Aggregated data on TBE cases in Latvia are available from 1955,1 but serological testing for TBE began in the 1970s.2 Since TBE became notifiable in Latvia, epidemiological changes of disease incidence have been dramatic. Between 1990–2000 Latvia had the highest rates of TBE incidence in the world, ranging from 8 to 53 cases per 100,000 population.2 Although the incidence has decreased significantly in the past 10 years to about half – from 14.58/100,000 in 2010 to 7.86/100,000 in 2018 – Latvia still ranks very high among all countries in Europe with an annual incidence of 12.67/100,000 in 2022. The distribution of TBE cases in Latvia varies between different regions with the highest incidence usually registered near the northwestern coast.