Tick-borne encephalitis in Japan, Republic of Korea and China

Yoshii, Kentaro; Song, Joon Young; Park, Seong Beom; Yang, Jun; Schmitt, H. J.

doi:10.1038/emi.2017.69

Cited by 72 publications

(15 citation statements)

References 50 publications

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“…Furthermore, based on travel history of the two TBE cases, both cases apparently acquired the TBEV infection outside of Hokkaido. Combined with previous studies that identified TBEV antibodies in rodents outside of Hokkaido [ 11 , 16 ], results from our study indicate that TBEV transmission occurs in Japan outside of Hokkaido. Finally, the illness onset and specimen collection dates for the two TBE cases were in February and November.…”

Section: Discussionsupporting

confidence: 87%

“…Finally, the illness onset and specimen collection dates for the two TBE cases were in February and November. The purported vectors for TBEV transmission in Hokkaido are Ixodes persulcatus and Ixodes ovatus [ 16 ]. Both of these ticks are present nationwide and may therefore be a vector for TBEV transmission elsewhere in Japan [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to the Japan Ministry of Health, Labour, and Welfare (MHLW), laboratory identification of a TBEV infection can be based on detection of TBEV antibodies by an enzyme-linked immunosorbent assay (ELISA) or a neutralization test (NT) [ 15 ]. Clinicians in Japan, however, seldom request TBEV diagnostics, apparently due to a low awareness of TBE [ 16 ]. If TBEV diagnostics are requested, the specimens must be sent to one of the few TBE reference laboratories in Japan because TBEV diagnostic kits, such as the commercial ELISA TBEV IgG and IgM antibody test kits, are not readily available.…”

Section: Introductionmentioning

confidence: 99%

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First evidence of tick-borne encephalitis (TBE) outside of Hokkaido Island in Japan

Ohira,

Yoshii,

Aso

et al. 2023

Emerging Microbes & Infections

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Tick-borne encephalitis (TBE) is an infection of the central nervous system caused by the tick-borne encephalitis virus (TBEV). TBE is endemic in parts of Europe and Asia. TBEV is transmitted to humans primarily by Ixodes ticks. There have been 5 TBE cases identified in Japan, all on the northern island of Hokkaido. Rodents with TBEV antibodies and Ixodes ticks have been identified throughout Japan, indicating that TBEV infection might be undiagnosed in Japan. Residual serum and cerebrospinal fluid (CSF) collected in 2010–2021 from 520 patients ≥1 year-of-age previously hospitalized with encephalitis or meningitis of unknown etiology at 15 hospitals (including 13 hospitals outside of Hokkaido) were screened by ELISA for TBEV IgG and IgM antibodies; TBEV infection was confirmed by the gold standard neutralization test. Residual serum was available from 331 (63.6%) patients and CSF from 430 (82.6%) patients; both serum and CSF were available from 189 (36.3%). Two patients were TBE cases: a female aged 61 years hospitalized for 104 days in Oita (2000 km south of Hokkaido) and a male aged 24 years hospitalized for 11 days in Tokyo (1200 km south of Hokkaido). Retrospective testing also identified a previous TBEV infection in a female aged 45 years hospitalized for 12 days in Okayama (1700 km south of Hokkaido). TBEV infection should be considered as a potential cause of encephalitis or meningitis in Japan. TBE cases are likely undiagnosed in Japan, including outside of Hokkaido, due to limited clinical awareness and lack of availability of TBE diagnostic tests.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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First evidence of tick-borne encephalitis (TBE) outside of Hokkaido Island in Japan

Ohira,

Yoshii,

Aso

et al. 2023

Emerging Microbes & Infections

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“…There is, however, some evidence that suboptimal vaccination rates have contributed to the recent rise in European TBE cases [ 62 ]. Historically, TBE in China was considered an occupational disease and the TBE immunisation policy recommends vaccination for people working or living in high-risk regions, especially forest workers or those who enter the forest areas for occupational reasons, including military personnel [ 63 ]. However, since the 1990s, more cases have been observed in people with other occupations suggesting an adjustment to the immunisation policy might need consideration.…”

Section: Prevention Through Vaccinationmentioning

confidence: 99%

“…Despite few cases, endemic foci of TBE virus have been identified in parts of Japan, especially Hokkaido. Currently no TBE vaccine is licensed in Japan [ 63 ].…”

Section: Prevention Through Vaccinationmentioning

confidence: 99%

Global Landscape of Encephalitis: Key Priorities to Reduce Future Disease Burden

Granerød

Huang

Davies

et al. 2023

Clinical Infectious Diseases

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Encephalitis affects people across the lifespan, has high rates of mortality and morbidity, and results in significant neurological sequelae with long-term consequences to quality of life and wider society. The true incidence is currently unknown due to inaccurate reporting systems. The disease burden of encephalitis is unequally distributed across the globe being highest in low- and middle-income countries where resources are limited. Here countries often lack diagnostic testing, with poor access to essential treatments and neurological services, and limited surveillance and vaccination programmes. Many types of encephalitis are vaccine preventable, whilst others are treatable with early diagnosis and appropriate management. In this viewpoint, we provide a narrative review of key aspects of diagnosis, surveillance, treatment, and prevention of encephalitis and highlight priorities for public health, clinical management, and research, to reduce the disease burden.

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