Tick-Borne Encephalitis—Review of the Current Status

Kwasnik, Malgorzata; Rola, Jerzy; Rozek, Wojciech

doi:10.3390/jcm12206603

Cited by 4 publications

(5 citation statements)

References 107 publications

(128 reference statements)

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“…Moreover, in every year from 2005 onwards, the majority of cases had been diagnosed outside the traditional hotspot of Åland archipelago. These developments are not surprising considering that TBE has become more common at least in Europe and Asia and in Finland tick contact areas have expanded over the past 60 years with observations becoming more common also in eastern Finland [12][13][14][15]. The majority of previous studies have globally reported HSV as the most frequent viral pathogen, followed by VZV in several studies.…”

Section: Discussionmentioning

confidence: 95%

Adult-Onset Encephalitis over Twelve Years in Easternmost Finland

Sipilä

2024

Neuroepidemiology

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Introduction: The epidemiology of encephalitis varies by region and time. Available Finnish data are outdated and there are no data from eastern parts of the country nor concerning the occurrence autoimmune encephalitides. Material and methods: Patients with encephalitis were identified from mandatory administrative registries in North Karelia Central Hospital. The diagnoses were verified, and data extracted by reviewing the patient records. Study period was 2010-2021. Only patients >16 years of age were included. Results: 51 patients with a clinical encephalitis were identified (55 % men) identified with a median age of 65 years [interquartile range (IQR) 45, 73; total age range 16-88 years] indicating a crude incidence of 3.1/100,000 person-years for the entire study period. A specific aetiology could be identified in 31 cases (61 %) with Tick-borne encephalitis (TBE) being the most common one (20 % of all 51 cases), followed by Herpes simplex virus type 1 (HSV-1, 16 %) and Varicella Zoster virus (VZV, 14 %). Autoimmune aetiology was confirmed in 10 %. TBE was most often found in the youngest age group (16-52 years of age) and the herpes viruses in the oldest group (71 years or older). A specific cause was most often identified in the oldest patients (78 %). TBE patients were younger than patients with VZV (p=0.0009) or HSV-1 (p=0.0057) but there was no difference when they were compared to patients with autoimmune (p=0.27) or unknown (p=0.074) aetiology. At presentation, there were differences in the occurrence of some clinical signs and symptoms between aetiologies but nothing specific. Eight patients (16 %) were immunosuppressed. Inpatient seizures occurred in 10 patients (20 %). In these cases, the etiology was HSV-1 in 50 % and TBE or VZV in none. A full recovery was observed in 51 % of all patients while three patients (6 %) had died of the encephalitis while in hospital or shortly after discharge. Conclusions: Adult-onset encephalitis was more common and the patients older in easternmost Finland than previously reported in other parts of the country. TBE, HSV-1 and VZV are the most commonly identified specific aetiologies whereas a fifth of the cases are probably caused by autoimmunity. Prognosis depended on aetiology but was very good in the majority of cases

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Section: Discussionmentioning

confidence: 95%

Adult-Onset Encephalitis over Twelve Years in Easternmost Finland

Sipilä

2024

Neuroepidemiology

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“…Lithuania, Latvia, and Estonia had the highest reporting rates [ 1 ]. The continuing increase in the number of TBEV strains detected in I. ricinus in Europe and the westward spread of I. persulcatus and the more virulent TBEV European and Siberian strains is of great concern [ 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the three main subtypes (European, Far Eastern, and Siberian), two other subtypes (Baikalian and Himalayan) have been described recently [ 4 ]. Tick Ixodes ricinus , mainly distributed in Europe, is the main vector for TBEV [ 5 ]. TBEV infections in humans mostly occur after the bite of an infected tick; however, the number of food-borne TBE infections occurring after consumption of unpasteurized goat milk has been increasing in recent years [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

An Overview of Tick-Borne Encephalitis Epidemiology in Endemic Regions of Continental Croatia, 2017–2023

Vilibic-Cavlek,

Krcmar,

Bogdanic

et al. 2024

Microorganisms

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Background: Tick-borne encephalitis (TBE) represents an important public health problem in Europe. We analyzed the epidemiology of TBE based on data from humans, animals, and Ixodes ricinus ticks in endemic regions of continental Croatia. Methods: In the period from 2017 to 2023, cerebrospinal fluid (CSF) and serum samples of 684 patients with neuroinvasive diseases, 2240 horse serum samples, and 300 sheep serum samples were tested for TBEV. In addition, 8751 I. ricinus ticks were collected. CSF samples were tested using RT-PCR. Serological tests (serum, CSF) were performed using commercial ELISA, with confirmation of cross-reactive samples by a virus neutralization test. Results: Eighty-four autochthonous human TBEV cases were confirmed. The majority of patients were in the age group of 40–69 years (58.3%) with a male predominance (70.2%). TBE showed a bimodal seasonality with a large peak in April–August and a small one in October–November. In addition to humans, TBEV IgG antibodies were found in 12.2% of horses and 9.7% of sheep. Seasonal tick abundance corresponds to the reported number of human infections. Conclusions: Continental Croatia is still an active natural focus of TBE. Continuous monitoring of infections in humans, sentinel animals, and ticks is needed for the implementation of preventive measures.

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“…The techniques used to experimentally transmit HRTV in H. longicornis ticks could also be attempted using other ticks to help determine their potential for HRTV transmission, including I. scapularis and D. variabilis . In consideration of the fact that changing climactic conditions may foster further spread of tickborne HRTV, other global tick species capable of disease transmission could similarly be tested [ 51 , 52 , 53 ].…”

Section: Tick Infection Distribution and Rangementioning

confidence: 99%

Heartland Virus Disease—An Underreported Emerging Infection

Dembek,

Mothershead,

Cirimotich

et al. 2024

Microorganisms

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First recognized 15 years ago, Heartland virus disease (Heartland) is a tickborne infection contracted from the transmission of Heartland virus (HRTV) through tick bites from the lone star tick (Amblyomma americanum) and potentially other tick species. Heartland symptoms include a fever <100.4 °F, lethargy, fatigue, headaches, myalgia, a loss of appetite, nausea, diarrhea, weight loss, arthralgia, leukopenia and thrombocytopenia. We reviewed the existing peer-reviewed literature for HRTV and Heartland to more completely characterize this rarely reported, recently discovered illness. The absence of ongoing serosurveys and targeted clinical and tickborne virus investigations specific to HRTV presence and Heartland likely contributes to infection underestimation. While HRTV transmission occurs in southern and midwestern states, the true range of this infection is likely larger than now understood. The disease’s proliferation benefits from an expanded tick range due to rising climate temperatures favoring habitat expansion. We recommend HRTV disease be considered in the differential diagnosis for patients with a reported exposure to ticks in areas where HRTV has been previously identified. HRTV testing should be considered early for those matching the Heartland disease profile and nonresponsive to initial broad-spectrum antimicrobial treatment. Despite aggressive supportive therapy, patients deteriorating to sepsis early in the course of the disease have a very grim prognosis.

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Tick-Borne Encephalitis—Review of the Current Status

Cited by 4 publications

References 107 publications

Adult-Onset Encephalitis over Twelve Years in Easternmost Finland

Adult-Onset Encephalitis over Twelve Years in Easternmost Finland

An Overview of Tick-Borne Encephalitis Epidemiology in Endemic Regions of Continental Croatia, 2017–2023

Heartland Virus Disease—An Underreported Emerging Infection

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