Abstract
BackgroundWhile the worldwide endemicity of tick-borne encephalitis (TBE) has been increasing, a lack of awareness of the risks of this life-threatening disease may be leading to an underutilization of preventive measures among travellers to TBE-endemic regions. This study’s objectives were to assess travellers’ awareness of TBE and advice-seeking attitudes, and to evaluate practices of travel clinics regarding pre-travel advice.MethodsWe used an online questionnaire to identify individuals aged 18–65 years residing in the UK, Germany, Canada and Sweden, who had travelled to TBE-endemic countries between 2013 and 2016. This sample was defined as the visit-risk sample. Of these, the first 375 respondents who reported that they had engaged in pre-defined at-risk activities (e.g. hiking in forests) were asked to complete an additional online survey and were included in the activity-risk sub-sample. We also used an online/phone questionnaire to interview travel clinic personnel.ResultsThe TBE visit-risk sample included 4375 individuals; 69% had heard of the disease and 32% had heard of a TBE vaccine. Before travelling, travellers most commonly sought information online (26%); fewer travellers consulted family doctors (8%) or travel clinics (5%). In the activity-risk sample, 79% of the travellers were aware of at least one correct TBE prevention measure; however, only 15% reported being vaccinated within the past 3 years, with 11% of vaccinated travellers doing so following a clinic’s recommendation. One hundred and eighty travel clinic representatives responded and reported that TBE vaccination was recommended to an average of 61% of travellers to endemic regions. Vaccination-reminder services such as follow-up appointments, e-mail and text reminders were offered by 50% of the clinics.ConclusionsThere is a need to increase awareness of the risk and prevention of TBE among travellers to endemic countries, and travel clinics could play an important role in this process.
Highlights
While the worldwide endemicity of tick-borne encephalitis (TBE) has been increasing, a lack of awareness of the risks of this life-threatening disease may be leading to an underutilization of preventive measures among travellers to TBE-endemic regions
TBE, tick-borne encephalitis; healthcare providers (HCPs), healthcare provider; N, number of respondents; %, percentage of respondents in each category. This questionnaire-based study is one of the first to assess the perception of international travellers and travel clinic HCPs on TBE, a neglected disease despite the known health risks in common tourist destinations in Europe and Asia
In the present study, only 32% of the visitrisk sample were aware of a vaccine for TBE, and this was mainly driven by increased awareness from countries with TBEendemic regions (Germany and Sweden)
Summary
While the worldwide endemicity of tick-borne encephalitis (TBE) has been increasing, a lack of awareness of the risks of this life-threatening disease may be leading to an underutilization of preventive measures among travellers to TBE-endemic regions. Tick-borne encephalitis (TBE) is a viral infection caused by the TBE virus (TBEV) of the family Flaviviridae; three of the TBEV subtypes are known to cause disease in humans.[1,2] The virus is predominantly transmitted through the bite of an infected tick or, in rare cases, through consumption of unpasteurized dairy products.[2].
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