Tick-borne encephalitis in Europe, 2012 to 2016

Beauté, Julien; Spiteri, Gianfranco; Warns-Petit, Eva; Zeller, H.

doi:10.2807/1560-7917.es.2018.23.45.1800201

Cited by 145 publications

(150 citation statements)

References 31 publications

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“…An increasing number of human cases of TBE has been recorded in Sweden as TBEV is emerging into new areas and vaccine coverage is incomplete. TBE is emerging into new areas not only in Sweden, but also establishing itself in regions all over Europe and Asia [19,33,34]. The epidemiology of TBE in Sweden has changed over the last 20 years.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…TBE is an important and growing public health problem in Europe and Asia [1][2][3][4]. In 2016, France reported a marked increase of TBE cases, following which Sweden reported its highest numbers of TBE cases since 1956 when comparable records were first kept, with 391 and 385 cases during 2017 and 2018, respectively, while in Finland the number of TBE cases has more than doubled during the last decade, fatalities have occurred and the disease has spread to new areas [29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

“…Tick-borne encephalitis virus (TBEV) is the most important tick-transmitted virus causing human disease in Europe and Asia [1][2][3][4]. TBEV belongs to the genus Flavivirus, within the Flaviviridae family, and can be divided into three distinct subtypes: the European (TBEV-Eur, formerly known as Central European encephalitis virus), the Siberian (TBEV-Sib, formerly known as Siberian encephalitis virus), and the Far Eastern (TBEV-FE, formerly known as Russian Spring Summer encephalitis virus) subtypes [3].…”

Section: Introductionmentioning

confidence: 99%

Multi-laboratory evaluation of ReaScan TBE IgM rapid test, 2016 to 2017

et al. 2020

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Background: Tick-borne encephalitis (TBE) is a potentially severe neurological disease caused by TBE virus (TBEV). In Europe and Asia, TBEV infection has become a growing public health concern and requires fast and specific detection. Aim: In this observational study, we evaluated a rapid TBE IgM test, ReaScan TBE, for usage in a clinical laboratory setting. Methods: Patient sera found negative or positive for TBEV by serological and/or molecular methods in diagnostic laboratories of five European countries endemic for TBEV (Estonia, Finland, Slovenia, the Netherlands and Sweden) were used to assess the sensitivity and specificity of the test. The patients' diagnoses were based on other commercial or quality assured in-house assays, i.e. each laboratory's conventional routine methods. For specificity analysis, serum samples from patients with infections known to cause problems in serology were employed. These samples tested positive for e.g. Epstein-Barr virus, cytomegalovirus and Anaplasma phagocytophilum, or for flaviviruses other than TBEV, i.e. dengue, Japanese encephalitis, West Nile and Zika viruses. Samples from individuals vaccinated against flaviviruses other than TBEV were also included. Altogether, 172 serum samples from patients with acute TBE and 306 TBE IgM negative samples were analysed. Results: Compared with each laboratory's conventional methods, the tested assay had similar sensitivity and specificity (99.4% and 97.7%, respectively). Samples containing potentially interfering antibodies did not cause specificity problems. Conclusion: Regarding diagnosis of acute TBEV infections, ReaScan TBE offers rapid and convenient complementary IgM detection. If used as a stand-alone, it can provide preliminary results in a laboratory or point of care setting.

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“…There is, however, increasing evidence about the occurrence of immunization failure with the TBE virus (TBEV) vaccine. 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].…”

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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Tick-borne encephalitis in Europe, 2012 to 2016

Cited by 145 publications

References 31 publications

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

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

Multi-laboratory evaluation of ReaScan TBE IgM rapid test, 2016 to 2017

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

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