An outbreak of tick-borne encephalitis associated with raw goat milk and cheese consumption, Croatia, 2015

Markovinović, Leo; Ličina, Mirjana Lana Kosanović; Tešić, Vanja; Vojvodić, Daniela; Lucić, Ivona Vladušić; Kniewald, Tihana; Vukas, Tina; Kutleša, Marko; Krajinović, Lidija Cvetko

doi:10.1007/s15010-016-0917-8

Cited by 54 publications

(39 citation statements)

References 9 publications

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“…Based on the results of the epidemiological investigation, in the majority of cases TBE virus was transmitted by raw (unpasteurized) goat's milk/cheese (6,8,10,14,15). The question is whether the goats have more intense viraemia, longer lasting viraemia or merely goat's milk/cheese is more often consumed raw due to the belief that it is "healthier" this way (14). Fewer authors have reported the occurrence of TBEV in milk and/or cheese from sheep and cows (6)(7)(8)10).…”

Section: Discussionmentioning

confidence: 99%

“…Many authors indicate in their works the transmission of TBE by food (5,6,8,10,14,15). Kríz et al between 1997 and 2008 recorded 64 cases of TBE in patients who reported consumption of unpasteurized goat's milk (36 patients, 56.3%) or cheese from unpasteurized sheep's milk (21 patients, 32.8%).…”

Section: Discussionmentioning

confidence: 99%

“…Adjustments in local and regional policies should be made to consider shifting trends of food origin, preparation and distribution. Better coordination between veterinary and public health sectors should result in a prompt action of recognizing every emergence of foodborne infection and, consequently, reducing the burden of the disease in the population (14).…”

Section: Discussionmentioning

confidence: 99%

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Milk outbreaks of tick-borne encephalitis in Slovakia, 2012-2016

Dorko¹,

Hockicko²,

Rimárová³

et al. 2018

Cent Eur J Public Health

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Objective: Tick-borne encephalitis virus (TBEV) is most commonly transmitted to humans via the bite of an infected tick. Alimentary infection through the consumption of TBEV-contaminated dairy products is also well-documented and is responsible for some diseases in endemic areas. The aim of the study was to emphasize the risk of contracting tick-borne encephalitis (TBE) by consuming raw milk and dairy products and to describe TBE epidemics in Slovakia for the period 2012-2016.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Milk outbreaks of tick-borne encephalitis in Slovakia, 2012-2016

Dorko¹,

Hockicko²,

Rimárová³

et al. 2018

Cent Eur J Public Health

View full text Add to dashboard Cite

show abstract

“…TBEV is usually transmitted to humans via bites from infected ticks. However, oral transmission from the consumption of unpasteurised dairy products, the socalled alimentary route, has also been reported [13][14][15][16][17][18][19][20][21]. In these studies, the source of TBEV transmission was primarily either unpasteurised goat milk or cheese.…”

Section: Introductionmentioning

confidence: 99%

Revealing new tick-borne encephalitis virus foci by screening antibodies in sheep milk

et al. 2020

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Background: Tick distribution in Sweden has increased in recent years, with the prevalence of ticks predicted to spread towards the northern parts of the country, thus increasing the risk of tick-borne zoonoses in new regions. Tickborne encephalitis (TBE) is the most significant viral tick-borne zoonotic disease in Europe. The disease is caused by TBE virus (TBEV) infection which often leads to severe encephalitis and myelitis in humans. TBEV is usually transmitted to humans via tick bites; however, the virus can also be excreted in the milk of goats, sheep and cattle and infection may then occur via consumption of unpasteurised dairy products. Virus prevalence in questing ticks is an unreliable indicator of TBE infection risk as viral RNA is rarely detected even in large sample sizes collected at TBE-endemic areas. Hence, there is a need for robust surveillance techniques to identify emerging TBEV risk areas at early stages.Methods: Milk and colostrum samples were collected from sheep and goats in Örebro County, Sweden. The milk samples were analysed for the presence of TBEV antibodies by ELISA and validated by western blot in which milk samples were used to detect over-expressed TBEV E-protein in crude cell extracts. Neutralising titers were determined by focus reduction neutralisation test (FRNT). The stability of TBEV in milk and colostrum was studied at different temperatures. Results:In this study we have developed a novel strategy to identify new TBEV foci. By monitoring TBEV antibodies in milk, we have identified three previously unknown foci in Örebro County which also overlap with areas of TBE infection reported during 2009-2018. In addition, our data indicates that keeping unpasteurised milk at 4 °C will preserve the infectivity of TBEV for several days. Conclusions:Altogether, we report a non-invasive surveillance technique for revealing risk areas for TBE in Sweden, by detecting TBEV antibodies in sheep milk. This approach is robust and reliable and can accordingly be used to map TBEV "hotspots". TBEV infectivity in refrigerated milk was preserved, emphasising the importance of pasteurisation (i.e. 72 °C for 15 s) prior to consumption.

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“…Tick-borne encephalitis virus (TBEV) is one of the most frequent causes of the central nervous system infections in Europe, especially in endemic areas of Central and Eastern Europe and Russia (1,2). The epidemiology of TBE depends on various factors, such as increased recreational activities in areas infested by ticks, and climatic changes affecting tick habitats and in addition, anthropomorphic changes in agriculture and outdoor and free-time activities, increase the risk that humans will be infected TBE (2,6).…”

Section: Introductionmentioning

confidence: 99%

Serostatus and risk factors of tick-borne encephalitis

Bušová¹,

Dorko²,

Feketeová³

et al. 2018

Cent Eur J Public Health

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The aim of this seroepidemiological study was to determine the current prevalence of antibodies against tick-borne encephalitis virus (TBEV) in the representative group of Slovak population with included potential risk factors for TBEV. Methods: Representative group consisted of 428 persons (also with possible exposure to risk factors for tick bite or raw milk consumption). Serum samples were screened by commercial enzyme-linked immunosorbent assay (ELISA). The persons involved in the study completed questionnaires with general demographic, epidemiological and clinical data. During the analysis, we used linear regression to interpret the influence between selected variables. Results: We detected 1.2% prevalence of positive IgG and 1.6% prevalence of positive IgM antibodies in all tested groups. Our results also confirmed that the following risk factors such as tourism, hunting, fishing, and consumption of raw milk are significantly associated with the prevalence of specific antibodies against TBEV. Conclusion: The results of seroprevalence obtained by this study confirm the possibility of infection with TBEV among respondents exposed to possible contact with ticks.

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An outbreak of tick-borne encephalitis associated with raw goat milk and cheese consumption, Croatia, 2015

Cited by 54 publications

References 9 publications

Milk outbreaks of tick-borne encephalitis in Slovakia, 2012-2016

Milk outbreaks of tick-borne encephalitis in Slovakia, 2012-2016

Revealing new tick-borne encephalitis virus foci by screening antibodies in sheep milk

Serostatus and risk factors of tick-borne encephalitis

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