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Surveillance Open Access
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Abstract

Background

Tick-borne encephalitis (TBE) is a vaccine-preventable disease involving the central nervous system. TBE became a notifiable disease on the EU/EEA level in 2012.

Aim

We aimed to provide an updated epidemiological assessment of TBE in the EU/EEA, focusing on spatiotemporal changes.

Methods

We performed a descriptive analysis of case characteristics, time and location using data of human TBE cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease onset in 2012–2020. We analysed data at EU/EEA, national, and subnational levels and calculated notification rates using Eurostat population data. Regression models were used for temporal analysis.

Results

From 2012 to 2020, 19 countries reported 29,974 TBE cases, of which 24,629 (98.6%) were autochthonous. Czechia, Germany and Lithuania reported 52.9% of all cases. The highest notification rates were recorded in Lithuania, Latvia, and Estonia (16.2, 9.5 and 7.5 cases/100,000 population, respectively). Fifty regions from 10 countries, had a notification rate ≥ 5/100,000. There was an increasing trend in number of cases during the study period with an estimated 0.053 additional TBE cases every week. In 2020, 11.5% more TBE cases were reported than predicted based on data from 2016 to 2019. A geographical spread of cases was observed, particularly in regions situated north-west of known endemic regions.

Conclusion

A close monitoring of ongoing changes to the TBE epidemiological situation in Europe can support the timely adaption of vaccination recommendations. Further analyses to identify populations and geographical areas where vaccination programmes can be of benefit are needed.

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/content/10.2807/1560-7917.ES.2023.28.11.2200543
2023-03-16
2024-07-15
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.11.2200543
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References

