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The Internet is an important gateway for accessing health-related information, and data generated through web queries have been increasingly used as a complementary source for monitoring and forecasting of infectious diseases and they may partially address the issue of underreporting. In this study, we assessed whether tick-borne encephalitis (TBE)-related Internet search volume may be useful as a complementary tool for TBE surveillance in Italy. Monthly Google Trends (GT) data for TBE-related information were extracted for the period between January 2017 and September 2022, corresponding to the available time series of TBE notifications in Italy. Time series modeling was performed by applying seasonal autoregressive integrated moving average (SARIMA) models with or without GT data. The search terms relative to tick bites reflected best the observed temporal distribution of TBE cases, showing a correlation coefficient of 0.81 (95 % CI: 0.71–0.88). Particularly, both the reported number of TBE cases and GT searches occurred mainly during the summer. The peak of disease notifications coincided with that of Google searches in 4 of 6 years. Once calibrated, SARIMA models with or without GT data were applied to a validation set. Retrospective forecast made by the model with GT data was associated with a lower prediction error and accurately predicted the peak timing. By contrast, the traditional SARIMA model underestimated the actual number of TBE notifications by 65 %. Timeliness, easy availability, low cost and transparency make monitoring of the TBE-related Internet search queries a promising addition to the traditional methods of TBE surveillance in Italy. [ABSTRACT FROM AUTHOR]

Abstract The 20th Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) − a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians, ecologists, and epidemiologists – was held under the theme "ISW-TBE: 20 years of commitment & still challenges ahead". On the occasion of the 20th anniversary of the ISW-TBE several key topics in TBE were extensively discussed, among them current epidemiological developments and investigations, expansion of risk areas, clinical aspects and cases, traveling and mobility, and latest news on TBE vaccination. The main goals that have been achieved by the ISW-TBE so far are, among others, an increased awareness in endemic and non-endemic countries, an increase of vaccination rates in various countries, getting TBE acknowledged and established as a travel-related risk, and building contact with the European Centre for Disease Prevention and Control. [ABSTRACT FROM AUTHOR]

Abstract Tick-borne encephalitis (TBE) vaccination recommendations for children residing in high-endemicity countries in Europe vary from universal recommendations to none at all. Such differences may result in uncertainty about the value of such prevention among public health authorities, healthcare professionals and parents. We conducted a systematic review of publications and data from the European Centres for Disease Prevention and Control focusing on the epidemiology, clinical characteristics, and outcomes of TBE in a pediatric population. TBE can affect children of any age, occasionally even before the first birthday. Overall, the clinical course of disease is milder compared to adults, and there are fewer neurologic sequelae persisting after the infection. However, recent follow-up surveys identified a substantial proportion of children with long-term cognitive impairment subsequent to TBE infection. Fortunately, two vaccines against western TBE are available, and both are effective and safe. It is an overly simplistic perception that TBE is severe in adults and mild in children, and to therefore conclude that vaccination is important mainly in older age groups. Even if TBE infection is less dramatic in pediatric populations, TBE often results in long-standing cognitive damage. Based on guidance from the World Health Organization, authorities in countries with high endemicity should either offer or recommend TBE vaccination to children at 1–3 years of age. [ABSTRACT FROM AUTHOR]

• 4085 animals from northern germany were tested for anti-TBEV antibodies. • Total seroprevalence was 1.5%, and was higher in wild than in domestic animals. • Clustering of positive samples in districts with TBEV transmission foci was noted. • Further clusters in other districts suggest so far undetected transmission foci. Tick-borne encephalitis virus (TBEV) is a tick-transmitted flavivirus, which can infect humans and animals, sometimes even with a fatal outcome. Since many decades, TBEV is endemic in southern Germany, while only sporadic occurrence has been noted in northern parts of the country so far. Nevertheless, autochthonous human clinical cases are increasing in the federal state of Lower Saxony in north-western Germany, and several natural foci of TBEV transmission have recently been detected in this federal state. In order to shed more light on the current distribution of TBEV in Lower Saxony, the present study examined blood samples from wild and domestic animals for antibodies against TBEV. Overall, samples from 4,085 animals were tested by ELISA, including wild boar (N = 1,208), roe deer (N = 149), red deer (N = 61), fallow deer (N = 18), red foxes (N = 9), nutria (N = 9), raccoon dogs (N = 3), raccoons (N = 3), badgers (N = 1), European pine martens (N = 1), horses (N = 574), sheep (N = 266), goats (N = 67), dogs (N = 1,317) and cats (N = 399). Samples with an ELISA result of ≥60 Vienna units (VIEU)/ml were subjected to confirmatory serum neutralization tests (SNT). In total, 343 of 4,085 (8.4%) animals tested positive for anti-TBEV-IgG by ELISA, of which 60 samples were confirmed by SNT. Samples of 89 animals showed a cytotoxic effect in the SNT and were excluded from seroprevalence calculation, resulting in an overall seroprevalence of 1.5% (60/3,996). Seroprevalence was higher among wild animals (wild boar: 2.9% [34/1,190], roe deer: 2.7% [4/149], red deer: 1.7% [1/60], fallow deer: 5.6% [1/18]) than among domestic animals (dogs: 1.1% [15/1,317], horses: 0.8% [4/505], sheep: 0.4% [1/266]). No anti-TBEV-antibodies were detected in the other wild animal species as well as goats and cats. A notable clustering of positive samples was observed in districts where TBEV transmission foci have been described. Further clusters in other districts suggest the existence of so far undetected transmission foci, underlining the fact that both wild and domestic animals are useful sentinels for monitoring the spread of TBEV. [Display omitted] [ABSTRACT FROM AUTHOR]

