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Angulo FJ, Halsby K, Davidson A, Ravikumar S, Pilz A, Stark JH, Moïsi JC. Publicly available surveillance data on tick-borne encephalitis in Europe, 2023. Ticks Tick Borne Dis 2024; 15:102388. [PMID: 39137541 DOI: 10.1016/j.ttbdis.2024.102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 07/15/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024]
Abstract
The European Centre for Disease Prevention and Control (ECDC) defines a case of tick-borne encephalitis (TBE) as an infection by the TBE virus (TBEV) with clinical manifestations of central nervous system inflammation (e.g., meningitis, encephalitis). To better understand the TBE surveillance landscape, online searches were conducted to determine if cases of TBE, TBEV infection, acute meningitis or encephalitis, or viral meningitis or encephalitis were subject to statutory reporting in European countries in 2023. In countries with statutory reporting, notification responsibility and available information on surveillance-reported cases were determined. The number of TBE cases reported to ECDC were compared with the number of cases recorded in national surveillance reports. Of 44 countries of the Europe Region of the United Nations, 37 (84 %) mandated statutory reporting of cases of TBE, TBEV infection, or acute/viral meningitis/encephalitis. Twenty-six (87 %) of 30 countries with identified surveillance reports recorded TBE cases in 2020-2023. Of these countries, 17 (65 %) required TBE reporting by clinicians and laboratories, 5 (19 %) by clinicians only, and 4 (15 %) by laboratories only. Twenty-four countries reported on TBE cases to ECDC in 2020; however, surveillance for TBE in Europe is heterogeneous. Standardization of TBE surveillance would enhance the understanding of TBE disease burden in Europe.
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Affiliation(s)
- Frederick J Angulo
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, 500 Arcola Rd, Collegeville, PA 19426, USA.
| | - Kate Halsby
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, London, United Kingdom
| | - Alexander Davidson
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, New York, NY, USA
| | - Saiganesh Ravikumar
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, 500 Arcola Rd, Collegeville, PA 19426, USA; Department of Anesthesiology, Northwell Health, New Hyde Park, NY 11040, USA
| | - Andreas Pilz
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, Vienna, Austria
| | - James H Stark
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, Cambridge, MA, USA
| | - Jennifer C Moïsi
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, Paris, France
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2
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Kauer L, Dobler G, Schmuck HM, Chitimia‐Dobler L, Pfeffer M, Kühn R. Interrelation of the spatial and genetic structure of tick-borne encephalitis virus, its reservoir host ( Myodes glareolus), and its vector ( Ixodes ricinus) in a natural focus area. Ecol Evol 2024; 14:e70163. [PMID: 39165543 PMCID: PMC11333545 DOI: 10.1002/ece3.70163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 06/21/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
Tick-borne encephalitis (TBE) virus is considered the medically most important arthropod-borne virus in Europe. Although TBE is endemic throughout central Europe, ticks and rodents determine its maintenance in small, difficult-to-assess, natural foci. We investigated the interrelation between the population genetics of the main TBE virus (TBEV) vector tick (Ixodes ricinus), the most important reservoir host (Myodes glareolus, syn. Clethrionomys glareolus), and TBEV. Rodents and ticks were sampled on 15 sites within an exploratory study area, which has been screened regularly for TBEV occurrence in ticks for more than 10 years. On all 15 sites, ticks and bank voles were sampled, screened for TBEV presence via serology and RT-PCR, and genetically examined. Moreover, TBEV isolates derived from these analyses were sequenced. In long-term TBEV foci bank vole populations show extraordinary genetic constitutions, leading to a particular population structure, whereas ticks revealed a panmictic genetic structure overall sampling sites. Landscape genetics and habitat connectivity modeling (analysis of isolation by resistance) showed no landscape-related barriers explaining the genetic structure of the bank vole populations. The results suggest that bank voles do not simply serve as TBEV reservoirs, but their genetic composition appears to have a significant influence on establishing and maintaining long-term natural TBEV foci, whereas the genetic structure of TBEV's main vector I. ricinus does not play an important role in the sustainability of long-term TBEV foci. A thorough investigation of how and to which extent TBEV and M. glareolus genetics are associated is needed to further unravel the underlying mechanisms.
