Abstract
Tick-borne encephalitis (TBE) virus is a major cause of central nervous system infections in endemic countries. Here, we present clinical and laboratory characteristics of a large international cohort of patients with confirmed TBE using a uniform clinical protocol. Patients were recruited in eight centers from six European countries between 2010 and 2017. A detailed description of clinical signs and symptoms was recorded. The obtained information enabled a reliable classification in 553 of 555 patients: 207 (37.3%) had meningitis, 273 (49.2%) meningoencephalitis, 15 (2.7%) meningomyelitis, and 58 (10.5%) meningoencephalomyelitis; 41 (7.4%) patients had a peripheral paresis of extremities, 13 (2.3%) a central paresis of extremities, and 25 (4.5%) had single or multiple cranial nerve palsies. Five (0.9%) patients died during acute illness. Outcome at discharge was recorded in 298 patients. Of 176 (59.1%) patients with incomplete recovery, 80 (27%) displayed persisting symptoms or signs without recovery expectation. This study provides further evidence that TBE is a severe disease with a large proportion of patients with incomplete recovery. We suggest monitoring TBE in endemic European countries using a uniform protocol to record the full clinical spectrum of the disease.
Highlights
IntroductionTick-borne encephalitis (TBE) is an infection of the central nervous system (CNS)
Tick-borne encephalitis (TBE) is an infection of the central nervous system (CNS)caused by the tick-borne encephalitis virus (TBEV) being transmitted by ticks in several central, eastern, and northern European countries [1,2]
A total of 1045 patients with TBE were recruited for genetic investigations (EU-TICKBO); 430 of a single center were excluded as they only participated in the genetic analysis; 17 patients were excluded due to their date of admission before 2010 and 43 because of an incomplete basic data set after quality control
Summary
Tick-borne encephalitis (TBE) is an infection of the central nervous system (CNS). Caused by the tick-borne encephalitis virus (TBEV) being transmitted by ticks in several central, eastern, and northern European countries [1,2]. The severity of the disease is broad, ranging from fever and headache to death, with a relatively high proportion of patients needing intensive care unit (ICU) treatment. Since the 1970s, a highly effective vaccine against TBE has been available and has led to a significant decrease in cases in countries with high vaccination rates [12]. TBE remains an important issue caused by climate change and residual low vaccination rates in several endemic countries [13,14]. Continuous monitoring and detailed clinical analysis are needed to inform health care professionals and public authorities
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