The 19th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) – a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians and epidemiologists–was held under the title “TBE in a changing world” . Key topics within virology, current epidemiological developments and investigations, expansion of risk areas, clinical aspects and cases, traveling and mobility, vaccination rates, and latest news on vaccination were presented and extensively discussed. Over the past four decades, TBE has become a growing public health challenge in Europe and parts of Asia. It may be considered a complex eco-epidemiological system, characterized by an intricate interplay between the virus, ticks and tick hosts on the one hand and human exposure strongly influenced by socioeconomic conditions on the other hand. Although the facts are simple – vaccination is the best prevention – the socioeconomic conditions keep changing, and with them the ability or willingness of people to get vaccinated. [ABSTRACT FROM AUTHOR]

This study investigated the geographical distribution of Ixodes ricinus and prevalence of the tick-borne encephalitis virus (TBEV) in northern Norway. Flagging for questing I. ricinus ticks was performed in areas ranging from Vikna in Nord-Trøndelag County, located 190 km south of the Arctic Circle (66.3°N), to Steigen in Nordland County, located 155 km north of the Arctic Circle. We found that ticks were abundant in both Vikna (64.5°N) and Brønnøy (65.1°N). Only a few ticks were found at locations ∼66°N, and no ticks were found at several locations up to 67.5°N. Real-time PCR (RT-PCR) analyses of the collected ticks (nymphs and adults) for the presence of TBEV revealed a low prevalence (0.1%) of TBEV among the nymphs collected in Vikna, while a prevalence of 0% to 3% was found among nymphs collected at five locations in Brønnøy. Adult ticks collected in Vikna and Brønnøy had higher rates of TBEV infection (8.6% and 0%–9.0%, respectively) than the nymphs. No evidence of TBEV was found in the few ticks collected further north of Brønnøy. This is the first report of TBEV being detected at locations up to 65.1°N. It remains to be verified whether viable populations of I. ricinus exist at locations north of 66°N. Future studies are warranted to increase our knowledge concerning tick distribution, tick abundance, and tick-borne pathogens in northern Norway. [ABSTRACT FROM AUTHOR]

Tick-borne encephalitis virus is the etiological agent of a severe human disease transmitted by hard ticks. It occurs in large parts of eastern, central, and western Asia and in Europe with thousands of human cases each year. Here, the discovery of the virus by Soviet scientists in the late 1930s in the Far East is described. The pioneering work involved with this discovery, which resulted in great scientific and epidemiological achievement, was undertaken under the most difficult conditions, and some of the scientists and their technical assistants paid for it with their health and even their lives. This paper briefly outlines the steps on the way that elucidated the basic etiology and eco-epidemiology of the disease, and does not omit that, as one result of the expeditions and the political situation in the former Soviet Union at that time, some scientists were sent to prison. [ABSTRACT FROM AUTHOR]

The 18th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE)−a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians and epidemiologists−was held under the title ’ Tick-borne encephalitis—still on the map ’. The conference agenda was divided into six sessions: ‘National Implementation of EU notifiable disease status’, ‘Virology’, ’Epidemiology and Risk areas & Poster Walk Epidemiological Update’, ‘Clinic’, ‘Environmental Factors’ and ‘New Findings and Diagnosis’. Key topics such as ‘TBE as a notifiable disease−results of the third European survey’, ‘TBE vaccines over the years’, ‘Overview of flaviviruses’, ‘TBE virus phylogenetics’, ‘Current epidemiological developments and investigations’, ‘Clinical aspects’, ‘TBE in veterinary medicine’, ‘Laboratory diagnostic’, ‘Occupational risk’, ‘Allergy, obesity, and vaccination’ were presented and extensively discussed. [ABSTRACT FROM AUTHOR]

