Estimating the annual burden of tick-borne encephalitis to inform vaccination policy, Slovenia, 2009 to 2013

Fafangel, Mario; Cassini, Alessandro; Colzani, Edoardo; Klavs, Irena; Vitek, Marta Grgič; Učakar, Veronika; Muehlen, Marion; Vudrag, Marko; Kraigher, Alenka

doi:10.2807/1560-7917.es.2017.22.16.30509

Cited by 23 publications

(22 citation statements)

References 35 publications

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“…For example, a recent Scientific Opinion by the European Food Safety Authority recommended using the BCoDE approach for ranking risks [ 56 ]. Another example is the Slovenian national estimation of the burden of tick-borne encephalitis that identified age groups with the highest DALYs in order to inform vaccination strategies [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013

et al. 2018

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Background and aimsThe Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and European Economic Area (EEA). Methods: DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessment of data availability and quality, and a correction was applied for under-estimation. Calculation of DALYs was performed with the BCoDE software toolkit without applying time discounting and age-weighting. Results: We estimated that one in 14 inhabitants experienced an infectious disease episode for a total burden of 1.38 million DALYs (95% uncertainty interval (UI): 1.25–1.5) between 2009 and 2013; 76% of which was related to the acute phase of the infection and its short-term complications. Influenza had the highest burden (30% of the total burden), followed by tuberculosis, human immunodeficiency virus (HIV) infection/AIDS and invasive pneumococcal disease (IPD). Men had the highest burden measured in DALYs (60% of the total), adults 65 years of age and over had 24% and children less than 5 years of age had 11%. Age group-specific burden showed that infants (less than 1 year of age) and elderly people (80 years of age and over) experienced the highest burden. Conclusions: These results provide baseline estimates for evaluating infectious disease prevention and control strategies. The study promotes an evidence-based approach to describing population health and assessing surveillance data availability and quality, and provides information for the planning and prioritisation of limited resources in infectious disease prevention and control.

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Section: Discussionmentioning

confidence: 99%

Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013

et al. 2018

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“…In the second phase of disease, the clinical spectrum of TBE goes from mild meningitis to severe form of encephalitis with, or without myelitis and spinal paralysis. Neurological symptoms in this stage, in principle, do not differ from other types of acute CNS infections [1,5,29,30], but the severity of the disease correlates with the age [23,30,31]. Our study revealed that the mean age of patients with easier clinical form of disease (meningitis) was lower in relation to the patients with severe clinical form of TBE (meningoencephalitis and meningoencephalomyelitis) (30 years vs. 53 years).…”

Section: Discussionmentioning

confidence: 50%

Tick-borne encephalitis in Serbia: A case series

Poluga¹,

Barać²,

Katanic³

et al. 2019

J Infect Dev Ctries

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Introduction: In the Europe, the number of tick-borne encephalitis (TBE) has been increased in the last decade, and the number of endemic areas has been also increased and is still growing. In the present case series, we present clinical and socio-epidemiological data of patients with TBE hospitalized in the period of TBE virus epidemic in Serbia. Methodology: A case series was conducted in Serbia in 2017. Patients with confirmed TBE were included in the study. Biochemical and serological analysis of blood and CSF, as well as radiological imaging (CT and MRI) were done. Results: In total, 10 patients with TBE were included in the study. M:F ratio was 1.5:1, while average age was 45.1 years. Half of the patients had severe clinical picture. Endocranial CT scan and MRI did not reveal any abnormality, except in the patient with the most severe CNS infection (meningoencephalomyelitis). Mean value of sedimentation and CRP was slightly elevated (29.6 mm/1hours and 20.1 mg/L, respectively) in 80% of the patients, although elevation was almost negligible. The average number of leucocytes in the cerebrospinal fluid (CSF) was 171×106/L, the mean value of the CSF protein was 1.1g/L. There were no fatal outcomes. Conclusion: Since other CNS infections have similar clinical picture and CSF finding as TBE, serological analysis for TBE should be included in routine diagnostic practice.

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“…Once it has occurred, TBEV infection can lead to severe and sometimes lasting ill health effects and even death, with a mortality rate of 1% reported for the Western type that is prevalent in Germany. This of course is linked to a considerable use of medical resources [1,6–8]. The available vaccines, Encepur ® by GSK and FSME Immun ® by Pfizer, fortunately offer very good protection and are safe, with more than 98% of patients completing the basic vaccination schedule exhibiting seroconversion [9].…”

Section: Introductionmentioning

confidence: 99%

Tick-borne encephalitis virus infections in Germany. Seasonality and in-year patterns. A retrospective analysis from 2001-2018

et al. 2019

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BackgroundLittle is known regarding the changing seasonality of infections with the tick-borne encephalitis virus (TBEV) and the incidence of the resulting disease over the last two decades. Seasonal patterns have to our knowledge not previously been systematically investigated and are poorly understood. We investigate emerging seasonal changes in clinical aspects like potentially increasing hospitalization during the year, variations in clinical symptoms and disease severity during the season and seasonal dynamics of fatal outcomes.Material and methodsTBEV infection became a notifiable disease in Germany in 2001. We used the national reporting dataset spanning from 2001–2018, provided by the Robert Koch-Institute (RKI). There were general epidemiological variables available, including “symptom onset”, “age” and “sex”. Furthermore, several variables documented disease severity. These included “CNS symptoms”, “myelitis”, “fatal outcome” and “hospitalization”. Potential factors influencing the occurrence of CNS symptoms, myelitis, hospitalizations and fatal outcome were analyzed using logistic regression models. Linear trends, including the “time point in year” at which TBEV infection related symptoms were detected, were tested using calendar year as a continuous covariate. In addition, seasonal trends and age and sex specific differences were exploratively tested for non-linear effects using restricted cubic splines with knot locations based on Harrell's recommended percentiles. Finally, the dynamic relationship between in-seasonal trends year of detection, sex and age was tested using interaction terms.Results6,073 TBEV infection cases from 2001–2018 were included in our analysis. We find that from 2001–2018 TBEV infections are reported 0.69 days earlier each year (p<0.001). There was no detectable seasonal variation regarding the occurrence of fatal outcome, CNS and myelitis. However, there was a significant changing trend regarding hospitalizations over the course of the year: The risk for hospitalization increases until August, decreases again from October on.ConclusionWe present epidemiological evidence that the TBE season in Germany has shifted to start earlier over the last years, beginning approximately 12 days earlier in 2018 than it did in 2001. There are seasonal patterns regarding a higher risk of hospitalization during August.

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Estimating the annual burden of tick-borne encephalitis to inform vaccination policy, Slovenia, 2009 to 2013

Cited by 23 publications

References 35 publications

Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013

Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013

Tick-borne encephalitis in Serbia: A case series

Tick-borne encephalitis virus infections in Germany. Seasonality and in-year patterns. A retrospective analysis from 2001-2018

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