Abstract
As a follow-up of a retrospective survey on tick borne-encephalitis (TBE) in 2008, the European Network for Diagnostics of 'Imported' Viral Diseases launched a new survey in 2010, to collect broader information on TBE prevalence between 2007 and 2009 and to observe possible changes compared to the previous data. A two-part questionnaire was mailed to contact points in all European Union (EU) Member States and four non-EU countries (Bosnia and Herzegovina, Norway, Russia, and Switzerland). The first part was identical to the 2008 survey, requesting information on case definition, diagnostic methods, investigations regarding tick-transmitted diseases, endemic foci mapping, vaccination programmes, and recommendations for travellers. The second newly added part, inquired about geographic and seasonal distribution of TBE cases, imported cases, TBE subtypes, animal cases, and prevalence in ticks and wildlife hosts. Of 28 participat-ing countries, 16 had TBE as a notifiable disease, as in the first survey. In the 2007-2009 period, the total number of notified cases (17,818) was lower than in 2004-2006 (21,339 cases), also when subtracting Russian cases (8,207 vs 9,073 cases respectively). The highest reported incidence was 18.5 per 100,000 population in Lithuania in 2009. The 2010 study showed that increased numbers of countries used PCR and nucleotide sequencing for particular investigations. Most countries, however, relied on specific antibody detection by enzyme linked immunosorbent assay for TBE laboratory diagnosis. Disparities nevertheless remained across countries regarding case definitions, and surveillance and prevention activities. To understand changing patterns in TBE transmission, surveillance strategies including screening of vector ticks and testing of animal hosts should be harmonised and done more systematically in Europe. Collected data will support rec-ommendations concerning diagnostic and mapping methods, case reporting, vaccination programmes and information campaigns. .
Highlights
Tick-borne encephalitis (TBE) is due to a zoonotic arbovirus infection of the central nervous system (CNS) and affects humans
Of the 16 countries with tick borneencephalitis (TBE) notification, five (Austria, Germany, Hungary, Norway, Slovenia) had a case definition based on clinical criteria and laboratory confirmation, five (Czech Republic, Estonia, Finland, Greece, Poland) included an epidemiological link in the case definition, and the remaining six countries had no official or clearly formulated case definition (Table 1)
Case definitions were provided by ten countries, differences still could be seen in the classification of relevant TBE cases according to clinical symptoms, as well as in the application of laboratory tests for case confirmation (Table 1)
Summary
Tick-borne encephalitis (TBE) is due to a zoonotic arbovirus infection of the central nervous system (CNS) and affects humans. More detailed information on the clinical picture, case definition and other issues of interest are available in a TBE fact sheet on the European Network for Diagnostics of “Imported” Viral Diseases (ENIVD) website [http://www.enivd.org] or in the 2010 spotlight for tick-borne diseases on the European Centre for Disease Prevention and Control (ECDC) website [http://ecdc.europa.eu]. Virus transmission occurs horizontally between tick vectors and vertebrate hosts, between spring and autumn. While most TBE virus infections of humans occur following the bite of an infected tick, alimentary routes of TBE virus transmis-sion by raw milk consumption have been described [14,15,16,17,18,19]
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