Incidence Of Tick-borne Encephalitis Research Articles

Epidemiological Situation on Tick-Borne Encephalitis in the Russian Federation in 2014–2023 and Short-Term Forecast of the Incidence for 2024

The aim of the review was to conduct a comparative analysis of the epidemiological situation on tick-borne encephalitis (TBE) over 2014–2023 in the constituent entities of the Russian Federation located in the European and Asian parts of the country and to give a forecast of incidence for 2024. The incidence of TBE in 2023 only marginally decreased as compared to the peak values in 2022, which leveled down the ten-year trend towards reduction. Grouping of the entities of the Russian Federation according to the average incidence of TBE over a decade made it possible to classify 17 of them as regions of low, 15 – of medium, and 17 – of high epidemiological risk. In general, the epidemiological situation regarding TBE is more unfavorable in the Asian part of the country. A list of species of Ixodidae ticks, the main vectors of the tick-borne encephalitis virus, is provided, as well as subtypes and genetic variants of the latter, identified in the European and Asian parts of the country. The peculiarities of the epidemiological situation on TBE and the scope of preventive measures undertaken in Russia in 2023 are considered. It is shown that there are no clearly outlined trends in the nature of changes in the incidence of TBE in endemic federal districts and entities of the country, and the expected incidence rates in 2024 will remain at the long-term average level.

Phylogenetic characterisation of tick-borne encephalitis virus from Lithuania.

The Baltic states are the region in Europe where tick-borne encephalitis (TBE) is most endemic. The highest notification rate of TBE cases is reported in Lithuania, where the incidence of TBE has significantly increased since 1992. A recent study reported 0.4% prevalence of TBE virus (TBEV) in the two most common tick species distributed in Lithuania, Ixodes ricinus and Dermacentor reticulatus, with the existence of endemic foci confirmed in seven out of Lithuania's ten counties. However, until now, no comprehensive data on molecular characterisation and phylogenetic analysis have been available for the circulating TBEV strains. The aim of this study was to analyse TBEV strains derived from I. ricinus and D. reticulatus ticks collected from Lithuania and provide a genotypic characterisation of viruses based on sequence analysis of partial E protein and NS3 genes. The 54 nucleotide sequences obtained were compared with 81 TBEV strains selected from the NCBI database. Phylogenetic analysis of the partial E and NS3 gene sequences derived from 34 Lithuanian TBEV isolates revealed that these were specific to Lithuania, and all belonged to the European subtype, with a maximum identity to the Neudoerfl reference strain (GenBank accession no. U27495) of 98.7% and 97.4%, respectively. The TBEV strains showed significant regional genetic diversity. The detected TBEV genotypes were not specific to the tick species. However, genetic differences were observed between strains from different locations, while strains from the same location showed a high similarity.

Assessment of registered and hidden epidemic process of tick-borne encephalitis in the Republic of Karelia

Introduction. The incidence of tick-borne encephalitis in the Russia remains relevant. The assessment of the epidemic process in the Republic of Karelia is important not only in terms of understanding its general patterns, but in connection with the growth of tourist attendance in the region.
 Aims: To assess the current epidemic situation of tick-borne encephalitis in the Republic of Karelia, and to compare the characteristics of registered and hidden epidemic processes.
 Materials and methods. The risk of infection and incidence were estimated based on the analysis of the registered cases of seeking medical help in connection with tick bites, the results of a study of tick-borne encephalitis virus (TBEV) infection rate in ticks, and the epidemiological investigation of cases of tick-borne encephalitis in 1992–2022. Clinical, gender and age structure, territorial distribution of patients and victims of the tick bites were compared with the results of serological studies of 2379 blood samples of the adult population, conducted in 2011–2022.
 Results. Infection rates of ticks removed from humans ranged from 23.6–27.0% in 2002–2005 to 1.0% in 2022. In 2004, the TBEV antigen was detected in mosquitoes. The territory of risk is the southern part of Republic. However, the increase in number of cases of seeking medical help was observed in the northern part of Republic. The incidence rates exceeded the national average, especially in 2003–2004 (15.3–11.6 per 100 thousand). In 2021–2022, it decreased to 1.8–1.5 per 100,000. The dynamics of incidence had a high-degree correlation with the dynamics of seeking medical help and infection rates in ticks (R = 0.92 and 0.73). The reported incidence was lower than the estimated risk of infection. The meningeal forms of infection were most often diagnosed. The risk of the disease was higher in the elderly and in men, which was determined by the conditions of infection. Antibodies to TBEV were detected in 11.8 ± 0.7% of the examined persons.
 Conclusion. A steady decrease in rates of registered tick-borne encephalitis incidence has been revealed in the Republic of Karelia, mainly due to the action of biological and natural factors. The assessment of seroprevalence made it possible to reveal the hidden part of the epidemic process.

