Abstract
In recent decades, the incidence of tick-borne encephalitis (TBE) in Sweden has increased. To calculate the burden of disease over a 17-year period, we analyzed data from the Swedish National Health Data Register for TBE cases diagnosed during 1998–2014. We compared healthcare use and sick leave associated with 2,429 persons with TBE with a referent cohort of 7,287 persons without TBE. Patients with TBE were hospitalized for significantly more days during the first year after disease onset (11.5 vs. 1.1 days), logged more specialist outpatient visits (3.6 vs. 1.2 visits), and logged more sick leave days (66 vs. 10.7 days). These differences generally increased over time. The case-fatality rate for TBE was 1.1%. Our calculated cost of TBE to society provides a baseline for decisions on immunization programs. Analyzing register data, our study adds to clinical studies of smaller cohorts and model-based studies that calculate disease burden.
Highlights
In recent decades, the incidence of tick-borne encephalitis (TBE) in Sweden has increased
In Sweden, the disease is caused by the European subtype (TBEV-Eu), which is transmitted by the vector tick Ixodes ricinus [3]
There is no cure for TBE, but 2 inactivated Tick-borne encephalitis virus (TBEV)-Eu vaccines resulting in 95%–100% immunogenicity are available [17]
Summary
The incidence of tick-borne encephalitis (TBE) in Sweden has increased. Patients with TBE were hospitalized for significantly more days during the first year after disease onset (11.5 vs 1.1 days), logged more specialist outpatient visits (3.6 vs 1.2 visits), and logged more sick leave days (66 vs 10.7 days) The growing incidence of TBE has stimulated discussion regarding the need for public vaccination programs in Sweden [20,21] and other countries in Europe [22,23,24], but thorough data concerning the burden of TBE are needed to determine cost-effectiveness. We analyzed the overall burden of TBE in Sweden in terms of hospitalization, specialist outpatient visits, primary care visits, and sick leave, on the basis of register data on TBE case-patients and a matched cohort. The study was approved by the Regional Ethical Review Board in Gothenburg (no. 141-16)
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