Abstract
In May 2017, a hospitalized index case of tick-borne encephalitis (TBE) was confirmed by Serology. The case was linked to alimentary infection by raw milk from a goat farm in the region of Tübingen, Baden-Württemberg, Germany, where no previous TBE cases in the area had been reported before. The TBE focus was confirmed by isolation of the TBE virus from ticks and Serological confirmation of past infection in one of the five flock goats. Additional investigations by the local public health office identified 27 consumers of goat milk at the putative period of exposure. For 20/27 exposed persons, anamnestic information was gained by the local public health office. Twelve/fourteen exposed and non-vaccinated people developed clinical illness and were confirmed as TBE cases by Serology. Five/six vaccinated and exposed people did not develop the disease. The one exposed and vaccinated person had their last TBE vaccination booster more than 15 years ago, and therefore a booster was more than 10 years overdue. None of the regularly vaccinated and exposed persons developed clinical overt TBE infection. We report the first known TBE outbreak, during which, protection by TBE vaccination against alimentary TBE infection was demonstrated.
Highlights
Published: 21 April 2021Tick-borne encephalitis (TBE) is the most important tick-borne viral disease in Europe and Asia
TBE is caused by tick-borne encephalitis virus (TBEV), a member of the genus Flavivirus in the family Flaviviridae [2]
We investigated a cluster of 14 human TBE cases that occurred in May 2017 in southern
Summary
Tick-borne encephalitis (TBE) is the most important tick-borne viral disease in Europe and Asia. Up to 10,000 human cases are reported annually. It is assumed that many mild and subclinical infections remain undiagnosed, and both the infection and the disease are supposedly highly under-reported [1]. TBE is caused by tick-borne encephalitis virus (TBEV), a member of the genus Flavivirus in the family Flaviviridae [2]. Only the European subtype has been detected circulating in Central European countries (Austria, Czech Republic, Germany, Slovak Republic, Switzerland) in ticks, rodents, and patients since the 1950s. TBEV circulates between ticks and natural hosts (small mammals) in strictly geographically limited natural foci [5]
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