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Affiliation(s)
- Lea Kauer
- Molecular Zoology, Department of Zoology, TUM School of Life SciencesTechnical University of MunichFreisingGermany
| | | | - Hannah M. Schmuck
- Institute of Animal Hygiene and Veterinary Public HealthUniversity of LeipzigLeipzigGermany
| | | | - Martin Pfeffer
- Institute of Animal Hygiene and Veterinary Public HealthUniversity of LeipzigLeipzigGermany
| | - Ralph Kühn
- Molecular Zoology, Department of Zoology, TUM School of Life SciencesTechnical University of MunichFreisingGermany
- Department of Fish, Wildlife and Conservation EcologyNew Mexico State UniversityLas CrucesNew MexicoUSA
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Yuan C, Xu Q, Ning Y, Xia Q. Potential mechanisms implied in tick infection by arboviruses and their transmission to vertebrate hosts. Integr Zool 2024. [PMID: 39016029 DOI: 10.1111/1749-4877.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Ticks can transmit many pathogens, including arboviruses, to their vertebrate hosts. Arboviruses must overcome or evade defense mechanisms during their passage from the tick gut to the hemolymph, salivary glands, and the feeding site in the host skin. This review summarizes current knowledge of defense mechanisms in specific tick tissues and at the feeding site in the host skin. We discuss the possible roles of these defense mechanisms in viral infection and transmission. The responses of tick salivary proteins to arbovirus infection are also discussed. This review provides information that may help accelerate research on virus-tick interactions.
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Affiliation(s)
- Chuanfei Yuan
- NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, China
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Qiong Xu
- NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, China
| | - Yunjia Ning
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
- Hubei Jiangxia Laboratory, Wuhan, China
| | - Qianfeng Xia
- NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, Hainan Medical University, Haikou, China
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Skudal H, Lorentzen ÅR, Stenstad T, Quist-Paulsen E, Egeland J, Fevang B, Jaioun K, Hansen BÅ, Solheim AM, Tveten Y, Veje M, Eikeland R, Kersten H. Clinical characteristics and factors affecting disease severity in hospitalized tick-borne encephalitis patients in Norway from 2018 to 2022. Eur J Clin Microbiol Infect Dis 2024; 43:1355-1366. [PMID: 38801484 PMCID: PMC11271349 DOI: 10.1007/s10096-024-04855-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE To describe the clinical characteristics and factors associated with disease severity in a Norwegian cohort of hospitalized patients with tick-borne encephalitis (TBE). METHODS This observational multicenter study included hospitalized patients with TBE in the endemic area in the southeastern region of Norway from 2018 to 2022. Clinical signs and findings from laboratory tests, EEG, CT and MRI scans were recorded. Patient characteristics were compared among those with mild, moderate, and severe TBE, and factors associated with disease severity were identified. RESULTS Nearly all eligible patients were included in the final cohort (153/189 participants, 81%). The median age was 56 years, 63% were men, and 7% were vaccinated against TBE; no participants were fully vaccinated. TBE presented as mild (meningeal) disease in 31% of patients and as moderate or severe (encephalitic) disease in 54% and 14% of patients, respectively. We found that 46% of the patients had a monophasic course, 64% had hyponatremia, and 7% presented with central nervous system (CNS) symptoms without pleocytosis in cerebrospinal fluid (CSF). Dysesthesia, a symptom previously not described, was reported in 10% of the patients. Most objective findings were related to the CNS. Preexisting comorbidities, CRP and CSF protein levels were predictors of more severe disease. CONCLUSION This novel presentation of a large Norwegian cohort supports TBE as a serious disease in the southeastern region of Norway. The majority of hospitalized patients presented with encephalitis, and fewer presented with meningitis. Comorbidities, CRP and CSF protein levels were associated with more severe disease. TRIAL REGISTRATION Prosjekt #2,296,959 - The Norwegian Tick-borne Encephalitis Study - NOTES. Acute phase characteristics and long-term outcomes. - Cristin.
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Affiliation(s)
- Hilde Skudal
- Department of Infectious Diseases, Telemark Hospital Trust, Skien, Norway.
- Institute of Clinical Medicine, Faculty of Medicine, Oslo University Hospital, Oslo, Norway.