The first tick-borne encephalitis (TBE) cases in Kotka, Finland appeared in 2010. Altogether ten human cases have been diagnosed by 2014. Four had long-lasting sequelae. We collected 195 Ixodes ricinus ticks, nine rodents, and eleven shrews from the archipelago of Kotka in 2011. Three Siberian subtype TBE virus (TBEV) strains were isolated from the ticks and three mammals were positive for TBEV antibodies. The archipelago of Kotka is a newly emerged TBE focus of Siberian subtype TBEV circulating notably in I. ricinus . The patients had on average longer hospitalization than reported for the European subtype infection. [ABSTRACT FROM AUTHOR]

Tick-borne encephalitis (TBE) is an infection caused by the Tick-borne encephalitis virus (TBEv) and it is common in Europe. The virus is predominantly transmitted by ticks, but other non-vectorial modes of transmission are possible. This systematic review synthesises the epidemiological impact of non-vectorial modes of TBEv transmission in Europe. 41 studies were included comprising of 1308 TBE cases. Alimentary (36 studies), handling infected material (3 studies), blood-borne (1 study), solid organ transplant (1 study) were identified as potential routes of TBEv transmission; however, no evidence of vertical transmission from mother to offspring was reported (2 studies). Consumption of unpasteurised milk/milk products was the most common vehicle of transmission and significantly increased the risk of TBE by three-fold (pooled RR 3.05, 95% CI 1.53 to 6.11; 4 studies). This review also confirms handling infected material, blood-borne and solid organ transplant as potential routes of TBEv transmission. It is important to tracing back to find the vehicle of the viral infection and to promote vaccination as it remains a mainstay for the prevention of TBE. [ABSTRACT FROM AUTHOR]

Health control measures instituted in 2020 to mitigate the COVID-19 pandemic decreased the case numbers of many infectious diseases across Europe. One notable exception was tick-borne encephalitis (TBE). In Austria, Germany, Switzerland, Lithuania, and the Czech Republic, the upturn was significantly higher compared to the average of the three years previously (P <0.05), with increases of 88%, 48%, 51%, 28%, and 18%, respectively. Six countries reported TBE incidences of ≥5 cases/100,000, defined as highly endemic by the World Health Organization (WHO). Possible factors contributing to this surge may include increased participation in outdoor activities in endemic regions and increased tick counts/tick activity. In highly endemic regions, the WHO recommends that vaccination be offered to all age groups, including children. [ABSTRACT FROM AUTHOR]

The 17th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE), a group of neurologists, general practicioners, clinicians, travel physicians, virologists, pediatricians, and epidemiologists, was held under the title “Tick-borne encephalitis as a notifiable disease – status quo and the way forward”. The conference agenda was divided into three parts on the first day: “Epidemiology & Risk areas”, “Poster Walk: Epidemiological Update in Europe”, and “News in TBE Research”. On the second day, a World Café Working Session took place where the participants could choose three tables out of six to join for discussion. Key topics on current epidemiological developments and investigations, risk areas, cases, travel and mobility, TBE in children, vaccination rates, and latest news on vaccination were presented and extensively discussed. [ABSTRACT FROM AUTHOR]

A large majority of Austrian citizens are aware of tick-borne encephalitis (TBE), consequently reflected by a high vaccination rate of 85%. In return, risk assessment and disease mapping on human cases might be hampered due to high and inhomogeneous vaccination rates and travel habitats of humans. The roe deer was used to obtain a starting point for the integral view on the actual risk of TBE in Austria. The roe deer exhibits several attributes which makes it suitable as an indicator species: the roe deer has a restricted home range and it is known to be a heavy tick carrier. Furthermore it sero-converts after infection with TBE, but no outbreak occurs. Sera from 945 roe deer were obtained from all over Austria and screened with IFAT for the antibodies against TBE. Twenty-two positive samples, 2.4%, and 17 samples at the borderline titre of 1:16 were identified. The majority of the positive samples, 70.6%, were located in known TBE areas based on human cases. Further research is needed to confirm or reject new endemic foci of TBE transmission. [ABSTRACT FROM AUTHOR]

