Clinical and Laboratory Characteristics and Outcome of Illness Caused by Tick-Borne Encephalitis Virus without Central Nervous System Involvement

Bogovič, Petra; Kastrin, Andrej; Lotrič‐Furlan, Stanka; Ogrinc, Katarina; Avšič-Županc, Tatjana; Korva, Miša; Knap, Nataša; Strle, Franc

doi:10.3201/eid2802.211661

Cited by 17 publications

(13 citation statements)

References 34 publications

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“…Because the only confirmed TBEV subtype in Slovenia is TBEV-Eu [17], different courses, severity, and outcomes of the disease are not related to other TBEV subtypes. The hypothesis on the relationship between the TBEV genome and disease course and outcome is intriguing but difficult to explore because the virus can only be detected in patients in the viremic phase, when, due to mild symptoms, patients rarely seek medical help and, due to nonspecific presentation, they are only exceptionally diagnosed with TBEV infection [18,19]. In addition, clinical isolates of TBEV are scant, and the amount of genetic material required for sequencing requires multiple passages of the virus in cell lines or in laboratory animals [20,21].…”

Section: Introductionmentioning

confidence: 99%

Complete Genome Sequencing of Tick-Borne Encephalitis Virus Directly from Clinical Samples: Comparison of Shotgun Metagenomic and Targeted Amplicon-Based Sequencing

Zakotnik

Knap

Bogovič

et al. 2022

Viruses

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The clinical presentation of tick-borne encephalitis virus (TBEV) infection varies from asymptomatic to severe meningoencephalitis or meningoencephalomyelitis. The TBEV subtype has been suggested as one of the most important risk factors for disease severity, but TBEV genetic characterization is difficult. Infection is usually diagnosed in the post-viremic phase, and so relevant clinical samples of TBEV are extremely rare and, when present, are associated with low viral loads. To date, only two complete TBEV genomes sequenced directly from patient clinical samples are publicly available. The aim of this study was to develop novel protocols for the direct sequencing of the TBEV genome, enabling studies of viral genetic determinants that influence disease severity. We developed a novel oligonucleotide primer scheme for amplification of the complete TBEV genome. The primer set was tested on 21 clinical samples with various viral loads and collected over a 15-year period using the two most common sequencing platforms. The amplicon-based strategy was compared to direct shotgun sequencing. Using the novel primer set, we successfully obtained nearly complete TBEV genomes (>90% of genome) from all clinical samples, including those with extremely low viral loads. Comparison of consensus sequences of the TBEV genome generated using the novel amplicon-based strategy and shotgun sequencing showed no difference. We conclude that the novel primer set is a powerful tool for future studies on genetic determinants of TBEV that influence disease severity and will lead to a better understanding of TBE pathogenesis.

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Section: Introductionmentioning

confidence: 99%

Complete Genome Sequencing of Tick-Borne Encephalitis Virus Directly from Clinical Samples: Comparison of Shotgun Metagenomic and Targeted Amplicon-Based Sequencing

Zakotnik

Knap

Bogovič

et al. 2022

Viruses

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“…The CRP levels were within reference values and did not reflect the patient status severity. The progression of aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, and alkaline phosphatase values throughout the second phase can be explained with maintenance of viremia, suggesting an effect of the virus on the bone marrow and liver [22]. Elevated CK levels could be consequence of muscle tissue affection presented as myositis, which is shown by some authors as a prognostic sign for a severe clinical course [23].…”

Section: Discussionmentioning

confidence: 97%

Fatal Case of Imported Tick-Borne Encephalitis in South Serbia

Vrbić¹,

Tasic²,

Simin³

et al. 2022

Preprint

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Tick-borne encephalitis (TBE) is vaccine-preventable neglected zoonotic neuroinvasive disease, caused by tick-borne encephalitis virus (TBEV). Many of the Central and Eastern European countries are affected by TBE, which is often poorly perceived by tourists visiting endemic territories. Here we are reporting a fatal case of imported TBE in Serbian resident who was exposed to tick bite during a visit to Switzerland.

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“…In several cases, the first phase of illness (fever only) does not progress to CNS inflammation, and in most countries, only cases following the ECDC criteria for inflammation of the CNS are reported. There are only a few countries—Austria, Latvia, Germany, and Slovenia—that collect data on nonspecific, non-CNS symptoms [ 15 , 24 , 47 , 48 , 49 ]. In addition, mild CNS symptoms may be missed and go un-reported since they would not fulfil the ECDC criteria, leading to underreporting of TBE.…”

Section: Tbe Surveillance In Europementioning

confidence: 99%

Recommendations to Improve Tick-Borne Encephalitis Surveillance and Vaccine Uptake in Europe

et al. 2022

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There has been an increase in reported TBE cases in Europe since 2015, reaching a peak in some countries in 2020, highlighting the need for better management of TBE risk in Europe. TBE surveillance is currently limited, in part, due to varying diagnostic guidelines, access to testing, and awareness of TBE. Consequently, TBE prevalence is underestimated and vaccination recommendations inadequate. TBE vaccine uptake is unsatisfactory in many TBE-endemic European countries. This review summarizes the findings of a scientific workshop of experts to improve TBE surveillance and vaccine uptake in Europe. Strategies to improve TBE surveillance and vaccine uptake should focus on: aligning diagnostic criteria and testing across Europe; expanding current vaccine recommendations and reducing their complexity; and increasing public education of the potential risks posed by TBEV infection.

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Clinical and Laboratory Characteristics and Outcome of Illness Caused by Tick-Borne Encephalitis Virus without Central Nervous System Involvement

Abstract: Illness progressed to encephalitis in 84% of patients within 18 days after defervescence.

Cited by 17 publications

References 34 publications

Complete Genome Sequencing of Tick-Borne Encephalitis Virus Directly from Clinical Samples: Comparison of Shotgun Metagenomic and Targeted Amplicon-Based Sequencing

Complete Genome Sequencing of Tick-Borne Encephalitis Virus Directly from Clinical Samples: Comparison of Shotgun Metagenomic and Targeted Amplicon-Based Sequencing

Fatal Case of Imported Tick-Borne Encephalitis in South Serbia

Recommendations to Improve Tick-Borne Encephalitis Surveillance and Vaccine Uptake in Europe

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