| | - Åslaug Rudjord Lorentzen
- Department of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway
- Norwegian National Advisory Unit on Tick-borne Diseases, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Tore Stenstad
- Department of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Jens Egeland
- Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Børre Fevang
- Section of Clinical Immunology and Infectious Diseases, Department of Rheumatology Dermatology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Keson Jaioun
- Department of Research, Telemark Hospital Trust, Skien, Norway
| | - Bjørn Åsheim Hansen
- Department of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Marit Solheim
- Department of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway
- Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Yngvar Tveten
- Department of Clinical Microbiology, Telemark Hospital Trust, Skien, Norway
| | - Malin Veje
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
| | - Randi Eikeland
- Norwegian National Advisory Unit on Tick-borne Diseases, Sørlandet Hospital Trust, Kristiansand, Norway
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Hege Kersten
- Institute of Clinical Medicine, Faculty of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Research, Telemark Hospital Trust, Skien, Norway
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Miao Y, Zheng Y, Wang T, Yi W, Zhang N, Zhang W, Zheng Z. Breast milk transmission and involvement of mammary glands in tick-borne flavivirus infected mice. J Virol 2024; 98:e0170923. [PMID: 38305156 PMCID: PMC10949448 DOI: 10.1128/jvi.01709-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024] Open
Abstract
Tick-borne flaviviruses (TBFs) are transmitted to humans through milk and tick bites. Although a case of possible mother-to-child transmission of tick-borne encephalitis virus (TBEV) through breast milk has been reported, this route has not been confirmed in experimental models. Therefore, in this study, using type I interferon receptor-deficient A129 mice infected with Langat virus (LGTV), we aimed to demonstrate the presence of infectious virus in the milk and mammary glands of infected mice. Our results showed viral RNA of LGTV in the pup's stomach milk clots (SMCs) and blood, indicating that the virus can be transmitted from dam to pup through breast milk. In addition, we observed that LGTV infection causes tissue lesions in the mammary gland, and viral particles were present in mammary gland epithelial cells. Furthermore, we found that milk from infected mice could infect adult mice via the intragastric route, which has a milder infection process, longer infection time, and a lower rate of weight loss than other modes of infection. Specifically, we developed a nano-luciferase-LGTV reporter virus system to monitor the dynamics of different infection routes and observed dam-to-pup infection using in vivo bioluminescence imaging. This study provides comprehensive evidence to support breast milk transmission of TBF in mice and has helped provide useful data for studying TBF transmission routes.IMPORTANCETo date, no experimental models have confirmed mother-to-child transmission of tick-borne flavivirus (TBF) through breastfeeding. In this study, we used a mouse model to demonstrate the presence of infectious viruses in mouse breast milk and mammary gland epithelial cells. Our results showed that pups could become infected through the gastrointestinal route by suckling milk, and the infection dynamics could be monitored using a reporter virus system during breastfeeding in vivo. We believe our findings have provided substantial evidence to understand the underlying mechanism of breast milk transmission of TBF in mice, which has important implications for understanding and preventing TBF transmission in humans.
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Affiliation(s)
- Yuanjiu Miao
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yue Zheng
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Ting Wang
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- The Center for Biomedical Research, Department of Respiratory and Critical Care Medicine, National Health Commission (NHC) Key Laboratory of Respiratory Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenfu Yi
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Nailou Zhang
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Wanpo Zhang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Zhenhua Zheng
- Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
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Ackermann-Gäumann R, Lang P, Zens KD. Defining the "Correlate(s) of Protection" to tick-borne encephalitis vaccination and infection - key points and outstanding questions. Front Immunol 2024; 15:1352720. [PMID: 38318179 PMCID: PMC10840404 DOI: 10.3389/fimmu.2024.1352720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
Tick-borne Encephalitis (TBE) is a severe disease of the Central Nervous System (CNS) caused by the tick-borne encephalitis virus (TBEV). The generation of protective immunity after TBEV infection or TBE vaccination relies on the integrated responses of many distinct cell types at distinct physical locations. While long-lasting memory immune responses, in particular, form the basis for the correlates of protection against many diseases, these correlates of protection have not yet been clearly defined for TBE. This review addresses the immune control of TBEV infection and responses to TBE vaccination. Potential correlates of protection and the durability of protection against disease are discussed, along with outstanding questions in the field and possible areas for future research.