The 16th Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practicioners, clinicians, travel physicans, virologists, paediatricians, and epidemiologists - was held under the title "Tick-borne Encephalitis - a Notifiable Disease, a Review after One Year".With the inclusion of TBE in the list of notifiable diseases in 2012, an important measure was established to continue improving the level of evidence on TBE in Europe to better help guide policies and methods to lower the burden of this disease.The conference agenda was divided into six parts concerning Travel Medicine, Epidemiology & Risk Areas, Poster Session with an Epidemiological Update in Europe, Interactive Debate, Cases, and Social Communiation and Recommendations. Important topics regarding current epidemiological investigations, risk areas, mobility, cases, TBE in children, treatment options, vaccination rates, and latest news on vaccination were presented and extensively discussed. [ABSTRACT FROM AUTHOR]

Tick-borne encephalitis (TBE) is a viral infection of the central nervous system (CNS) caused by tick-borne encephalitis virus (TBEV). It might take several clinical courses such as: meningitis, meningoencephalitis or meningoencephalomyelitis. The aim this study was to compare the YKL-40 concentration in cerebrospinal fluid (CSF) of patients with different clinical presentations of TBE and patients with excluded meningitis (control group). The concentration of YKL-40 in CSF was determined using Fujirebio tests (Ghent, Belgium) in 32 patients with TBE: Group I—patients with meningoencephalitis (n = 16); Group II—patients with meningitis (n = 16). The control group (CG) consisted of 17 patients in whom any inflammatory process in central nervous system was excluded. The concentration of YKL-40 was significantly higher in encephalitis group than in the CG after 7 days from the last dose of treatment. The concentration in patients with neuroinflammation had a significantly different concentration of YKL-40 compared to patients from the neuroinflammation control group. The ROC curve analysis indicates that CSF YKL-40 concentration at cut-off 783.87 differentiated TBE patients from CG with 100% specificity and 70% sensitivity and CSF YKL-40 concentration at cut-off 980.11 differentiated meningitis from meningoencephalitis with 87.5% specificity and 62.5% sensitivity. YKL-40 takes part in TBE pathogenesis, its concentration is the highest at the early stage of CNS involvement and decreases in the convalescent period. As YKL-40 was significantly higher in the meningitis than in the meningoencephalitis group, it might be used as biomarker in differentiation of these clinical forms of TBE. [ABSTRACT FROM AUTHOR]

Abstract: Today, the risk of getting tick-borne encephalitis (TBE) is still underestimated in many parts of Europe and worldwide. Therefore, the 14th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) – a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians, and epidemiologists – was held under the title “Tick-borne encephalitis: an underestimated risk…still”. Among the discussed issues were: TBE, an underestimated risk in children, a case report in two Dutch travelers, the very emotional report of a tick victim, an overview of the epidemiological situation, investigations to detect new TBE cases in Italy, TBE virus (TBEV) strains circulation in Northern Europe, TBE Program of the European Centre for Disease Prevention and Control (ECDC), efforts to increase the TBE vaccination rate in the Czech Republic, positioning statement of the World Health Organization (WHO), and TBE in dogs. To answer the question raised above: Yes, the risk of getting TBE is underestimated in children and adults, because awareness is still too low. It is still underestimated in several areas of Europe, where, for a lack of human cases, TBEV is thought to be absent. It is underestimated in travelers, because they still do not know enough about the risk, and diagnostic awareness in non-endemic countries is still low. [Copyright &y& Elsevier]

Abstract: Tick-borne encephalitis (TBE) is the most important viral infection transmitted by ticks in Central Europe. In Germany, where TBE was classified as a notifiable disease in 2001, a highly variable number of clinically apparent human cases was reported in the last few years, ranging from the lowest number of 238 in 2007 to a maximum of 546 in 2006. The dynamics of the virus and its vector tick remain poorly understood. We investigated a highly active TBE focus in south-eastern Germany where from 2003 to 2008 a total of 9 clinical human cases was diagnosed. Three out of these 9 cases were fatal indicating an unusually high mortality rate possibly due to a highly virulent TBEV strain. From 2005 till 2008, 2150 Ixodes ricinus ticks were collected and tested for the presence of TBE virus. Five TBEV-positive ticks were detected by real-time RT-PCR. A viable virus strain was isolated from one of the positive ticks sampled in 2005. This is the first TBE virus isolate from a tick in Germany for 30 years. Sequencing of the full-length genome of this virus strain (AS33) revealed 2 unique amino acid substitutions in the envelope protein known to play a role in the pathogenicity of TBE virus. Amplification of the envelope gene using 2 TBEV-PCR-positive ticks from 2006 also showed these particular mutations indicating that this TBE virus strain was present in at least 2 consecutive years. The entire sampling area was divided into smaller sectors for the exact location of TBEV-positive ticks. Virus-positive ticks were found to be randomly distributed throughout the investigated focus, which is used as recreational area by the local people. [Copyright &y& Elsevier]

