T ick-borne encephalitis (TBE) is a severe viral zoonosis caused by TBE virus (TBEV) (1). To date, confi rmed locally acquired human TBEV infections have not been reported in Belgium, although the most common vector, the tick Ixodes ricinus, is abundant in Belgium and seroprevalence studies have revealed the presence of TBEV antibodies in dogs, cattle, roe deer, and wild boar (2,3). We report 3 confi rmed autochthonous TBE cases, diagnosed at the National Reference Centre (NRC) for Arboviruses (Antwerp, Belgium) during summer 2020.
The StudyA 48-year-old woman had muscle pain and an elevated body temperature 2 weeks after a tick bite on her right hip. She tested negative for coronavirus disease (COVID-19), and her general practitioner prescribed antimicrobial drugs. A few days later, the patient was hospitalized with asthenia, tremor, drowsiness, and fever. A neurologist determined signs of peripheral facial palsy with brachial weakness and nuchal rigidity. Cerebrospinal fl uid (CSF) showed an elevated leukocyte count (37 cells/µL; reference range 0-5 cells/µL). Borrelia serology and PCR results were negative. Magnetic resonance imaging
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