Epidemic status in Russia’s Northwestern Federal District: tick-borne encephalitis and ixodes tick-borne borreliosis (lyme disease), 2002–2021

The study's objective was to reveal trends in tick-borne encephalitis (TBE) and Ixodes tick-borne borreliosis (ITBB) epidemic processes in Russia's Northwestern Federal District (NWFD) in 2002–2021. In the NWFD during the analyzed period, more than 1.1 million patients sought medical help following tick bites (14% of all cases registered nationwide). The long-term average tick bite incidence rate in the NWFD exceeded the nation-wide value: 409.5 and 280.7, respectively. In the NWFD, the highest long-term average tick bite incidence rates were recorded in Vologda Oblast, Pskov Oblast, and Novgorod Oblast. The tick bite incidence rate tended to grow in the NWFD, as well as nationally. The growth in tick bite incidence was statistically significant in the Republic of Komi, Kaliningrad Oblast, and Arkhangelsk Oblast. In 2002–2021, more than 6000 TBE cases were registered in the NWFD (11% of all cases registered nationwide), and the TBE long-term average incidence rate in the NWFD exceeded the national value: 2.3 and 2.0, respectively. The Republic of Karelia, Arkhangelsk Oblast, and Vologda Oblast were three NWFD subjects with high TBE epidemical hazard. TBE incidence in the analyzed period tended to decrease, both in the NWFD and nationwide. A statistically significant decrease in TBE incidence was revealed in St. Petersburg, in the Republic of Karelia, in Novgorod Oblast, and in Leningrad Oblast. About 22 000 ITBB cases were reported in the NWFD during the analyzed period (15% of all ITBB cases in Russia). The ITBB long-term average incidence rate in the NWFD exceeded the national value: 7.9 and 4.9, respectively. Vologda Oblast, Kaliningrad Oblast, and Pskov Oblast were three NWFD subjects with high epidemical hazard in terms of ITBB. ITBB incidence during the analyzed period tended to decrease, both in the NWFD and nationwide. The decrease in ITBB incidence was statistically significant in Vologda, Kaliningrad, Novgorod, Leningrad and Pskov Oblasts, as well as in St. Petersburg. In the Republic of Komi, in contrast to other NWFD subjects or national data, there was an uptrend in both TBE and ITBB incidence.

Outdoor recreation, tick borne encephalitis incidence and seasonality in Finland, Norway and Sweden during the COVID-19 pandemic (2020/2021)

