EAN consensus review on prevention, diagnosis and management of tick‐borne encephalitis

Taba, Pille; Schmutzhard, Erich; Forsberg, Pia; Lutsar, Irja; Ljøstad, Unn; Mygland, Åse; Левченко, И Л; Strle, F.; Steiner, Israel

doi:10.1111/ene.13356

Cited by 170 publications

(221 citation statements)

References 238 publications

(468 reference statements)

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“…Transmitted by infected ticks, this virus may cause severe neurological symptoms in a form of encephalitis or meningoencephalitis, eventually leading to death or serious disabilities. Over ten thousand cases are registered annually despite the availability of vaccines, and small molecule compounds comprise a promising and highly expected treatment option …”

Section: Introductionsupporting

confidence: 77%

“…Furano[2, 3‐ d ]pyrimidine nucleosides 6 ‐ 9 and their synthetic precursor analogue 10 showed a specific pattern of antiviral activity. These compounds were previously assessed for inhibition of reproduction of HCV and BVDV (RNA viruses, Flaviviridae family) . The only active compound in these assays was 9 , with EC 50 of 1.9 μM against BVDV and moderate HCV inhibition at 100 μM, without inhibition of RNA‐dependent RNA polymerase NS5B and RNA helicase NS3.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Selective Inhibition of Enterovirus A Species Members’ Reproduction by Furano[2, 3‐d]pyrimidine Nucleosides Revealed by Antiviral Activity Profiling against (+)ssRNA Viruses

et al. 2018

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The rational design of broad‐spectrum antivirals requires data on antiviral activity of compounds against multiple viruses, which are often not available. We have developed a panel of (+)ssRNA viruses composed of Enterovirus and Flavivirus genera members allowing to study these activity spectra. Antiviral activity profiling of a set of nucleoside analogues revealed N4‐hydroxycytidine as an efficient inhibitor of replication of coxsackieviruses and other enteroviruses, but ineffective against tick‐borne encephalitis virus. Furano[2, 3‐d]pyrimidine nucleosides with n‐pentyl or n‐hexyl tails showed selective inhibition of Enterovirus A representatives. 5‐(Tetradec‐1‐yn‐1‐yl)‐uridine showed selective inhibition of tick‐borne encephalitis virus at the micromolar level.

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Section: Introductionsupporting

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Selective Inhibition of Enterovirus A Species Members’ Reproduction by Furano[2, 3‐d]pyrimidine Nucleosides Revealed by Antiviral Activity Profiling against (+)ssRNA Viruses

et al. 2018

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“…None of the patients had been vaccinated against TBE. Disease was diagnosed based on the clinical picture, presence of inflammatory parameters in the CSF (Table ), and specific antibodies in serum and CSF according to the case definition that is: the presence of clinical signs of meningitis, meningoencephalitis or meningoencephalomyelitis, an epidemiological link, CSF pleocytosis (>5 cells/dl), and demonstration of recent TBEV infection by the presence of specific serum IgM and IgG antibodies (Taba et al, ).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of NSE and S100B in patients with tick‐borne encephalitis

et al. 2018

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IntroductionThe aim of this study was the assessment of neuron‐specific enolase (NSE) and S‐100 concentration in serum and cerebrospinal fluid (CSF) in patients with different clinical forms of tick‐borne encephalitis (TBE).Material and MethodsThe serum and CFS concentrations of S100B and NSE of 43 patients with TBE were measured with ELISA method using commercial kits: NSE and S100B Elisa Kit (DRG, Germany). Subjects were divided into: Group I—patients with meningoencephalitis (n = 17) and Group II—patients with meningitis (n = 26). None of the patients reported any neurodegenerative disorder that could affect the results of the study. The control group (CG) consisted of 13 patients. These patients were admitted to the hospital because of headache, and the CSF examination excluded inflammatory process. Samples were collected on admission (sample 1) and after treatment (sample 2).ResultsNeuron‐specific enolase concentration in CSF was higher in group I than in group II (p = 0.0002) and controls (p = 0.04). NSE concentration was higher in the second serum and CSF sample in both groups. S100B concentration did not differ between TBE patients and controls. NSE concentration in serum after 14 days was higher in the sequelae group (34.3 ± 9.7 vs. 16.7 ± 15, p = 0.04). Also, NSE serum sample 2/serum sample 1 ratio was significantly higher in the sequelae group (3.57 ± 0.92 vs. 1.53 ± 1.99, p = 0.04). Receiver Operating Characteristic curve analysis indicated that NSE concentration in serum II differentiates sequelae group from other meningoencephalitis patients (p = 0.0001). S100B serum sample 2/CSF sample 2 ratio was lower in the sequelae group (0.05 ± 0.1 vs. 0.37 ± 0.28, p = 0.02).Conclusions(a) Neurodegeneration process is present in TBE encephalitis. (b) NSE concentration correlates with inflammatory parameters in CSF in TBE. (c) Neurodegeneration is present even after clinical recovery of TBE. (d) NSE could be used in the prediction of TBE course. (e) S‐100 did not differ between TBE patients and controls.

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“…Vaccination is an effective measure to prevent morbidity and mortality associated with infectious diseases. This is also the case for TBE where no specific therapy is approved and treatment is supportive only [6]. TBE is also endemic in all Austrian federal states and a vigorous vaccination campaign launched in 1981 can be regarded as a continuing success story [7].…”

Section: Introductionmentioning

confidence: 99%

“…A comprehensive study on TBE in Europe (5205 cases) reported that the condition developed in 87 patients (1.7%) despite those individuals receiving at least two primary vaccination courses [9]. The European vaccines are licensed for adults and children >1 years [6]. They require a primary series of three doses.…”

Section: Introductionmentioning

confidence: 99%

Clinical Challenges in a 49-Year-Old Patient with Severe Tick-Borne Myeloradiculitis Despite Complete Active Vaccination

et al. 2020

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Vaccination is an effective means to prevent infectious diseases including tick-borne encephalitis (TBE), an emerging Flavivirus infection. There is, however, only limited knowledge about risk of vaccination failure, the disease course and the challenges for work-up and care. Of note, there is evidence that patients with breakthrough disease experience a more severe disease course. We report the case of a previously healthy 49-year-old woman who developed severe myeloradiculitis caused by the TBE virus despite receiving a complete cycle of primary immunization and booster vaccinations within the recommended timeframe. The disease course was characterized by progressive tetraparesis, pain and bladder dysfunction and necessitated intensive care unit admission (ICU) and the escalation of pain management. This case raises awareness for the recognition of breakthrough disease in younger patients and reinforces the need to develop measures to identify patients with insufficient protection.

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EAN consensus review on prevention, diagnosis and management of tick‐borne encephalitis

Cited by 170 publications

References 238 publications

Selective Inhibition of Enterovirus A Species Members’ Reproduction by Furano[2, 3‐d]pyrimidine Nucleosides Revealed by Antiviral Activity Profiling against (+)ssRNA Viruses

Selective Inhibition of Enterovirus A Species Members’ Reproduction by Furano[2, 3‐d]pyrimidine Nucleosides Revealed by Antiviral Activity Profiling against (+)ssRNA Viruses

Evaluation of NSE and S100B in patients with tick‐borne encephalitis

Clinical Challenges in a 49-Year-Old Patient with Severe Tick-Borne Myeloradiculitis Despite Complete Active Vaccination

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