Tick-borne encephalitis in children

Kevin, Rostasy

doi:10.1007/s10354-012-0101-4

Cited by 17 publications

(12 citation statements)

References 25 publications

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“…The disease is fatal in less than 1% of European subtype TBE cases, but the lethality of the two Eastern TBEV subtypes is much higher [1]. In elder patients, severe disease courses are more frequent than in children, but severe courses also occur in children (for review see [4,5]). It has not been systematically resolved, whether antibody-dependent enhancement (ADE) may have taken place in some childhood TBE cases after post-exposure prophylaxis [6-8], as it has been described for secondary DENV infection.…”

Section: Introductionmentioning

confidence: 99%

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May early intervention with high dose intravenous immunoglobulin pose a potentially successful treatment for severe cases of tick-borne encephalitis?

Růžek

Dobler²,

Niller

2013

BMC Infect Dis

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BackgroundArthropod-borne viral encephalitis of diverse origins shows similar clinical symptoms, histopathology and magnetic resonance imaging, indicating that the patho mechanisms may be similar. There is no specific therapy to date. However, vaccination remains the best prophylaxis against a selected few. Regardless of these shortcomings, there are an increasing number of case reports that successfully treat arboviral encephalitis with high doses of intravenous immunoglobulins.DiscussionTo our knowledge, high dose intravenous immunoglobulin has not been tested systematically for treating severe cases of tick-borne encephalitis. Antibody-dependent enhancement has been suspected, but not proven, in several juvenile cases of tick-borne encephalitis. Although antibody-dependent enhancement during secondary infection with dengue virus has been documented, no adverse effects were noticed in a controlled study of high dose intravenous immunoglobulin therapy for dengue-associated thrombocytopenia. The inflammation-dampening therapeutic effects of generic high dose intravenous immunoglobulins may override the antibody-dependent enhancement effects that are potentially induced by cross-reactive antibodies or by virus-specific antibodies at sub-neutralizing levels.SummaryAnalogous to the increasing number of case reports on the successful treatment of other arboviral encephalitides with high dose intravenous immunoglobulins, we postulate whether it may be possible to also treat severe cases of tick-borne encephalitis with high dose intravenous immunoglobulins as early in the course of the disease as possible.

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Section: Introductionmentioning

confidence: 99%

“…Widespread lesions in the CNS may involve gray matter and leptomeninges of the brain stem, medulla oblongata, nuclei, cerebellum and spinal cord (for review see [4,5]). A prominent perivascular infiltration by activated inflammatory cells such as macrophages and leukocytes is observed.…”

Section: Introductionmentioning

confidence: 99%

May early intervention with high dose intravenous immunoglobulin pose a potentially successful treatment for severe cases of tick-borne encephalitis?

Růžek

Dobler²,

Niller

2013

BMC Infect Dis

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“…In TBEV-infected children, meningitis is the most common form of CNS inflammation. 6 Although TBEV infections in children are purported to be generally milder than in adults, infections in children may result in severe neurological disease and long-term sequelae and death. [6][7][8][9][10][11] When children with TBE were followed for >4 years in Sweden, two-thirds of infected children experienced residual problems including cognitive disorders.…”

mentioning

confidence: 99%

“…6 Although TBEV infections in children are purported to be generally milder than in adults, infections in children may result in severe neurological disease and long-term sequelae and death. [6][7][8][9][10][11] When children with TBE were followed for >4 years in Sweden, two-thirds of infected children experienced residual problems including cognitive disorders. 11 A recent review provided a summary of the subjective complaints and neurologic dysfunction impacting daily life and school performance following TBEV infection in children.…”