ABSTRACTDuring the pandemic outdoor activities were encouraged to mitigate transmission risk while providing safe spaces for social interactions. Human behaviour, which may favour or disfavour, contact rates between questing ticks and humans, is a key factor impacting tick-borne encephalitis (TBE) incidence.We analyzed annual and weekly TBE cases in Finland, Norway and Sweden from 2010 to 2021 to assess trend, seasonality, and discuss changes in human tick exposure imposed by COVID-19. We compared the pre-pandemic incidence (2010–2019) with the pandemic incidence (2020–2021) by fitting a generalized linear model (GLM) to incidence data.Pre-pandemic incidence was 1.0, 0.29 and 2.8 for Finland, Norway and Sweden, respectively, compared to incidence of 2.2, 1.0 and 3.9 during the pandemic years. However, there was an increasing trend for all countries across the whole study period. Therefore, we predicted the number of cases in 2020/2021 based on a model fitted to the annual cases in 2010–2019. The incidences during the pandemic were 1.3 times higher for Finland, 1.7 times higher for Norway and no difference for Sweden. When social restrictions were enforced to curb the spread of SARS-CoV-2 there were profound changes in outdoor recreational behavior. Future consideration of public health interventions that promote outdoor activities may increase exposure to vector-borne diseases.

Tick-Borne Encephalitis (TBE): From Tick to Pathology.

Tick-borne encephalitis (TBE) is a viral arthropod infection, endemic to large parts of Europe and Asia, and is characterised by neurological involvement, which can range from mild to severe, and in 33-60% of cases, it leads to a post-encephalitis syndrome and long-term morbidity. While TBE virus, now identified as Orthoflavivirus encephalitidis, was originally isolated in 1937, the pathogenesis of TBE is not fully appreciated with the mode of transmission (blood, tick, alimentary), viral strain, host immune response, and age, likely helping to shape the disease phenotype that we explore in this review. Importantly, the incidence of TBE is increasing, and due to global warming, its epidemiology is evolving, with new foci of transmission reported across Europe and in the UK. As such, a better understanding of the symptomatology, diagnostics, treatment, and prevention of TBE is required to inform healthcare professionals going forward, which this review addresses in detail. To this end, the need for robust national surveillance data and randomised control trial data regarding the use of various antivirals (e.g., Galidesivir and 7-deaza-2'-CMA), monoclonal antibodies, and glucocorticoids is required to improve the management and outcomes of TBE.

Tick-Borne Encephalitis-Review of the Current Status.

The tick-borne encephalitis virus (TBEV) is the arboviral etiological agent of tick-borne encephalitis (TBE), considered to be one of the most important tick-borne viral diseases in Europe and Asia. In recent years, an increase in the incidence of TBE as well as an increasing geographical range of the disease have been noted. Despite the COVID-19 pandemic and the imposition of restrictions that it necessitated, the incidence of TBE is rising in more than half of the European countries analyzed in recent studies. The virus is transmitted between ticks, animals, and humans. It seems that ticks and small mammals play a role in maintaining TBEV in nature. The disease can also affect dogs, horses, cattle, and small ruminants. Humans are incidental hosts, infected through the bite of an infected tick or by the alimentary route, through the consumption of unpasteurized milk or milk products from TBEV-infected animals. TBEV infections in humans may be asymptomatic, but the symptoms can range from mild flu-like to severe neurological. In Europe, cases of TBE are reported every year. While there is currently no effective treatment for TBE, immunization and protection against tick bites are critical in preventing this disease.

Dynamics of the Epidemic Process of Tick-Borne Encephalitis in Irkutsk Region in 2001–2021

