Abstract
In October 2011, a cluster of four tick-borne encephalitis (TBE) cases was identified in Hungary. Initial investigations revealed a possible link with consumption of unpasteurised cow milk sold by a farmer without authorisation. We performed a cohort study including all regular customers of the farmer. Overall, eleven cases (seven confirmed and four suspected) were identified. Customers who had consumed the farmer’s unpasteurised cow milk had more than a two-fold increased risk for being a TBE case, although not at statistically significant level.
Highlights
IntroductionAll four patients had already been interviewed by local public health authorities when National Center of Epidemiology (NCE) was alerted: none of them could remember having recently been bitten by a tick, but all of them referred to having consumed unpasteurised cow milk during the incubation period, which had been purchased from a farmer who has ten dairy cows producing about 70 litres milk per day
On 14 October 2011, the Department of Infectious Disease Epidemiology at the National Center of Epidemiology (NCE) in Budapest was alerted about a cluster of four hospitalised tick-borne encephalitis (TBE) cases that had occurred between 19 September and 1 October 2011, in the area surrounding K, a small town in western Hungary close to the Austrian border
All four patients had already been interviewed by local public health authorities when NCE was alerted: none of them could remember having recently been bitten by a tick, but all of them referred to having consumed unpasteurised cow milk during the incubation period, which had been purchased from a farmer who has ten dairy cows producing about 70 litres milk per day
Summary
All four patients had already been interviewed by local public health authorities when NCE was alerted: none of them could remember having recently been bitten by a tick, but all of them referred to having consumed unpasteurised cow milk during the incubation period, which had been purchased from a farmer who has ten dairy cows producing about 70 litres milk per day. The milk of this farmer was sold without being pasteurised and without authorisation, to regular customers from approximately 40 families residing in four villages in the countryside surrounding K. In Hungary, groups at risk such as forest workers, geologists and laboratory workers are advised to get vaccinated [4]
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