This article presents major epidemiologic features of tick-borne encephalitis (TBE) in the Czech Republic, using data of laboratory-confirmed cases since 1970. A total of 17,053 cases of TBE were reported in the Czech Republic (population 10 million) in 1970-2008. The data show several important features. First, the pattern of TBE incidence changed over time. Until the end of the 1970s, TBE was characterized by periods of alternately higher and lower incidence (between 180 and 595 cases per year); the 1980s were a period of low incidence with minimum variability; since the beginning of the 1990 s, there has been a steep rise in incidence, with marked year-to-year variation (e.g., 745 cases were registered in 1995, and a maximum of 1029 cases were registered in 2006). Second, the age distribution of TBE incidence has changed. Until the end of 1990 s, incidence peaked among those 15-19 years of age, with a gradual decline with age. In the 2000s, however, TBE incidence has been rising in those aged 60-64 years, with a sharp decline in those older than 65 years. Third, the seasonal pattern of TBE has changed markedly over time. In the earlier period, incidence had a clear peak in July/August; since the 1990 s, more cases have occurred in earlier and later months of the year. The proportion of cases occurring in April, May, October, and November increased from 9% in the 1970s to 23% in 2000-2008. Fourth, the geographical distribution of TBE also changed over time, with TBE increasingly occurring in the mountainous districts at higher altitudes. These changes in incidence patterns appear to be linked with changes in climatic and meteorological conditions. The link between climate change and TBE incidence is plausible, since TBE is a recreation-related infection associated with outdoor activities, and since climatic changes affect the life cycle of the vector.
The steep rise in the incidence of tick-borne encephalitis (TBE) in the 1990s and its subsequent high level in the Czech Republic are not even over the whole territory. It is manifested markedly in the Czech-Moravian Highland region. In the decades of 1971 through 1992, TBE incidence in the Highland Region did not reach the countrywide average. The rise has been noted only since 1997; in the year 2006 TBE incidence in that administrative region was more than double the countrywide average. Analysis of the situation have not found any socioeconomic shifts or land-use changes, or in the numbers of game animals, that could have had an effect on TBE incidence. The rise of infections in localities 500 m above sea level (a.s.l.) and more was markedly steeper than that below that altitudinal limit. At those altitudes there has been found an increase in average monthly temperatures exceeding countrywide averages namely in the period of maximum Ixodes ricinus activity (May-August). Detailed analysis of meteorological conditions and comparison with a long-term study of the influence of modifications of the mountain climate in the Krkonoše Mts. on I. ricinus tick distribution and the pathogens transmitted by them, have led to the conclusion that likewise in the Czech-Moravian Highland a marked warming had influenced the local population of the vector I. ricinus, caused an activation of foci of TBE, increased contacts of humans with the vector, consequently giving rise to an apparent increase in the incidence of human cases of TBE.
In the Czech Republic, the incidence of human tick-borne encephalitis (TBE) has been increasing over the last two decades. At the same time, populations of game have also shown an upward trend. In this country, the ungulate game is the main host group of hosts for Ixodes ricinus female ticks. This study examined the potential contribution of two most widespread game species (roe deer [Capreolus capreolus] and wild boar [Sus scrofa]) to the high incidence of TBE in the Czech Republic, using the annual numbers of culls as a proxy for the game population. This was an ecological study, with annual figures for geographical areas-municipalities with extended competence (MEC)-used as units of analysis. Between 2003 and 2011, a total of 6213 TBE cases were reported, and 1062,308 roe deer and 989,222 wild boars were culled; the culls of roe deer did not demonstrate a clear temporal trend, but wild boar culls almost doubled (from 77,269 to 143,378 per year). Statistical analyses revealed a positive association between TBE incidence rate and the relative number of culled wild boars. In multivariate analyses, a change in the numbers of culled wild boars between the 25th and 75th percentile was associated with TBE incidence rate ratio of 1.23 (95% confidence interval 1.07-1.41, p = 0.003). By contrast, the association of TBE with culled roe deer was not statistically significant ( p = 0.481). The results suggest that the size of the wild boar population may have contributed to the current high levels and the rising trend in incidence of TBE, whereas the regulated population of roe deer does not seem to be implicated in recent geographical or temporal variations in TBE in the Czech Republic.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.