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Tick-borne encephalitis virus (TBEV) infection may cause acute central nervous system inflammation varying in clinical manifestations and severity. A possible correlation of TBEV-specific antibody and cell-mediated immune responses, shortly after infection, with clinical manifestations, severity and long-term outcome has been poorly investigated. In a cohort of thirty early tick-borne encephalitis (TBE) patients, we assessed the magnitude, specificity and functional properties of TBEV-specific T-cell and antibody responses. These responses early during disease were assessed in view of clinical manifestations, severity and long-term outcome. TBEV-specific T-cell responses to C, E, NS1, and NS5 proteins were significantly lower in patients with severe acute illness than in patients with mild TBE. Lower T-cell responses to E, NS1, and NS5 proteins also correlated with the development of meningoencephalomyelitis. Virus-specific antibody titres early after infection did not correlate with disease severity, clinical manifestations, or long-term outcome in this study, possibly due to the small number of patients of which matching serum and peripheral blood mononuclear cells were available. The findings suggest that virus-specific T cells afford a certain degree of protection against the development of severe TBEV-induced disease.

Rift Valley fever (RVF) is a mosquito-borne zoonotic disease caused by RVF virus (RVFV). RVFV infections in humans are usually asymptomatic or associated with mild febrile illness, although more severe cases of haemorrhagic disease and encephalitis with high mortality also occur. Currently, there are no licensed human vaccines available. The safety and efficacy of a genetically engineered four-segmented RVFV variant (hRVFV-4s) as a potential live-attenuated human vaccine has been tested successfully in mice, ruminants, and marmosets though the correlates of protection of this vaccine are still largely unknown. In the present study, we have assessed hRVFV-4s-induced humoral and cellular immunity in a mouse model of RVFV infection. Our results confirm that a single dose of hRVFV-4s is highly efficient in protecting naïve mice from developing severe disease following intraperitoneal challenge with a highly virulent RVFV strain and data show that virus neutralizing (VN) serum antibody titres in a prime-boost regimen are significantly higher compared to the single dose. Subsequently, VN antibodies from prime-boost-vaccinated recipients were shown to be protective when transferred to naïve mice. In addition, hRVFV-4s vaccination induced a significant virus-specific T cell response as shown by IFN-γ ELISpot assay, though these T cells did not provide significant protection upon passive transfer to naïve recipient mice. Collectively, this study highlights hRVFV-4s-induced VN antibodies as a major correlate of protection against lethal RVFV infection.

Tick-borne encephalitis virus (TBEV) vaccine breakthrough (VBT) infections are not uncommon in endemic areas. The clinical and immunological outcomes have been poorly investigated. We assessed the magnitude and specificity of virus-specific antibody and T cell responses after TBE in previously vaccinated subjects and compared the results with those of unvaccinated TBE patients and study subjects that received vaccination without VBT infection. Symptomatic TBEV infection of unvaccinated study subjects induced virus-specific antibody responses to the E protein and non-structural protein 1 (NS1) as well as T cell responses to structural and other non-structural (NS) proteins. After VBT infections, significantly impaired NS1-specific antibody responses were observed, while the virus-specific T cell responses to the NS proteins were relatively strong. VBT infection caused predominantly moderate to severe disease during hospitalization. The level of TBEV EDIII- and NS1-specific antibodies in unvaccinated convalescent patients inversely correlated with TBE severity and neurological symptoms early after infection., (© 2024. The Author(s).)

Tick-borne encephalitis (TBE) is a serious neurological disease caused by TBE virus (TBEV). Because antiviral treatment options are not available, vaccination is the key prophylactic measure against TBEV infections. Despite the availability of effective vaccines, cases of vaccination breakthrough infections have been reported. The multienzymatic non-structural protein 3 (NS3) of orthoflaviviruses plays an important role in polyprotein processing and virus replication. In the present study, we evaluated NS3 of TBEV as a potential vaccine target for the induction of protective immunity. To this end, a recombinant modified vaccinia virus Ankara that drives the expression of the TBEV NS3 gene (MVA-NS3) was constructed. MVA-NS3 was used to immunize C57BL/6 mice. It induced NS3-specific immune responses, in particular T cell responses, especially against the helicase domain of NS3. However, MVA-NS3-immunized mice were not protected from subsequent challenge infection with a lethal dose of the TBEV strain Neudoerfl, indicating that in contrast to immunity to prME and NS1, NS3-specific immunity is not an independent correlate of protection against TBEV in this mouse model.

