An accelerated schedule for tick-borne encephalitis vaccine: the American Military experience in Bosnia.

Abstract

Abstract. Tick-borne encephalitis (TBE) is a viral illness endemic to the Balkan region. United States military forces were deployed to Bosnia in early 1996 as part of Operation Joint Endeavor, a U.S.-led multinational peacekeeping operation. To counteract the TBE threat, an inactivated, parenteral vaccine (FSME-Immun Inject; Immuno AG, Vienna, Austria) was offered to soldiers at high risk on a volunteer basis in an accelerated, 3-dose schedule (0, 7, and 28 days). Passive adverse reaction surveillance was conducted on 3,981 vaccinated personnel. Paired sera from a randomly selected group of 1,913 deployed personnel (954 who received vaccine and 959 who were unvaccinated) were tested for antibodies to TBE by an ELISA. Three-dose recipients demonstrated an 80% seroconversion rate (4-fold or greater increase in anti-TBE titers). By comparison, the TBE infection rate in the unvaccinated cohort was found to be only 0.42% (4 of 959). Only 0.18% of vaccinees reported self-limited symptoms. An accelerated immunization schedule appears to be an acceptable option for military personnel or travelers on short-term notice to TBE-endemic areas.

Description and Utilization of the United States Department of Defense Serum Repository: A Review of Published Studies, 1985-2012

“…Another study established that there was a relatively low risk of HIV, HCV, or HBV transmission from field blood donors during deployments to Iraq and Afghanistan. [24] DoDSR specimens were also used to determine that exposures to certain infectious agents—Mycoplasma fermentans , [47] tick-borne encephalitis virus, [18, 48] numerous arborviruses, [49] and several rickettsiae [48]—were relatively uncommon during military service (including deployments). One publication reported on attempts to identify serum analytes that could be used to confirm P .…”

“…Two publications [18, 74] addressed both the incidence of acute infection (as indicated by the presence of pathogen-induced antibody) and vaccine-induced antibody. In the table, this affects the row and columns totals but not the grand total.…”

“…[14] Other early retrospective serum studies were used to inform military vaccination policies for measles and rubella,[15] Japanese encephalitis virus,[16] adenovirus (serotypes 4 and 7),[17] and tick-borne encephalitis virus. [18]…”

A literature review of medical aspects of post-cold war UN peacekeeping operations: trends, lessons learnt, courses of action and recommendations

“…Peacekeeping forces identified tickborne encephalitis as endemic in the Balkans where they would be deployed and successfully initiated an accelerated inoculation regime;40 Korzeniewski41 reported on an effective predeployment preventive medicine assessment of environmental and epidemiological hazards and precautionary recommendations for a UN PKO Polish contingent anticipating deployment in war-torn Somalia. Recognising the importance of onsite preinvestigations, the Swedes have developed several templates for reconnaissance teams to use in conducting onsite environmental and disease hazard risk assessments and developing needed preventive measures 42…”

Immunization to Protect the U.S. Armed Forces: Heritage, Current Practice, Prospects

“…A similar product was used in 1996 during U.S. military deployment to Bosnia. (7,10,130,168,232,233) In the 1950s, IGIM was used to treat patients deficient in the antibody-rich gamma-globulin fraction of serum, first described by COL Ogden C. Bruton, an Army pediatrician at Walter Reed Army Hospital. …”