  1. Lindquist L. Tick-borne encephalitis. Handb Clin Neurol. 2014;123:531-59.  https://doi.org/10.1016/B978-0-444-53488-0.00025-0  PMID: 25015503 
  2. Martello E, Gillingham EL, Phalkey R, Vardavas C, Nikitara K, Bakonyi T, et al. Systematic review on the non-vectorial transmission of Tick-borne encephalitis virus (TBEv). Ticks Tick Borne Dis. 2022;13(6):102028.  https://doi.org/10.1016/j.ttbdis.2022.102028  PMID: 36030646 
  3. Bogovic P, Strle F. Tick-borne encephalitis: A review of epidemiology, clinical characteristics, and management. World J Clin Cases. 2015;3(5):430-41.  https://doi.org/10.12998/wjcc.v3.i5.430  PMID: 25984517 
  4. Kollaritsch H, Paulke-Korinek M, Holzmann H, Hombach J, Bjorvatn B, Barrett A. Vaccines and vaccination against tick-borne encephalitis. Expert Rev Vaccines. 2012;11(9):1103-19.  https://doi.org/10.1586/erv.12.86  PMID: 23151167 
  5. Beauté J, Spiteri G, Warns-Petit E, Zeller H. Tick-borne encephalitis in Europe, 2012 to 2016. Euro Surveill. 2018;23(45):1800201.  https://doi.org/10.2807/1560-7917.ES.2018.23.45.1800201  PMID: 30424829 
  6. European Centre for Disease Prevention and Control (ECDC). Introduction to the Annual Epidemiological Report. Stockholm: ECDC; 2021. Available from: https://www.ecdc.europa.eu/en/surveillance-and-disease-data/annual-epidemiological-reports/introduction-annual
  7. Eurostat. Data: Bulk download. 2022. [Accessed: 15 Mar 2022]. Available from: https://ec.europa.eu/eurostat/estat-navtree-portlet-prod/BulkDownloadListing
  8. The European Commission. Commission Implementing Decision (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions (Text with EEA relevance). Brussels: Official Journal of the European Union; 2018. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv%3AOJ.L_.2018.170.01.0001.01.ENG
  9. Erber W, Schmitt HJ. Self-reported tick-borne encephalitis (TBE) vaccination coverage in Europe: Results from a cross-sectional study. Ticks Tick Borne Dis. 2018;9(4):768-77.  https://doi.org/10.1016/j.ttbdis.2018.02.007  PMID: 29501619 
  10. Eurostat, the statistical office of the European Union. Nomenclature of Territorial Units for Statistics. Luxembourg: Eurostat. [Accessed: 7 Mar 2023]. Available from: http://ec.europa.eu/eurostat/web/nuts/overview
  11. R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2020. Available from: http://www.Rproject.org/
  12. Heinz FX, Stiasny K, Holzmann H, Grgic-Vitek M, Kriz B, Essl A, et al. Vaccination and tick-borne encephalitis, central Europe. Emerg Infect Dis. 2013;19(1):69-76.  https://doi.org/10.3201/eid1901.120458  PMID: 23259984 
  13. Jepsen MT, Jokelainen P, Jore S, Boman A, Slunge D, Krogfelt KA. Protective practices against tick bites in Denmark, Norway and Sweden: a questionnaire-based study. BMC Public Health. 2019;19(1):1344.  https://doi.org/10.1186/s12889-019-7613-4  PMID: 31640665 
  14. Nygren TM, Pilic A, Böhmer MM, Wagner-Wiening C, Wichmann O, Harder T, et al. Tick-borne encephalitis risk increases with dog ownership, frequent walks, and gardening: a case-control study in Germany 2018-2020. Microorganisms. 2022;10(4):690.  https://doi.org/10.3390/microorganisms10040690  PMID: 35456742 
  15. Publication WHO, Who Publication. Vaccines against tick-borne encephalitis: WHO position paper--recommendations. Vaccine. 2011;29(48):8769-70.  https://doi.org/10.1016/j.vaccine.2011.07.024  PMID: 21777636 
  16. Rubel F, Brugger K. Tick-borne encephalitis incidence forecasts for Austria, Germany, and Switzerland. Ticks Tick Borne Dis. 2020;11(5):101437.  https://doi.org/10.1016/j.ttbdis.2020.101437  PMID: 32723631 
  17. Kunze U, Kunze M. The Austrian vaccination paradox: tick-borne encephalitis vaccination versus influenza vaccination. Cent Eur J Public Health. 2015;23(3):223-6.  https://doi.org/10.21101/cejph.a4169  PMID: 26615654 
  18. Slunge D. The willingness to pay for vaccination against tick-borne encephalitis and implications for public health policy: evidence from Sweden. PLoS One. 2015;10(12):e0143875.  https://doi.org/10.1371/journal.pone.0143875  PMID: 26641491 
  19. Smit R. Cost-effectiveness of tick-borne encephalitis vaccination in Slovenian adults. Vaccine. 2012;30(44):6301-6.  https://doi.org/10.1016/j.vaccine.2012.07.083  PMID: 22885012 
  20. Shedrawy J, Henriksson M, Hergens MP, Askling HH. Estimating costs and health outcomes of publicly funded tick-born encephalitis vaccination: A cost-effectiveness analysis. Vaccine. 2018;36(50):7659-65.  https://doi.org/10.1016/j.vaccine.2018.10.086  PMID: 30385058 
  21. Folkhälsomyndigheten. Hälsoekonomisk analys av TBE-vaccination i Stockholms läns landsting. [Health economic analysis of TBE vaccination in the Stockholm County Council]. Stockholm: Folkhälsomyndigheten; 2018. Swedish. Available from: https://www.folkhalsomyndigheten.se/contentassets/9e5836078931460fb4b719df4535ee43/halsoekonomisk-analys-tbe-18125.pdf
  22. Steffen R, Erber W, Schmitt HJ. Can the booster interval for the tick-borne encephalitis (TBE) vaccine ‘FSME-IMMUN’ be prolonged? - A systematic review. Ticks Tick Borne Dis. 2021;12(5):101779.  https://doi.org/10.1016/j.ttbdis.2021.101779  PMID: 34298356 
  23. Kreusch TM, Holding M, Hewson R, Harder T, Medlock JM, Hansford KM, et al. A probable case of tick-borne encephalitis (TBE) acquired in England, July 2019. Euro Surveill. 2019;24(47):1900679.  https://doi.org/10.2807/1560-7917.ES.2019.24.47.1900679  PMID: 31771699 