Introduction: Tick-borne encephalitis virus (TBEV) is one of the most relevant tick-transmitted neurotropic arboviruses in Europe and Asia and the causative agent of tick-borne encephalitis (TBE). Annually more than 10,000 TBE cases are reported despite having vaccines available. In Europe, the vaccines FSME-IMMUN® and Encepur® based on formaldehyde-inactivated whole viruses are licensed. However, demanding vaccination schedules contribute to sub-optimal vaccination uptake and breakthrough infections have been reported repeatedly. Due to its immunogenic properties as well as its role in viral replication and disease pathogenesis, the non-structural protein 1 (NS1) of flaviviruses has become of interest for non-virion based flavivirus vaccine candidates in recent years., Methods: Therefore, immunogenicity and protective efficacy of TBEV NS1 expressed by neuraminidase (NA)-deficient Influenza A virus (IAV) or Modified Vaccinia virus Ankara (MVA) vectors were investigated in this study., Results: With these recombinant viral vectors TBEV NS1-specific antibody and T cell responses were induced. Upon heterologous prime/boost regimens partial protection against lethal TBEV challenge infection was afforded in mice., Discussion: This supports the inclusion of NS1 as a vaccine component in next generation TBEV vaccines., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Beicht, Kubinski, Zdora, Puff, Biermann, Gerlach, Baumgärtner, Sutter, Osterhaus, Prajeeth and Rimmelzwaan.)

Introduction: Tick-borne encephalitis virus (TBEV) is an important human pathogen that can cause a serious disease involving the central nervous system (tick-borne encephalitis, TBE). Although approved inactivated vaccines are available, the number of TBE cases is rising, and breakthrough infections in fully vaccinated subjects have been reported in recent years., Methods: In the present study, we generated and characterized a recombinant Modified Vaccinia virus Ankara (MVA) for the delivery of the pre-membrane (prM) and envelope (E) proteins of TBEV (MVA-prME)., Results: MVA-prME was tested in mice in comparison with a licensed vaccine FSME-IMMUN® and proved to be highly immunogenic and afforded full protection against challenge infection with TBEV., Discussion: Our data indicate that MVA-prME holds promise as an improved next-generation vaccine for the prevention of TBE., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kubinski, Beicht, Zdora, Biermann, Puff, Gerlach, Tscherne, Baumgärtner, Osterhaus, Sutter, Prajeeth and Rimmelzwaan.)

Introduction: Naturally attenuated Langat virus (LGTV) and highly pathogenic tick-borne encephalitis virus (TBEV) share antigenically similar viral proteins and are grouped together in the same flavivirus serocomplex. In the early 1970s, this has encouraged the usage of LGTV as a potential live attenuated vaccine against tick-borne encephalitis (TBE) until cases of encephalitis were reported among vaccinees. Previously, we have shown in a mouse model that immunity induced against LGTV protects mice against lethal TBEV challenge infection. However, the immune correlates of this protection have not been studied., Methods: We used the strategy of adoptive transfer of either serum or T cells from LGTV infected mice into naïve recipient mice and challenged them with lethal dose of TBEV., Results: We show that mouse infection with LGTV induced both cross-reactive antibodies and T cells against TBEV. To identify correlates of protection, Monitoring the disease progression in these mice for 16 days post infection, showed that serum from LGTV infected mice efficiently protected from developing severe disease. On the other hand, adoptive transfer of T cells from LGTV infected mice failed to provide protection. Histopathological investigation of infected brains suggested a possible role of microglia and T cells in inflammatory processes within the brain., Discussion: Our data provide key information regarding the immune correlates of protection induced by LGTV infection of mice which may help design better vaccines against TBEV., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kubinski, Beicht, Zdora, Saletti, Kircher, Petry-Gusmag, Steffen, Puff, Jung, Baumgärtner, Rimmelzwaan, Osterhaus and Prajeeth.)