The aim of this work was to analyze the spatial and temporal features of the epidemic process dynamics of tick-borne encephalitis (TBE) in Irkutsk Region in 2001–2021.Materials and methods. The data of the Rospotrebnadzor Administration for the Irkutsk Region, the Reference Center of the Irkutsk Research Anti-Plague Institute, the materials of the state statistical reporting form No. 2 “Information on infectious and parasitic diseases”, and scientific publications were analyzed. The chronological and chorological features of the change in the incidence of TVE have been traced. In the latter case, the administrative-territorial formations (ATF) of the subject were differentiated by epidemiological risk groups over two ten-year periods: 2001–2010 and 2011–2020. At each time interval, the grouping of areas according to the level of TBE incidence was carried out using the calculation of 95% confidence interval. Time sequences of observations were analyzed using the construction of regression equations. Standard methods of variation statistics in the Microsoft Excel were deployed.Results and discussion. Over the course of the 21st century, the incidence of TBE in Irkutsk Region has been declining. Based on 2001–2010 data, there were no cases of TBE in six ATF, and endemic areas were divided into three groups: with low (15 districts), medium (6) and high (8) incidence of TBE. A separate assessment of morbidity rates was conducted in the administrative center of the entity, the city of Irkutsk. In 2011–2020, the structure of ATF with varying epidemiological risk of TBE underwent a change. Six non-endemic areas, groups of low (12 ATFs), medium (9), high (6) and very high (2) epidemiological risk were identified. The spatial arrangement of high epidemiological risk zones changed, and their area increased. Each ATF cluster with different TBE incidence in 2011–2020 is characterized by the number of TBE cases and the volume of measures to prevent the infection. It is concluded that preventive measures were insufficient in ATF groups of high and very high epidemiological risk.

Analysis of the Dynamics of Tick-Borne Encephalitis Incidence and the Number of People who Appealed to Medical Organizations about Tick Bites in the European North of Russia

In recent decades, a significant increase in the incidence of tick-borne viral encephalitis (TBVE) and the number of people attacked by ticks has been recorded in the European North of Russia.The aim of the study was to analyze the dynamics of the TBVE incidence and the number of people who appealed to medical organizations regarding tick bites in the European North of Russia.Materials and methods. We used the Form No. 2 “Information on infectious and parasitic diseases”, the results of operational seasonal monitoring of TBVE, presented by the Rospotrebnadzor Administrations of the respective territories for our study. Statistical data processing was performed using the Microsoft Excel program. Display of the results on the map was carried out in the geographic information system ESRI ArcMap.Results and discussion. Combined analysis of the data on the number of cases and TBVE incidence, the number of people who appealed to medical organizations about tick bites and the number of people seeking advice about tick bites per 100 thousand population for the Arkhangelsk Region, the Republics of Karelia and Komi and their municipal districts has been performed. The mean values and gradients of the number of cases, incidence (2010–2020), the number of people who appealed to medical organizations regarding tick bites, and the number of people seeking treatment for tick bites per 100 000 population (2002–2020) have been calculated; maps of average values and gradients constructed. The incidence and the number of cases remain at the high level, exceeding the national average, but have been declining in the last decade. The number of people who appealed to medical organizations and the appealability of the population about tick bites per 100 000 of the population remain at a consistently high level and show no downward trend. The incidence and appealability of the population due to tick bites per 100 thousand of the population is spreading in a northerly direction, covering new territories in the Arctic zone. The main driving force behind the observed epidemic situation in the European North of Russia is the natural processes of climate change.

Tick-borne encephalitis in children.

The incidence of tick-borne encephalitis in Norway is increasing. The risk of infection shows considerable geographical variations, with clusters of cases in certain municipalities in the counties of Agder, and Vestfold and Telemark. There is also a major variation in clinical presentation. Only a small number of cases of tick-borne encephalitis in children have been reported in Norway, and the condition may be underdiagnosed. We present a clinical review, including two case studies, that focuses on the clinical presentation and diagnosis of tick-borne encephalitis in children.

Similarities and differences in the characteristics of the epidemical process tick-borne encephalitis and Lyme borreliosis