  24. National Institute for Public Health and the Environment (RIVM). Spread of tick-borne encephalitis virus in the Netherlands. Bilthoven: RIVM. [Accessed: 2 Mar 2023]. Available from: https://www.rivm.nl/en/news/spread-of-tick-borne-encephalitis-virus-in-netherlands
  25. Stoefs A, Heyndrickx L, De Winter J, Coeckelbergh E, Willekens B, Alonso-Jiménez A, et al. Autochthonous cases of tick-borne encephalitis, Belgium, 2020. Emerg Infect Dis. 2021;27(8):2179-82.  https://doi.org/10.3201/eid2708.211175  PMID: 34111382 
  26. Hellenbrand W, Kreusch T, Böhmer MM, Wagner-Wiening C, Dobler G, Wichmann O, et al. Epidemiology of tick-borne encephalitis (TBE) in Germany, 2001-2018. Pathogens. 2019;8(2):42.  https://doi.org/10.3390/pathogens8020042  PMID: 30934855 
  27. Botelho-Nevers E, Gagneux-Brunon A, Velay A, Guerbois-Galla M, Grard G, Bretagne C, et al. Tick-Borne Encephalitis in Auvergne-Rhône-Alpes Region, France, 2017-2018. Emerg Infect Dis. 2019;25(10):1944-8.  https://doi.org/10.3201/eid2510.181923  PMID: 31538929 
  28. Statens Serum Institut (SSI). TBE report on disease occurence 2017-2019. Copenhagen: SSI; 2020. Available from: https://en.ssi.dk/surveillance-and-preparedness/surveillance-in-denmark/annual-reports-on-disease-incidence/tbe-report-on-disease-occurrence-2017-2019
  29. European Centre for Disease Prevention and Control (ECDC). Ixodes ricinus - current known distribution: March 2022. Stockholm: ECDC; 13 Apr 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/ixodes-ricinus-current-known-distribution-march-2022
  30. Jaenson TGT, Petersson EH, Jaenson DGE, Kindberg J, Pettersson JH, Hjertqvist M, et al. The importance of wildlife in the ecology and epidemiology of the TBE virus in Sweden: incidence of human TBE correlates with abundance of deer and hares. Parasit Vectors. 2018;11(1):477.  https://doi.org/10.1186/s13071-018-3057-4  PMID: 30153856 
  31. Andersen NS, Larsen SL, Olesen CR, Stiasny K, Kolmos HJ, Jensen PM, et al. Continued expansion of tick-borne pathogens: Tick-borne encephalitis virus complex and Anaplasma phagocytophilum in Denmark. Ticks Tick Borne Dis. 2019;10(1):115-23.  https://doi.org/10.1016/j.ttbdis.2018.09.007  PMID: 30245088 
  32. Norwegian Institute of Public Health (NIPH). Tick-borne encephalitis (TBE virus infections). NIPH: Oslo. [Accessed: 2 Mar 2023]. Available from: https://www.fhi.no/en/op/smittevernveilederen/sykdommer-a-a/tick-borne-encephalitis--tbe-virus-infections/
  33. Mohareb E, Christova I, Soliman A, Younan R, Kantardjiev T. Tick-borne encephalitis in Bulgaria, 2009 to 2012. Euro Surveill. 2013;18(46):20635.  https://doi.org/10.2807/1560-7917.ES2013.18.46.20635  PMID: 24256889 
  34. Bundesamt für Gesundheit (BAG). Zahlen zu Infektionskrankheiten: Zeckenenzephalitis FSME [Figures on infectious diseases: tick-borne encephalitis TBE]. Bern: BAG. German. [Accessed: 10 Oct 2022]. Available from: https://www.bag.admin.ch/bag/de/home/zahlen-und-statistiken/zahlen-zu-infektionskrankheiten.exturl.html/aHR0cHM6Ly9tZWxkZXN5c3RlbWUuYmFnYXBwcy5jaC9pbmZyZX/BvcnRpbmcvZGF0ZW5kZXRhaWxzL2QvZnNtZS5odG1sP3dlYmdy/YWI9aWdub3Jl.html
  35. Tagliapietra V, Riccardo F, del Manso M. TBE in Italy. In: The TBE Book. 5th ed. Singapore: Global Health Press; 2022.
  36. Hrvatski Zavod Za Javno Zdravstvo (Croatian Institute of Public Health HZJZ). Hrvatski zdravstveno-statistički ljetopis za 2020. – tablični podaci: Zarazne bolesti u Hrvatskoj. [Croatian health statistics yearbook for 2020 - tabular data: infectious diseases in Croatia]. Zagreb: HZJZ. [Accessed: 10 Oct 2022]. Croatian. Available from: https://www.hzjz.hr/hrvatski-zdravstveno-statisticki-ljetopis/hrvatski-zdravstveno-statisticki-ljetopis-za-2020-tablicni-podaci/
  37. Mulić R, Petković B, Klismanić Z, Jeroncić I. [Tick-borne diseases in the Republic of Croatia]. Lijec Vjesn. 2011;133(3-4):89-95. PMID: 21612103 
  38. Van Esbroeck M, Lernout T, Suin V, Van Gucht S. TBE in Belgium. In: The TBE Book. 5th ed. In. Singapore: Global Health Press; 2022.
  39. Daniel M, Danielová V, Fialová A, Malý M, Kříž B, Nuttall PA. Increased relative risk of tick-borne encephalitis in warmer weather. Front Cell Infect Microbiol. 2018;8:90.  https://doi.org/10.3389/fcimb.2018.00090  PMID: 29623261 
  40. European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority. (EFSA). VectorNet. Issue N.2. November 2020. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/newsletter-vectornet-2-2020.pdf
  41. Gonzalez G, Bournez L, Moraes RA, Marine D, Galon C, Vorimore F, et al. A one-health approach to investigating an outbreak of alimentary tick-borne encephalitis in a non-endemic area in France (Ain, eastern France): a longitudinal serological study in livestock, detection in ticks, and the first tick-borne encephalitis virus isolation and molecular characterisation. Front Microbiol. 2022;13:863725.  https://doi.org/10.3389/fmicb.2022.863725  PMID: 35479640 
  42. Friedsam AM, Brady OJ, Pilic A, Dobler G, Hellenbrand W, Nygren TM. Geo-spatial characteristics of 567 places of tick-borne encephalitis infection in southern Germany, 2018-2020. Microorganisms. 2022;10(3):643.  https://doi.org/10.3390/microorganisms10030643  PMID: 35336218 
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