The long-term outcome of tick-borne encephalitis in Central Europe

Bogovič, Petra; Stupica, Daša; Rojko, Tereza; Lotrič‐Furlan, Stanka; Avšič-Županc, Tatjana; Kastrin, Andrej; Lusa, Lara; Strle, Franc

doi:10.1016/j.ttbdis.2017.12.001

Cited by 44 publications

(52 citation statements)

References 30 publications

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“…After 12 months, PES frequency stabilised while severity continued to decline. Unfavourable outcomes at 12 months and at the final hospital visit (at 7 years post-acute illness) were strongly associated with the presence of PES at previous time points [17].…”

Section: Introductionmentioning

confidence: 93%

“…According to a 10-year follow-up survey in Germany, 80% of patients with primary myelitic manifestations suffered long-term sequelae [16]. A recent study on post-encephalitic syndrome (PES) after TBE in Slovenia revealed that the frequency and severity of PES diminished over time following acute illness [17]. After 12 months, PES frequency stabilised while severity continued to decline.…”

Section: Introductionmentioning

confidence: 99%

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Multi-laboratory evaluation of ReaScan TBE IgM rapid test, 2016 to 2017

et al. 2020

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Background: Tick-borne encephalitis (TBE) is a potentially severe neurological disease caused by TBE virus (TBEV). In Europe and Asia, TBEV infection has become a growing public health concern and requires fast and specific detection. Aim: In this observational study, we evaluated a rapid TBE IgM test, ReaScan TBE, for usage in a clinical laboratory setting. Methods: Patient sera found negative or positive for TBEV by serological and/or molecular methods in diagnostic laboratories of five European countries endemic for TBEV (Estonia, Finland, Slovenia, the Netherlands and Sweden) were used to assess the sensitivity and specificity of the test. The patients' diagnoses were based on other commercial or quality assured in-house assays, i.e. each laboratory's conventional routine methods. For specificity analysis, serum samples from patients with infections known to cause problems in serology were employed. These samples tested positive for e.g. Epstein-Barr virus, cytomegalovirus and Anaplasma phagocytophilum, or for flaviviruses other than TBEV, i.e. dengue, Japanese encephalitis, West Nile and Zika viruses. Samples from individuals vaccinated against flaviviruses other than TBEV were also included. Altogether, 172 serum samples from patients with acute TBE and 306 TBE IgM negative samples were analysed. Results: Compared with each laboratory's conventional methods, the tested assay had similar sensitivity and specificity (99.4% and 97.7%, respectively). Samples containing potentially interfering antibodies did not cause specificity problems. Conclusion: Regarding diagnosis of acute TBEV infections, ReaScan TBE offers rapid and convenient complementary IgM detection. If used as a stand-alone, it can provide preliminary results in a laboratory or point of care setting.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Multi-laboratory evaluation of ReaScan TBE IgM rapid test, 2016 to 2017

et al. 2020

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“…Neurological sequelae is reported in 30-40% of cases, ranging from concentration disabilities to tremor and paresis. [1,[6][7][8][9][10][11][12] In Europe two inactivated vaccines are presently registered, FSME-immune (available in Sweden since 1980s, Pfizer) and Encepur (GSK). The immunogenicity of any of those vaccines is 95-100%.…”

Section: Tbe Infection and Preventionmentioning

confidence: 99%

“…The probabilities of events after the incidence year were derived from several follow-up studies on TBE-infection. [1,[6][7][8][9][10][11][12]…”

Section: Tbe Incidence and Long Term Outcomesmentioning

confidence: 99%

“…The probabilities of dying due to TBE in the incidence year were derived from clinical follow up studies on TBE. [1,[6][7][8][9][10][11][12] There is no available data regarding the increased risk of death from TBE after the incidence year and therefore it was assumed that these probabilities are the same as for the incident year. As patients with severe sequelae have a higher risk of dying from other causes like infections and respiratory insufficiency this appears to be a plausible assumption.…”

Section: Mortalitymentioning

confidence: 99%

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Estimating costs and health outcomes of publicly funded tick-born encephalitis vaccination: A cost-effectiveness analysis

Shedrawy

Henriksson

Hergens

et al. 2018

Vaccine

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Severe Tick-Borne Encephalitis (TBE) in a Patient with X-Linked Agammaglobulinemia; Treatment with TBE Virus IgG Positive Plasma, Clinical Outcome and T Cell Responses

Hedin,

Bergman,

Akhirunessa

et al. 2024

J Clin Immunol

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Purpose A patient with X-linked agammaglobulinemia (XLA) and severe tick-borne encephalitis (TBE) was treated with TBE virus (TBEV) IgG positive plasma. The patient’s clinical response, humoral and cellular immune responses were characterized pre- and post-infection. Methods ELISA and neutralisation assays were performed on sera and TBEV PCR assay on sera and cerebrospinal fluid. T cell assays were conducted on peripheral blood the patient and five healthy vaccinated controls. Results The patient was admitted to the hospital with headache and fever. He was not vaccinated against TBE but receiving subcutaneous IgG-replacement therapy (IGRT). TBEV IgG antibodies were low-level positive (due to scIGRT), but the TBEV IgM and TBEV neutralisation tests were negative. During hospitalisation his clinical condition deteriorated (Glasgow coma scale 3/15) and he was treated in the ICU with corticosteroids and external ventricular drainage. He was then treated with plasma containing TBEV IgG without apparent side effects. His symptoms improved within a few days and the TBEV neutralisation test converted to positive. Robust CD8+ T cell responses were observed at three and 18-months post-infection, in the absence of B cells. This was confirmed by tetramers specific for TBEV. Conclusion TBEV IgG-positive plasma given to an XLA patient with TBE without evident adverse reactions may have contributed to a positive clinical outcome. Similar approaches could offer a promising foundation for researching therapeutic options for patients with humoral immunodeficiencies. Importantly, a robust CD8+ T cell response was observed after infection despite the lack of B cells and indicates that these patients can clear acute viral infections and could benefit from future vaccination programs.

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The long-term outcome of tick-borne encephalitis in Central Europe

Cited by 44 publications

References 30 publications

Multi-laboratory evaluation of ReaScan TBE IgM rapid test, 2016 to 2017

Multi-laboratory evaluation of ReaScan TBE IgM rapid test, 2016 to 2017

Estimating costs and health outcomes of publicly funded tick-born encephalitis vaccination: A cost-effectiveness analysis

Severe Tick-Borne Encephalitis (TBE) in a Patient with X-Linked Agammaglobulinemia; Treatment with TBE Virus IgG Positive Plasma, Clinical Outcome and T Cell Responses

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