Objective: To identify common and distinctive characteristics of the epidemical process of tick-borne encephalitis and Lyme borreliosis on the example of the Republic of Karelia.Materials and methods. The frequency of infected tick bites, dynamics, intensity, territorial, gender, age and social features of the incidence of tick-borne encephalitis and Lyme borreliosis in 2000–2021 were analyzed according to official statistics, epidemiological examination of foci and laboratory studies. The results of studies of 2379 blood samples of adults who were not ill and not vaccinated against tick-borne encephalitis for the presence of antibodies to the virus were analyzed.Results. The virulence of ticks in 2000–2021 decreased from 23.6 to 1.3%, infection with borrelia at the level of 13.4– 38.4%. The average long-term incidence rates of tick-borne encephalitis and Lyme borreliosis were 6.2 and 6.6 per 100 thousand, the dynamics of incidence had an average pronounced downward trend, correlated with the dynamics of requests for medical care of the population affected by ticks. The main clinical form of tick–borne encephalitis is meningeal (48%). Non-erythemic forms of borreliosis in recent years amounted to 39.1%. Antibodies of class G to tick-borne encephalitis virus were detected in 11.8±0.7% of the examined individuals. The territory of risk of infection with tick-borne encephalitis and Lyme borreliosis is the central and eastern part of the south of the Republic, where I.persulcatus dominates. The proportion of urban residents among patients with both infections is higher, but the incidence of urban and rural populations did not have significant differences. The incidence rates of tick-borne borreliosis in persons aged 40-49, 50-59 and 60 years and older are 1.6-2.2 times higher than those of tick-borne encephalitis, but the difference is not significant. At working age, the percent of men is higher than women, there are no differences among the elderly.Conclusions: Similar and different features of the epidemic process of tick-borne encephalitis and tick-borne borreliosis have been identified, which should be taken to improving the detection of diseases, predicting the situation and planning preventive measures.

Development of ahighly purified tick-borne encephalitis vaccine : Apersonal historical account.

Before the advent of avaccine, infections with tick-borne encephalitis (TBE) virus in Austria led to the hospitalization of several hundred and, due to underreporting, possibly more than thousand patients with severe neurological disease every year. In the late 1960s and early 1970s, this country had the highest recorded morbidity of TBE in Europe, but similar endemic risk areas exist in many other European countries as well as Central and Eastern Asia. In this article, Idescribe my personal recollections of the development of ahighly purified TBE vaccine in the late 1970s, to which Icontributed as ayoung post-doctoral scientist mentored by Christian Kunz (then director of the Institute of Virology at the Medical Faculty, University of Vienna) in acollaboration with the Austrian biopharmaceutical company Immuno. Low reactogenicity of the newly developed vaccine was aprerequisite for mass vaccination campaigns in Austria that started in the early 1980s. Because of its excellent immunogenicity, broad application of the highly purified vaccine paved the way for adramatic reduction of the incidence of TBE in Austria, which is outstanding in Europe and referred to as an Austrian success story of immunoprophylaxis.

Effectiveness of Tick-borne Encephalitis Vaccines in Children, Latvia, 2018-2020.

Tick-borne encephalitis (TBE) is an infection by the tick-borne encephalitis virus (TBEV) with symptoms of central nervous system inflammation. TBE is endemic in Latvia and other parts of Europe. TBE vaccination is recommended for children in Latvia. TBE vaccine effectiveness (VE) was estimated in Latvia, a country with high TBE incidence, providing the first VE estimates against a range of TBEV infection outcomes in children 1-15 years-of-age. Rīga Stradinš University conducted nationwide surveillance for suspected TBE cases. Serum and cerebrospinal fluid were ELISA tested for TBEV-specific IgG and IgM antibodies. A fully vaccinated child was an individual who had received the 3-dose primary series and appropriately timed boosters. The proportion of laboratory-confirmed TBE cases fully vaccinated (PCV) was determined from interviews and medical records. The proportion of the general population fully vaccinated (PPV) was determined from national surveys conducted in 2019 and 2020. TBE VE in children 1-15 years-of-age was estimated using the screening method: VE = 1 - [PCV/(1 - PCV)/PPV/(1 - PPV)]. From 2018 to 2020, surveillance identified 36 TBE cases in children 1-15 years-of-age; all were hospitalized, 5 (13.9%) for >12 days. Of the TBE cases, 94.4% (34/36) were unvaccinated compared with 43.8% of children in the general population. VE against TBE hospitalization in children 1-15 years-of-age was 94.9% (95% confidence interval 63.1-99.3). In 2018-2020, vaccination in children 1-15 years-of-age averted 39 hospitalized TBE cases. Pediatric TBE vaccines were highly effective in preventing TBE in children. Increasing TBE vaccine uptake in children is essential to maximize the public health impact of TBE vaccination.