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confidence: 99%

Effectiveness of Tick-borne Encephalitis Vaccines in Children, Latvia, 2018–2020

Zavadska,

Freimane,

Karelis

et al. 2023

Pediatric Infectious Disease Journal

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Background: Tick-borne encephalitis (TBE) is an infection by the tick-borne encephalitis virus (TBEV) with symptoms of central nervous system inflammation. TBE is endemic in Latvia and other parts of Europe. TBE vaccination is recommended for children in Latvia. TBE vaccine effectiveness (VE) was estimated in Latvia, a country with high TBE incidence, providing the first VE estimates against a range of TBEV infection outcomes in children 1–15 years-of-age. Methods: Rīga Stradinš University conducted nationwide surveillance for suspected TBE cases. Serum and cerebrospinal fluid were ELISA tested for TBEV-specific IgG and IgM antibodies. A fully vaccinated child was an individual who had received the 3-dose primary series and appropriately timed boosters. The proportion of laboratory-confirmed TBE cases fully vaccinated (PCV) was determined from interviews and medical records. The proportion of the general population fully vaccinated (PPV) was determined from national surveys conducted in 2019 and 2020. TBE VE in children 1–15 years-of-age was estimated using the screening method: VE = 1 − [PCV/(1 − PCV)/PPV/(1 − PPV)]. Results: From 2018 to 2020, surveillance identified 36 TBE cases in children 1–15 years-of-age; all were hospitalized, 5 (13.9%) for >12 days. Of the TBE cases, 94.4% (34/36) were unvaccinated compared with 43.8% of children in the general population. VE against TBE hospitalization in children 1–15 years-of-age was 94.9% (95% confidence interval 63.1–99.3). In 2018–2020, vaccination in children 1–15 years-of-age averted 39 hospitalized TBE cases. Conclusion: Pediatric TBE vaccines were highly effective in preventing TBE in children. Increasing TBE vaccine uptake in children is essential to maximize the public health impact of TBE vaccination.

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“…Meist besteht eine anfangs granulozytäre, später lymphozytäre Pleozytose sowie eine Störung der Blut-Liquor-Schrankenfunktion Die MRT hilft vor allem zur differenzialdiagnostischen Abgrenzung gegenüber der HSV-Enzephalitis Fieber, Kopfschmerzen und Anfälle werden symptomatisch behandelt Bis zu 58 % der über 15-Jährigen wiesen nach der akuten Erkrankung langwierige und z. T. auch dauerhafte Funktionsstörungen auf CME Die Prognose zeigt eine gute Korrelation zum akuten klinischen Verlauf: Schwere neurologische Funktionsstörungen heilen häufig unvollständig aus. Da das Ausmaß der Veränderungen von Laborbefunden keine Rückschlüsse auf die Prognose erlaubt, sind -unter gutachterlichem Aspekt -frühzeitig detaillierte Dokumentationen des neurologischen Befundes und neuropsychologische Testungen erforderlich.Während in früheren Studien bei Kindern und Jugendlichen nur in einem geringen Teil über anhaltende neurologische Defizite (epileptische Anfälle, Paresen, Ataxie, Lernbehinderung, Verhaltensauffälligkeiten) berichtet wurde, weisen aktuelle Untersuchungen auf die häufigen kognitiven Störungen auch in dieser Altersgruppe hin[28, 32, 34, 39, 40, 53, 78,79,80,81,82,83,84,85]. Dennoch ist die Gesamtprognose bei Kindern und Jugendlichen günstiger als im Erwachsenenalter.ExpositionsprophylaxeWer sich in Zeckengebieten aufhält, sollte möglichst helle, geschlossene Kleidung tragen, auf der die Zecken gut zu erkennen sind.…”

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Frühsommermeningoenzephalitis

Kaiser

2016

Nervenarzt

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Tick-borne encephalitis (TBE) is one of the most important viral infections of the human central nervous system. Approximately 10,000 cases of TBE are referred to hospitals in Europe and Asia each year. The TBE virus (TBEV) is mainly transmitted by tick bites but also occasionally by unpasteurized goat's milk. As in endemic areas on average only 1-3 % of ticks are infected with the TBEV and the clinical manifestation rate is approximately 33 %, only approximately 1 in every 100-300 tick bites leads to disease. The incubation period varies from 5-28 days and typically has a biphasic course of fever. The TBE manifests as meningitis in approximately 50 % of patients, as meningoencephalitis in 40 % and as encephalomyelitis in 10 %. The suspected diagnosis is confirmed by the demonstration of TBEV-specific IgM and IgG antibodies in serum and the presence of elevated cell counts in cerebrospinal fluid. No specific treatment for TBE is known but it can be successfully prevented by active immunization.

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Tick-borne encephalitis in children

Cited by 17 publications

References 25 publications

May early intervention with high dose intravenous immunoglobulin pose a potentially successful treatment for severe cases of tick-borne encephalitis?

May early intervention with high dose intravenous immunoglobulin pose a potentially successful treatment for severe cases of tick-borne encephalitis?

Effectiveness of Tick-borne Encephalitis Vaccines in Children, Latvia, 2018–2020

Frühsommermeningoenzephalitis

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