The newly discovered group of Jingmenviruses has been shown to infect a wide range of hosts and has been associated with febrile illness in humans. During a survey for Jingmenviruses in ticks from Lower Saxony, Germany, Alongshan virus (ALSV) was identified in Ixodes spp. ticks. Additional virus screenings revealed the presence of ALSV in the bodies and saliva of ticks collected at several locations in Lower Saxony. Vector competence studies that included Ixodes ricinus and Dermacentor reticulatus validated the replication of ALSV within those tick species. In vitro feeding experiments with ALSV-injected Ixodes ricinus demonstrated effective viral transmission during blood feeding. To evaluate the potential viral transmission during a natural blood meal, sera from wild game and domestic animals were investigated. One serum sample from a red deer was found to be positive for ALSV RNA, while serological screenings in game and domestic animals revealed the presence of ALSV-specific antibodies at different locations in Lower Saxony. Overall, those results demonstrate the broad distribution of ALSV in ticks in Lower Saxony and hypothesize frequent exposure to animals based on serological investigations. Hence, its potential risk to human and animal health requires further investigation.

Tick-borne encephalitis virus (TBEV), a member of the family Flaviviridae , is one of the most important tick-transmitted viruses in Europe and Asia. Being a neurotropic virus, TBEV causes infection of the central nervous system, leading to various (permanent) neurological disorders summarized as tick-borne encephalitis (TBE). The incidence of TBE cases has increased due to the expansion of TBEV and its vectors. Since antiviral treatment is lacking, vaccination against TBEV is the most important protective measure. However, vaccination coverage is relatively low and immunogenicity of the currently available vaccines is limited, which may account for the vaccine failures that are observed. Understanding the TBEV-specific correlates of protection is of pivotal importance for developing novel and improved TBEV vaccines. For affording robust protection against infection and development of TBE, vaccines should induce both humoral and cellular immunity. In this review, the adaptive immunity induced upon TBEV infection and vaccination as well as novel approaches to produce improved TBEV vaccines are discussed.

Tick-borne encephalitis (TBE) is the most important tick-borne arboviral disease in Europe. Presently, the main endemic regions in Germany are located in the southern half of the country. Although recently, sporadic human TBE cases were reported outside of these known endemic regions. The detection and characterization of invading TBE virus (TBEV) strains will considerably facilitate the surveillance and assessment of this important disease. In 2018, ticks were collected by flagging in several locations of the German federal state of Lower Saxony where TBEV-infections in humans (diagnosed clinical TBE disease or detection of TBEV antibodies) were reported previously. Ticks were pooled according to their developmental stage and tested for TBEV-RNA by RT-qPCR. Five of 730 (0.68%) pools from Ixodes spp. ticks collected in the areas of "Rauher Busch" and "Barsinghausen/Mooshuette" were found positive for TBEV-RNA. Phylogenetic analysis of the whole genomes and E gene sequences revealed a close relationship between the two TBEV isolates, which cluster with a TBEV strain from Poland isolated in 1971. This study provides first data on the phylogeny of TBEV in the German federal state of Lower Saxony, outside of the known TBE endemic areas of Germany. Our results support the hypothesis of an east-west invasion of TBEV strains in Western Europe.

Parental loss of a child to mental illness and the resulting grief is a relatively unacknowledged phenomenon. This study aimed to capture the process through which parents journey in the face of their child's mental illness. Conducting a series of focus groups, the authors sought to further the understanding and the needs of these families. They identify seven themes from initial awareness to the formation of a new stability. Identification of this grief process is an important step that can heighten practitioners' awareness so that future interventions and support systems can be developed to help these families deal with their pain and burden., (Copyright 2001 by W.B. Saunders Company.)

The DSM is the key reference guide for clinicians and it continues to be the way in which practitioners apply discrete categories to behaviors that are sufficiently disruptive to social institutions to have come to the attention of tertiary care systems. As a way to classify and diagnose mental disorders, the DSM has been a source of controversy in the psychiatric community since its development. This article reviews some of the limitations of the DSM approach to psychiatric nosology with respect to practice with children. Alternative conceptualizations and approaches to childhood psychopathology are proposed and implications for child psychiatric nurses are discussed.

A new paradigm for delivering comprehensive mental and general health services has been born out of the necessity to integrate all aspects of health care. Because of issues of cost-effectiveness and capitation, fragmentation of services is no longer viable. Graduate programs in nursing will need to: (1) effectively prepare its practitioners to manage the complexity of both medical and psychiatric problems of clients, (2) promote health and prevent disease, and (3) counsel and refer clients. The psychiatric nurse practitioner is uniquely suited to provide comprehensive health care to both clients in psychiatric settings as well as primary care environments. An overview of the Psychiatric-Primary Care Nurse Practitioner program at the University of Pittsburgh is described.