Correlation between airborne pollen data and the risk of tick-borne encephalitis in northern Italy

Tick-borne encephalitis (TBE) is caused by a flavivirus that infects animals including humans. In Europe, the TBE virus circulates enzootically in natural foci among ticks and rodent hosts. The abundance of ticks depends on the abundance of rodent hosts, which in turn depends on the availability of food resources, such as tree seeds. Trees can exhibit large inter-annual fluctuations in seed production (masting), which influences the abundance of rodents the following year, and the abundance of nymphal ticks two years later. Thus, the biology of this system predicts a 2-year time lag between masting and the incidence of tick-borne diseases such as TBE. As airborne pollen abundance is related to masting, we investigated whether inter-annual variation in pollen load could be directly correlated with inter-annual variation in the incidence of TBE in human populations with a 2-year time lag. We focused our study on the province of Trento (northern Italy), where 206 TBE cases were notified between 1992 and 2020. We tested the relationship between TBE incidence and pollen load collected from 1989 to 2020 for 7 different tree species common in our study area. Through univariate analysis we found that the pollen quantities recorded two years prior for two tree species, hop-hornbeam (Ostrya carpinifolia) and downy oak (Quercus pubescens), were positively correlated with TBE emergence (R2 = 0.2) while a multivariate model with both tree species better explained the variation in annual TBE incidence (R2 = 0.34). To the best of our knowledge, this is the first attempt at quantifying the correlation between pollen quantities and the incidence of TBE in human populations. As pollen loads are collected by widespread aerobiological networks using standardized procedures, our study could be easily replicated to test their potential as early warning system for TBE and other tick-borne diseases.

TBE in Denmark

Since the 1950s, tick-borne encephalitis (TBE) has been known to be endemic in Denmark but only on the island of Bornholm. Bornholm is situated east of mainland Denmark, south of Sweden (Figure 3) and has a different fauna and flora from the rest of Denmark. Bornholm has about 45,000 inhabitants, but about 500,000 tourists visit the island every year. Freundt carried out a serosurvey during 1958–1962 and found TBE antibodies in 1.4% of blood donors and 30% of woodworkers on Bornholm but no antibodies in subjects living in mainland Denmark. In 1963, Freundt found that 8 of 12 patients admitted to the hospital with acute meningoencephalitis of unknown etiology during 1951–1960 had antibodies to tick-borne encephalitis (TBEV). In 2000, TBE was rediscovered on Bornholm, where a retrospective study covering the period 1994–2002 (7 years) identified 14 TBE cases; 2 cases were tourists and 12 were inhabitants of Bornholm, giving an incidence of 3.81 per 100,000 inhabitants. At least 5 patients (37.7%) got permanent sequelae. In addition, 32 forest workers on Bornholm were tested in 2000, and 20% had IgG antibodies but never symptoms. This is similar to the finding of Freundt in 1960. It was concluded that the data did not provide evidence of an increase in incidence of TBE. Ticks (Ixodes ricinus) from Bornholm were investigated for TBEV in 2000 and 2% were found to be infected. Since 2001 an average of 2.5 (range 1–8) TBE cases per year have been reported in Bornholm (Figure 1).