• Travelers in TBE endemic areas should be proactive when found to be tick exposed. • Medical doctors should consider travel history and tick exposure of their patients. • Detached ticks and traveler's blood should be tested for the presence of TBEV. Although travel-related tick-borne encephalitis (TBE) cases have been increasingly registered worldwide, very few published case studies are available to date. The present report describes a travel-related TBE case and provides genotypic characterization of two viral isolates. Laboratory diagnostics were based on complement fixation test and virus isolation. This report is unique because the TBE case was first confirmed by virus isolation from the engorged tick and only later from the patient's blood. Moreover, this case demonstrated a successful prophylaxis performed on day 8 post tick exposure although it is generally recommended that anti-TBEV immunoglobulins should be administered not later than on day 4 after tick bite. Sequences of E protein gene fragments were used to phylogenetically characterize the two isolates. The results demonstrated that both viral isolates belonged to clusteron 3A (Zausaev group) of the Asian lineage of the TBEV Siberian subtype. The synonymous nucleotide substitution, C351 T, was identified in E protein gene fragments of TBEV 88 and TBEV 89, which could have been induced by virus transmission. A few important take-home messages can be gleaned from the reported case. First, travelers should be aware of TBE endemic areas that they plan to visit and be proactive when exposed to Ixodes ticks. Second, medical practitioners should always consider travel history and potential tick exposure of patients. Lastly, engorged Ixodes spp. ticks removed from the patients, who have arrived from endemic areas, should be tested for TBEV even in the absence of TBE clinical signs. [ABSTRACT FROM AUTHOR]

Abstract: The 15th Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) – a group of neurologists, general practicioners, clinicians, travel physicans, virologists, pediatricians, and epidemiologists – was held under the title “Tick-Borne Encephalitis – a notifiable disease”. With the inclusion of TBE in the list of notifiable diseases, an important measure was established to continue improving the level of evidence on TBE in Europe to better help guide policies and methods to lower the burden of this disease. Due to differences in diagnosis, case definition, and reporting in European countries, the overall epidemiology and burden of TBE remains unclear. During the meeting, important issues regarding epidemiology, risk areas, vaccination rates, and latest news on vaccination were presented and extensively discussed. A poster session provided an overview of the epidemiological situation 2012 in 13 European countries. [Copyright &y& Elsevier]

The 21st Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) − a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians, ecologists, and epidemiologists − was held under the theme " TBE – record year 2018″. Several key topics in the field of TBE were extensively discussed, among them current epidemiological developments in different countries, expansion of risk areas, virological and clinical aspects, importance of awareness, traveling and mobility, and latest news on TBE vaccination. The main goals that have been achieved by the ISW-TBE so far are, among others, an increased awareness in endemic and non-endemic countries, an increase of vaccination rates in various countries, getting TBE acknowledged and established as a travel-related risk, and building contact with the European Centre for Disease Prevention and Control. [ABSTRACT FROM AUTHOR]

Tick-borne encephalitis (TBE) is an occupational hazard for forestry workers. We measured knowledge levels, misbeliefs, and vaccination rates in forestry trainees in order to tailor specific measures aimed at reducing occupational TBE incidence. A paper-based survey was performed at a central training site for forestry workers in the state of Baden-Wuerttemberg. The questionnaire contained items regarding vaccination status against tick-borne encephalitis virus (TBEV), self-reported tick-borne diseases, knowledge of and attitudes towards tick-borne disease, and practices in the context of ticks and tick bites. All trainees in the period June-December 2018 were surveyed. Statistical analyses were conducted using Mann-Whitney-Rank sum test and one-way ANOVA tests. Two-hundred-twenty-five trainees participated in the survey. Almost all (>99%) were aware of living in a TBE high-risk area. Eighty-three percent of respondents were vaccinated in line with current recommendations. Seventeen percent had no effective vaccination status. Twenty-seven percent believed that ticks can transmit only TBEV and Borrelia spp. Sixty-two percent knew that TBEV infections can be fatal. Only 8% of respondents use tick repellents and only 17% wear long sleeves and pants. Trainees who graduated from a six and (eight or) nine secondary school (Realschule and Abitur respectively) had more knowledge on ticks and tick-borne disease compared to graduates from a five year school (Hauptschule) (p = 0.002 and p = 0,037 respectively). Overall, the TBE vaccination rate is not high enough in this high-risk occupational group. We identified gaps in knowledge and practices that could have an impact on TBE incidence in this group if addressed. Further epidemiological research is needed on knowledge, attitudes, and practices in different high-risk populations. [ABSTRACT FROM AUTHOR]