BackgroundThe incidence of tick-borne encephalitis (TBE) varies significantly over time. To better understand the annual incidence of all TBE cases in Latvia we investigated the disease burden in the country from 1973–2016 using several available sources and case definitions.MethodsWe identified cases of TBE from an electronic database (maintained by the Centre for Disease Prevention and Control of Latvia [CDPC]) by the use of ICD-10 diagnosis codes for TBE (A84; A84.0; A84.1; A84.8; A84.9). In addition, previously unreported TBE cases were found by review of TBE diagnoses according to ICD-10 codes in four hospital databases.ResultsFrom 1973 to 2016 a total of 15,193 TBE cases were reported to the CDPC, 2,819 of which were reported from January 2007 through December 2016, additionally for this time period, 104 cases were identified via hospital survey. From all 2,923 reported cases (2007–2016), 1,973 met TBE case definition criteria and were included in the TBE study analysis. The highest average 10 year incidence was observed from 1990–1999 (27.9 cases per 100,000; range 4.6–53.0), however, the average 10-year incidence from 2007–2016 using officially adopted TBE case definition was 9.6 cases per 100,000 (range 5.8–14.6). For this 10-year time period most cases were adults (95.1%) and male (52.2%). The most common clinical form of TBE was meningitis (90.6%). A tick bite prior to TBE onset was reported in 60.6% of TBE cases and 98.2% of cases were not vaccinated against TBE.ConclusionThe data demonstrate that the incidence of TBE varies by about one third based on the case definition used. TBE occurs almost entirely in the unvaccinated population. Regular TBE awareness campaigns could encourage the population in Latvia to use protective measures to further control TBE in the country, either via vaccination or tick avoidance.
Sepsis is widespread among hospitalised patients worldwide. In fact, severe sepsis and septic shock is a major cause of patient admission and mortality in intensive care units and the difficulty in diagnosing the initial stage of the disease is a major obstacle to the reduction of mortality from sepsis. Retrospective analysis of medical records of 72 patients was carried out within the framework of the study. The study included patients of both sexes and all ages, who were hospitalised at the stationary “Gaiļezers” of the Rīga East Clinical University Hospital from 2011 to 2014. The study aim was to determine the clinical course of treated septic patients and conduct a pharmaco-economic analysis. In the course of the disease, almost half of the patients - 34 (48.6%) showed development of septic shock. Mortality in these patients exceeded a half (60.0%; 21 patients). Artificial lung ventilation during hospitalisation was received by 43 (59.7%) of patients. Artificial lung ventilation had been required in a significantly larger number of cases in the dead patient group (75%, p = 0.01). The average costs per one patient day (including bed-day price and manipulation costs) was 383 euros. Septic shock was associated with high mortality. Severe sepsis is an expensive diagnosis, as the average cost of one patient exceeds costs of other departments by 4.5 times.
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