al, 2006; Plisek et al, 2008). Use of a live attenuated TBEV vaccine that induces long-lasting protective immunity is the most likely alternative approach to prevent TBE, since one or two doses of live attenuated yellow fever (YF) virus 17D vaccine (Monath, 2005) and Japanese encephalitis (JE) virus SA 14-14-2 vaccine (Halstead and Tsai, 2004) have been shown to provide immunity for at least ten years.…”

Antibody persistence after two vaccinations with either FSME-IMMUN® Junior or ENCEPUR® Children followed by third vaccination with FSME-IMMUN® Junior

“…1,2 Although TBE in children is generally considered a milder illness than among adults, there have been a number of severe cases reported in the pediatric population. [3][4][5][6] Despite strong evidence that TBE vaccines protect children and adolescents against clinical TBE, vaccine formulations and immunization strategies capable of ensuring optimal protection of the pediatric population combined with an acceptable tolerability profile are under continuous evaluation. 7 In Europe, two pediatric TBE vaccines are currently available on the market: FSME-IMMUN ® Junior (Baxter AG),…”