Potential drivers of human tick-borne encephalitis in the Örebro region of Sweden, 2010–2021

Incidence of tick-borne encephalitis (TBE) has increased during the last years in Scandinavia, but the underlying mechanism is not understood. TBE human case data reported between 2010 and 2021 were aggregated into postal codes within Örebro County, south-central Sweden, along with tick abundance and environmental data to analyse spatial patterns and identify drivers of TBE. We identified a substantial and continuing increase of TBE incidence in Örebro County during the study period. Spatial cluster analyses showed significant hotspots (higher number of cases than expected) in the southern and northern parts of Örebro County, whereas a cold spot (lower number of cases than expected) was found in the central part comprising Örebro municipality. Generalised linear models showed that the risk of acquiring TBE increased by 12.5% and 72.3% for every percent increase in relative humidity and proportion of wetland forest, respectively, whereas the risk decreased by 52.8% for every degree Celsius increase in annual temperature range. However, models had relatively low goodness of fit (R2 < 0.27). Results suggest that TBE in Örebro County is spatially clustered, however variables used in this study, i.e., climatic variables, forest cover, water, tick abundance, sheep as indicator species, alone do not explain this pattern.

Epidemiological Characteristics of Tick-Borne Encephalitis in the Sverdlovsk District over a 20-Year Period

Relevance. Despite the ongoing program of mass vaccination of tick-borne encephalitis (TBE) for more than 20 years in the Sverdlovsk district, the incidence rate of TBE continues to exceed the average in Russia and the Ural Federal region.Aim. To analyze the main indicators of the manifestation of the epidemic process of TBE in the territory of the Sverdlovsk district under the conditions of planned vaccination over a 20-year period (2002–2021).Materials and methods. The article uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002-2021, methods of statistical analysis.Results and discussion. During the study period (2002-2021), 3861 cases of TBE were registered in the Sverdlovsk district, while the highest incidence rate was detected in 2005 – 10.1 per 100 thousand population, and the lowest in 2020 – 1.0 per 100 thousand population. The share of the vector-borne mechanism was 78.4%, the unidentified path – 20.1%, alimentary – 1.5%. Analysis of the seasonal distribution of cases of TBE showed that the incidence is recorded from April to November. Cases of TBE were recorded in all age groups, including the child population. Most often, people aged 60 years old and older (24.6%) were ill with TBE. Among the children's population, the largest share fell on children aged 7–14 years (5.4%). Men of working age prevailed among the patients (66.0%). TBE was mainly registered among the unvaccinated population (81.5%) with a predominance of urban (86.1%). Officials predominated among the sick persons – 29.8%, pensioners made up 22.3%, unemployed – 19.8%. Persons whose work is professionally connected with the forest made up only 0.6%. The ongoing program of mass vaccination of TBE has led to a decrease in the proportion of severe and moderate forms of diseases (focal – 9.8% and meningeal – 24.0%) and an increase in the proportion of febrile (33.8%) and atypical forms (32.4%). Deaths during the studied period were recorded mainly among the adult unvaccinated population.Conclusions. The Sverdlovsk district continues to be a tense natural focus of TBE with a constantly recorded incidence among contingents of different age and social groups. In the absence of highly effective etiotropic drugs for the treatment of TBE, the only strategy for reducing the incidence of TBE, the development of severe forms and deaths in the territory of the Sverdlovsk district is mass vaccination of the population.

The Effect of COVID‑19 on the Incidence of Human Vector-Borne Infections Transmitted by Ixodid Ticks (Illustrated by the Example of Krasnoyarsk Territory)

