Do We Know the True Burden of Tick-Borne Encephalitis? A Cross-Sectional Study

Cocchio, Silvia; Bertoncello, Chiara; Napoletano, Giuseppina; Claus, Mirko; Furlan, Patrizia; Fonzo, Marco; Gagliani, Alberto; Saïa, Mario; Russo, Francesca; Baldovin, Tatjana; Baldo, Vincenzo

doi:10.1159/000503236

Cited by 12 publications

(26 citation statements)

References 20 publications

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“…On the other hand, Occupational Physicians acknowledging TBE as a severe disease were less frequently promoting TBE vaccine among high-risk groups. These results may appear as inconsistent, or even openly in opposition with the basic assumption that a better understanding of the risk associated with a certain disorder will ultimately increase the acceptance of countermeasures [ 22 , 28 ], but it should be stressed that with an overall annual incidence of 0.1 cases/100,000 people, TBE remains an uncommon event for the majority of professionals not working in high-risk areas [ 1 , 2 , 3 , 4 , 5 ]. Previous studies on KAP of Italian OP have shown significant knowledge gaps and misunderstandings on up-to-date vaccinology [ 18 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Tick-borne encephalitis (TBE) is a potentially lethal vaccine-preventable infection of the central nervous system (CNS) caused by an arbovirus (TBE virus, or TBEV) included within the Flavivirus genus, Flaviviridae family [ 1 ]. Overall incidence rates for TBE in most Western European countries have ranged between 0.4 and 0.6/100,000 over the years 2011–2015; but notification rates in certain areas (e.g., Czech Republic, Estonia, Lithuania, Slovenia) have largely exceeded 5 cases/100,000 population/years [ 2 , 3 , 4 , 5 ]. With mortality rates up to 2% and long-term neurological complications in around 10% of patients, TBE has emerged as an increasing cause of morbidity and mortality [ 1 , 2 , 3 , 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…The geographical distribution of the competent vector, Ixodes spp., is expanding as an effect of climate change. For this reason, previously spared countries have become endemic for TBE [ 8 , 10 , 11 ], particularly in northern regions and in mountainous territory, whose forests support the life cycle of Ixodes ricinus [ 1 , 2 , 3 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…For instance, Italy has historically been considered as a relatively low-risk region, having no cases reported until 1978, and a total of 456 cases notified between 2000 and 2016 [ 2 , 3 , 7 ]. With 0.1 incident cases/100,000 population/year and no TBE-related deaths since 2016, Italy remains, actually, a low-incidence country [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…As a consequence, TBE has become a significant health threat for outdoor workers in North Eastern Italy [ 6 , 7 , 14 , 15 , 16 ], and the Italian Ministry of Health has recommended TBE vaccination for forestry workers, farmers, and veterinarians from endemic areas [ 1 , 2 , 3 , 8 , 12 ]. Even though official data on TBE vaccination rates in Italy are lacking, some reports hint towards figures ranging between 10% and 40%, even in high-risk groups from highly endemic areas [ 2 , 3 , 4 , 7 , 12 ]. Such recommendations have been issued by means of the National Immunization Prevention Plan 2017–2019 (Piano Nazionale Prevenzione Vaccinale—PNPV), a guidance document for immunization policies [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Knowledge, Attitudes, Practices (KAP) of Italian Occupational Physicians towards Tick Borne Encephalitis

et al. 2020

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Tick-Borne Encephalitis (TBE) is an occupational health threat with increasing incidence in the geographic area of Italy. Despite this, TBE vaccination rates have ranged from 10% to 40% in Italy, even in at-risk workers. The reasons for this low rate are investigated in this present study of the knowledge, attitudes, and practices of occupational physicians (OP) regarding TBE disease and vaccination in at-risk workers. A total of 229 OP participated in an internet-based survey by completing a structured questionnaire. Adequate general knowledge of TBE disease was found in 58% of OP. Accurate perception of TBE risk in occupational settings was found in 20%. TBE vaccination for at-risk workers was recommended by 19%. Willingness to recommend TBE vaccination was more likely by OP practicing in endemic areas (Odds Ratio 3.10, 95% confidence intervals 1.47–6.55), who knew the existence of the term “arboviruses” (3.10, 1.29–7.44), or exhibited a better understanding of TBE (2.38, 1.11–5.12)—and were positive predictors for promoting TBE vaccine, while acknowledging that TBE as a severe disease was a negative one. Tick-borne disorders in Italy are a still rare (but increasing) occupational health threat, and vaccination gaps for TBE virus may find an explanation in OP incomplete knowledge of evidence-based recommendations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Knowledge, Attitudes, Practices (KAP) of Italian Occupational Physicians towards Tick Borne Encephalitis

et al. 2020

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Tick‐borne encephalitis: A comprehensive review of the epidemiology, virology, and clinical picture

Chiffi

Grandgirard

Leib

et al. 2023

Reviews in Medical Virology

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Tick‐borne encephalitis virus (TBEV) is a flavivirus commonly found in at least 27 European and Asian countries. It is an emerging public health problem, with steadily increasing case numbers over recent decades. Tick‐borne encephalitis virus affects between 10,000 and 15,000 patients annually. Infection occurs through the bite of an infected tick and, much less commonly, through infected milk consumption or aerosols. The TBEV genome comprises a positive‐sense single‐stranded RNA molecule of ∼11 kilobases. The open reading frame is > 10,000 bases long, flanked by untranslated regions (UTR), and encodes a polyprotein that is co‐ and post‐transcriptionally processed into three structural and seven non‐structural proteins. Tick‐borne encephalitis virus infection results in encephalitis, often with a characteristic biphasic disease course. After a short incubation time, the viraemic phase is characterised by non‐specific influenza‐like symptoms. After an asymptomatic period of 2–7 days, more than half of patients show progression to a neurological phase, usually characterised by central and, rarely, peripheral nervous system symptoms. Mortality is low—around 1% of confirmed cases, depending on the viral subtype. After acute tick‐borne encephalitis (TBE), a minority of patients experience long‐term neurological deficits. Additionally, 40%–50% of patients develop a post‐encephalitic syndrome, which significantly impairs daily activities and quality of life. Although TBEV has been described for several decades, no specific treatment exists. Much remains unknown regarding the objective assessment of long‐lasting sequelae. Additional research is needed to better understand, prevent, and treat TBE. In this review, we aim to provide a comprehensive overview of the epidemiology, virology, and clinical picture of TBE.

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