A preliminary investigation of relationships among perceived self-efficacy, uncertainty, social support, psychological distress, and problem-focused coping was conducted in a convenience sample of 41 HIV-infected mothers. The mothers represented 93% of the clients in a large HIV clinic in 1992 who met the study criteria. Support was found for using Lazarus and Folkman's stress, appraisal, and coping framework to understand the health-related needs of HIV-infected mothers. Maternal coping was related to living with one's children and their HIV-status. The feasibility of studying this population of women was demonstrated. Findings suggest the need for exploration of family-focused interventions.

Despite the increasing prevalence of human immunodeficiency virus (HIV) infection in the female population the responses of women to their HIV-positive status and their resultant needs remain largely unexplored. This investigation explored the needs, choices, and decisions faced by 38 mothers since becoming HIV-positive. Participants were recruited from an infectious disease clinic in a large mid-Atlantic urban area. The results are based on data from taped, semistructured interviews with participants. Themes that emerged from these verbal reports illustrated that decisions and choices, uncertainty, their relationship to their children, and a renewed spirituality influenced the actions that they took in response to their HIV-positive status. Themes are discussed in relation to needs for further research and health-related interventions.

Problem: What are the cognitive tasks involved in making judgments in psychiatric nursing?, Methods: Fifteen nurses with varied educational preparation provided 36 in-depth interviews. A comparative content analysis was done to determine the underlying structure of judgment tasks., Findings: Nurses use clients' presenting behaviors as a basis for making judgments, with judgments being multiple multidimensional, overlapping, and holistic., Conclusions: Understanding judgment tasks delineates the kind of information needed to provide the best possible care.

Recent literature pertinent to adult survivors suggests that childhood sexual abuse is a serious problem, and that disclosure is on the rise. The aftereffects of childhood sexual abuse can cause dysfunction in various aspects of the survivor's physical and mental health. Understanding the traumagenic dynamics of childhood sexual abuse and its aftereffects provides direction for the nurse therapist during both the client's disclosure and intervention planning. This knowledge assists the therapist in promoting mental health and healing, as well as providing comfort for the therapist. The nurse therapist's reactions to the client's disclosure can affect the way the client feels about disclosure and the therapeutic relationship. If a negative message is conveyed to the survivor at the time of disclosure, the feelings of betrayal, stigmatization, and powerlessness that the survivor experienced as a child will be replicated. This can damage the therapeutic relationship and delay the healing process. When disclosure is received and acted upon in a sensitive, therapeutic manner, the survivor is empowered and can enter with the nurse therapist into an effective therapeutic alliance. Nurse therapists should gain awareness of the types of emotional responses that can be engendered in the health professional during disclosure. Awareness of these emotional reactions can lead to the identification of coping strategies useful to both the therapist and the adult survivor. Coping strategies useful to the therapist include maintaining adequate boundaries, understanding oneself and one's responses to sexual-abuse issues, utilizing ongoing consultation or supervision, and preventing burnout.(ABSTRACT TRUNCATED AT 250 WORDS)

1. Special attention is particularly important in addressing the mental health needs of HIV-infected women. These needs may involve issues such as concerns about present or future pregnancy; child-rearing, often as single parents; poverty, illicit drug use or addiction; and the potential lack of support services. 2. Diagnosis of HIV infection in women may be overlooked, as the clinical signs that routinely trigger the suspicion of HIV illness in men are often interpreted to reflect depression or psychological factors, such as stress or overwork, rather than raise the suspicion of HIV infection in women. 3. Understanding a woman's illness cognition is an important component of designing strategies that can enhance coping. The picture a woman generates regarding her illness is a composite of her experiences and responses, and determines to a large extent what she will do in response to her illness.

This study addressed judgment processes in psychiatric nursing by analyzing reported use of clinical cues cited as being relevant in the process of making a nursing judgment. Using an exploratory, qualitative approach, data were collected by interviewing 15 subjects who provided 36 in-depth interviews upon completion of an intake interview. Comparative content analysis was used to determine the underlying structure in subject reports. A model depicting judgment processes is presented and discussed. Results suggest that although judgments were highly context-dependent, all subjects assessed data labeled as universals in the psychiatric nursing assessment: suicidality, depression, drug and alcohol use, and patient functional abilities. Similarities among subjects were noted in that presenting behaviors were most salient, a categorization process occurs within the judgment process, and patients are included in the judgment process. Finally, nursing judgments uncovered an action orientation rather than a labeling function.