In 2022, there was an increase in the incidence of tick-borne encephalitis (TBE) and ixodid tick-borne borreliosis (ITBB) in the subjects of the Russian Federation, federal districts and the country as a whole. At the same time, among people affected by ixodid ticks, the proportion of clinical forms of the diseases has increased. The aim of this study is to analyze the possible causes of the simultaneous increase in the incidence of vector-borne infections and the proportion of clinical forms among the people bitten by the ticks, using the materials on Krasnoyarsk Territory as an example. Materials and methods. We analyzed the incidence of TBE and ITBB among the people who have or haven’t had COVID‑19, the number of people affected by tick bites in 2021–2022 in Krasnoyarsk Territory. Statistical analysis is performed by standard methods of variational statistics using Excel. Results and discussion. It is shown that in the Krasnoyarsk Territory, with a decrease in the number of individuals affected by tick bites in 2022 as compared to 2021 (12216 and 13214, respectively), there was an increase in the number of cases of TBE (from 124 to 250) and ITBB (from 115 to 224), as well as the proportion of people who had clinical forms of the infections after tick bites. Among three possible explanations of the observed pattern, a decrease in the immune status of Krasnoyarsk residents who had had COVID‑19 before the contact with ticks is considered as the most likely one. Using statistical methods it was substantiated that among people with TBE and ITBB, the proportion of individuals who have had COVID‑19 is significantly higher than expected, based on the actual incidence of the Krasnoyarsk Territory population with a new coronavirus infection. Thus, COVID‑19 affects the incidence of vector-borne infections indirectly, through a change in the number of people contacts with natural stations, and directly, by changing the immune status.

First Expert Elicitation of Knowledge on Possible Drivers of Observed Increasing Human Cases of Tick-Borne Encephalitis in Europe

Tick-borne encephalitis (TBE) is a viral disease endemic in Eurasia. The virus is mainly transmitted to humans via ticks and occasionally via the consumption of unpasteurized milk products. The European Centre for Disease Prevention and Control reported an increase in TBE incidence over the past years in Europe as well as the emergence of the disease in new areas. To better understand this phenomenon, we investigated the drivers of TBE emergence and increase in incidence in humans through an expert knowledge elicitation. We listed 59 possible drivers grouped in eight domains and elicited forty European experts to: (i) allocate a score per driver, (ii) weight this score within each domain, and (iii) weight the different domains and attribute an uncertainty level per domain. An overall weighted score per driver was calculated, and drivers with comparable scores were grouped into three terminal nodes using a regression tree analysis. The drivers with the highest scores were: (i) changes in human behavior/activities; (ii) changes in eating habits or consumer demand; (iii) changes in the landscape; (iv) influence of humidity on the survival and transmission of the pathogen; (v) difficulty to control reservoir(s) and/or vector(s); (vi) influence of temperature on virus survival and transmission; (vii) number of wildlife compartments/groups acting as reservoirs or amplifying hosts; (viii) increase of autochthonous wild mammals; and (ix) number of tick species vectors and their distribution. Our results support researchers in prioritizing studies targeting the most relevant drivers of emergence and increasing TBE incidence.

The current state of the problem of tick-borne encephalitis in Russia and the world

Relevance. Despite the successes achieved over the 85-year history of the study of tick-borne encephalitis (TBE), there are still many controversial and unresolved issues. It is obvious that in the second decade of the XXI century, this natural focal neuroinfection, as before, poses a great threat to public health not only in Russia, but also in endemic countries of the world.Aim. To present modern aspects of etiology, epidemiology, diagnosis, specific prevention of TBE in Russia and endemic countries of the world.Conclusions. Currently, there are 4 genotypes of the TBE virus: Far Eastern, European, Siberian and Baikal, each of which has its own area, pathogenic potential for humans. Nosoareal of TBE covers most of the territory of Russia, 29 European countries. Cases of TBE disease or viral activity are registered in six Asian countries. For the correct verification of the diagnosis, criteria for the diagnosis of cases of the disease have been developed, which mainly concern unvaccinated persons. Since highly effective etiotropic drugs for the treatment of TBE have not yet been developed, the only strategy for reducing the incidence of TBE is mass vaccination of the population of endemic regions. Due to the increase in the rate of vaccination in Russia and European countries, in order to improve epidemiological surveillance of TBE, standards for specific laboratory diagnosis of the disease among vaccinated persons, clarification of the causes of the incidence of vaccinated, as well as deaths among them, need to be clarified. In conditions of combination of natural foci of TBE and other tick-borne infections, it is important to develop diagnostic algorithms, including differential diagnosis of this disease with other infections transmitted by Ixodic ticks.