Tick-borne encephalitis in Europe: a brief update on epidemiology, diagnosis, prevention, and treatment

Riccardi, Niccolò; Antonello, Roberta Maria; Luzzati, Roberto; Zajkowska, Joanna; Bella, Stefano Di; Giacobbe, Daniele Roberto

doi:10.1016/j.ejim.2019.01.004

Cited by 92 publications

(94 citation statements)

References 45 publications

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“…An increasing number of human cases of TBE has been recorded in Sweden as TBEV is emerging into new areas and vaccine coverage is incomplete. TBE is emerging into new areas not only in Sweden, but also establishing itself in regions all over Europe and Asia [19,33,34]. The epidemiology of TBE in Sweden has changed over the last 20 years.…”

Section: Discussionmentioning

confidence: 99%

Revealing new tick-borne encephalitis virus foci by screening antibodies in sheep milk

et al. 2020

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Background: Tick distribution in Sweden has increased in recent years, with the prevalence of ticks predicted to spread towards the northern parts of the country, thus increasing the risk of tick-borne zoonoses in new regions. Tickborne encephalitis (TBE) is the most significant viral tick-borne zoonotic disease in Europe. The disease is caused by TBE virus (TBEV) infection which often leads to severe encephalitis and myelitis in humans. TBEV is usually transmitted to humans via tick bites; however, the virus can also be excreted in the milk of goats, sheep and cattle and infection may then occur via consumption of unpasteurised dairy products. Virus prevalence in questing ticks is an unreliable indicator of TBE infection risk as viral RNA is rarely detected even in large sample sizes collected at TBE-endemic areas. Hence, there is a need for robust surveillance techniques to identify emerging TBEV risk areas at early stages.Methods: Milk and colostrum samples were collected from sheep and goats in Örebro County, Sweden. The milk samples were analysed for the presence of TBEV antibodies by ELISA and validated by western blot in which milk samples were used to detect over-expressed TBEV E-protein in crude cell extracts. Neutralising titers were determined by focus reduction neutralisation test (FRNT). The stability of TBEV in milk and colostrum was studied at different temperatures. Results:In this study we have developed a novel strategy to identify new TBEV foci. By monitoring TBEV antibodies in milk, we have identified three previously unknown foci in Örebro County which also overlap with areas of TBE infection reported during 2009-2018. In addition, our data indicates that keeping unpasteurised milk at 4 °C will preserve the infectivity of TBEV for several days. Conclusions:Altogether, we report a non-invasive surveillance technique for revealing risk areas for TBE in Sweden, by detecting TBEV antibodies in sheep milk. This approach is robust and reliable and can accordingly be used to map TBEV "hotspots". TBEV infectivity in refrigerated milk was preserved, emphasising the importance of pasteurisation (i.e. 72 °C for 15 s) prior to consumption.

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Section: Discussionmentioning

confidence: 99%

Revealing new tick-borne encephalitis virus foci by screening antibodies in sheep milk

et al. 2020

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“…Tick-borne encephalitis virus (TBEV), a member of the family Flaviviridae, genus Flavivirus [1], presents significant health risks in a large proportion of Europe and Asia. During the last decades, incidence rates have increased and the endemic areas have expanded [2,3]. For example, the virus has recently been detected in the United Kingdom, which was previously considered to be a TBEV-free country [4,5].…”

Section: Introductionmentioning

confidence: 99%

Tick-Borne Encephalitis Virus Vaccines Contain Non-Structural Protein 1 Antigen and May Elicit NS1-Specific Antibody Responses in Vaccinated Individuals

et al. 2020

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Vaccination against tick-borne encephalitis (TBE) is based on the use of formalin-inactivated, culture-derived whole-virus vaccines. Immune response following vaccination is primarily directed to the viral envelope (E) protein, the major viral surface antigen. In Europe, two TBE vaccines are available in adult and pediatric formulations, namely FSME-IMMUN® (Pfizer) and Encepur® (GlaxoSmithKline). Herein, we analyzed the content of these vaccines using mass spectrometry (MS). The MS analysis revealed that the Encepur vaccine contains not only proteins of the whole virus particle, but also viral non-structural protein 1 (NS1). MS analysis of the FSME-IMMUN vaccine failed due to the high content of human serum albumin used as a stabilizer in the vaccine. However, the presence of NS1 in FSME-IMMUN was confirmed by immunization of mice with six doses of this vaccine, which led to a robust anti-NS1 antibody response. NS1-specific Western blot analysis also detected anti-NS1 antibodies in sera of humans who received multiple doses of either of these two vaccines; however, most vaccinees who received ≤3 doses were negative for NS1-specific antibodies. The contribution of NS1-specific antibodies to protection against TBE was demonstrated by immunization of mice with purified NS1 antigen, which led to a significant (p < 0.01) prolongation of the mean survival time after lethal virus challenge. This indicates that stimulation of anti-NS1 immunity by the TBE vaccines may increase their protective effect.

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“…Tick-borne encephalitis virus (TBEV), a member of the family Flaviviridae, genus Flavivirus [1], presents significant health risks in a large proportion of Europe and Asia. During the last decades, incidence rates have been increasing and the endemic areas expanding [2][3]. For example, the virus has recently been detected in the United Kingdom, which was previously considered to be a TBEVfree country [4][5].…”

Section: Introductionmentioning

confidence: 99%

Tick-borne Encephalitis Virus Vaccines Contain Non-structural Protein 1 (NS1) Antigen and May Elicit NS1-Specific Antibody Responses in Vaccinated Individuals

Salát¹,

Mikulášek²,

Larralde³

et al. 2020

Preprint

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Vaccination against tick-borne encephalitis (TBE) is based on the use of formalin-inactivated, culture-derived whole-virus vaccines. Immune response following vaccination is primarily directed to the viral envelope (E) protein, the major viral surface antigen. In Europe, two TBE vaccines are available in adult and pediatric formulations, FSME-IMMUN® (Pfizer) and Encepur® (GlaxoSmithKline). Herein, we analyzed the content of these vaccines using mass spectrometry (MS). The MS analysis revealed that the Encepur vaccine contains not only proteins of the whole virus particle, but also viral non-structural protein 1 (NS1). MS analysis of the FSME-IMMUN vaccine failed due to the high content of human serum albumin used as a stabilizer in the vaccine. However, the presence of NS1 in FSME-IMMUN was confirmed by immunization of mice with six doses of this vaccine, which led to a robust anti-NS1 antibody response. NS1-specific western blot analysis detected anti-NS1 antibodies also in sera of humans who received multiple doses of either of these two vaccines; however, most vaccinees who received ≤3 doses were negative for NS1-specific antibodies. The contribution of NS1-specific antibodies to protection against TBE was demonstrated by immunization of mice with purified NS1 antigen, which led to a significant (p < 0.01) prolongation of the mean survival time after lethal virus challenge. This indicates that stimulation of anti-NS1 immunity by the TBE vaccines may increase their protective effect.

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Tick-borne encephalitis in Europe: a brief update on epidemiology, diagnosis, prevention, and treatment

Cited by 92 publications

References 45 publications

Revealing new tick-borne encephalitis virus foci by screening antibodies in sheep milk

Revealing new tick-borne encephalitis virus foci by screening antibodies in sheep milk

Tick-Borne Encephalitis Virus Vaccines Contain Non-Structural Protein 1 Antigen and May Elicit NS1-Specific Antibody Responses in Vaccinated Individuals

Tick-borne Encephalitis Virus Vaccines Contain Non-structural Protein 1 (NS1) Antigen and May Elicit NS1-Specific Antibody Responses in Vaccinated Individuals

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