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Affiliation(s)
- Rahel Ackermann-Gäumann
- Microbiologie, ADMED Analyses et Diagnostics Médicaux, La Chaux-de-Fonds, Switzerland
- Swiss National Reference Center for Tick-transmitted Diseases, La Chaux-de-Fonds, Switzerland
| | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kyra D. Zens
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Institute for Experimental Immunology, University of Zurich, Zurich, Switzerland
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7
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Mukhopadhyay K, Sengupta M, Misra SC, Majee K. Trends in emerging vector-borne viral infections and their outcome in children over two decades. Pediatr Res 2024; 95:464-479. [PMID: 37880334 DOI: 10.1038/s41390-023-02866-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/27/2023]
Abstract
This review utilizes quatitative methods and bibliometric data to analyse the trends of emerging and re-emerging vector-borne diseases, with a focus on their impact on pediatric population. To conduct this analysis, a systematic search of PubMed articles from the past two decades was performed, specifically looking at 26 different vector-borne viruses listed in WHO and CDC list of vector-borne viruses. The review found that diseases like Dengue, Zika, West Nile, and Chikungunya were frequently discussed in the literature. On the other hand, diseases such as Tick-borne encephalitis, Rift Valley fever, Venezuelan equine encephalitis, Sindbis fever, Venezuelan equine encephalitis, Ross River virus, and Eastern equine encephalitis showed an upward trend in publications, indicating potential resurgence. In addition to discussing trends and patterns, the review delves into the clinical manifestations and long-term effects of the top 10 viruses in children. It highlights various factors including deforestation, urbanization, global travel, and immunosuppression that contribute to disease emergence and resurgence. To effectively combat these vector-borne diseases, continuous surveillance is crucial. The review also emphasizes the importance of increased vaccination efforts and targeted research to address the health challenges they pose. IMPACT: This review employs quantitative analysis of publications to elucidate trends in emerging pediatric vector-borne viral diseases over two decades. Dengue, the most prevalent of these diseases, has spread to new regions. New strains of Japanese Encephalitis have caused outbreaks. Resurgence of Tick-borne Encephalitis, West Nile, and Yellow Fever due to vaccine hesitancy has also transpired. Continuous global surveillance, increased vaccination, and research into novel therapeutics are imperative to combat the substantial morbidity and mortality burden these diseases pose for children worldwide.
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Affiliation(s)
| | - Mallika Sengupta
- Microbiology, AIIMS Kalyani, Basantapur, Saguna, West Bengal, India
| | | | - Kiranmay Majee
- Student, AIIMS Kalyani, Basantapur, Saguna, West Bengal, India
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Granerod J, Huang Y, Davies NWS, Sequeira PC, Mwapasa V, Rupali P, Michael BD, Solomon T, Easton A. Global Landscape of Encephalitis: Key Priorities to Reduce Future Disease Burden. Clin Infect Dis 2023; 77:1552-1560. [PMID: 37436770 PMCID: PMC10686956 DOI: 10.1093/cid/ciad417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 07/13/2023] Open
Abstract
Encephalitis affects people across the lifespan, has high rates of mortality and morbidity, and results in significant neurological sequelae with long-term consequences to quality of life and wider society. The true incidence is currently unknown due to inaccurate reporting systems. The disease burden of encephalitis is unequally distributed across the globe being highest in low- and middle-income countries where resources are limited. Here countries often lack diagnostic testing, with poor access to essential treatments and neurological services, and limited surveillance and vaccination programs. Many types of encephalitis are vaccine preventable, whereas others are treatable with early diagnosis and appropriate management. In this viewpoint, we provide a narrative review of key aspects of diagnosis, surveillance, treatment, and prevention of encephalitis and highlight priorities for public health, clinical management, and research, to reduce the disease burden.
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Affiliation(s)
- Julia Granerod
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- Dr JGW Consulting Ltd., London, United Kingdom
| | - Yun Huang
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, United Kingdom
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | | | | | - Victor Mwapasa
- University of Malawi, College of Medicine, Blantyre, Malawi
| | - Priscilla Rupali
- Department of Infectious Diseases, Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | - Benedict D Michael
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, United Kingdom
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Tom Solomon
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, United Kingdom
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- The Pandemic Institute, Liverpool, United Kingdom
| | - Ava Easton
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- The Encephalitis Society, Malton, United Kingdom
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Simkute E, Pautienius A, Grigas J, Urbute P, Stankevicius A. The Prevalence, Seroprevalence, and Risk Factors of Tick-Borne Encephalitis Virus in Dogs in Lithuania, a Highly Endemic State. Viruses 2023; 15:2265. [PMID: 38005941 PMCID: PMC10674385 DOI: 10.3390/v15112265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
The rising awareness and increasing number of case reports of tick-borne encephalitis (TBE) in dogs indicate that the virus might be an important tick-borne pathogen in dogs, especially in endemic areas. Therefore, the aim of the present study was to investigate the prevalence rate of TBEV RNA and TBEV-specific antibodies in clinical samples of dogs living in a highly endemic region of Lithuania and to evaluate the main risk factors for severe disease course and death. The blood samples (n = 473) of dogs were collected in two veterinary clinics in central Lithuania. Tick-borne encephalitis virus (TBEV) RNA was detected in 18.6% (88/473; CI 95% 15.2-22.4) and TBEV-specific antibodies were found in 21.6% (102/473; CI 95% 17.9-25.6) of dog blood serum samples after confirmation with a virus neutralization test. The death/euthanasia rate was 18.2% (16/88; CI 95% 10.8-27.8) in PCR-positive dogs. Male dogs were more likely to develop neurological symptoms (p = 0.008). Older dogs (p = 0.003), dogs with the presence of neurological symptoms (p = 0.003), and dogs with the presence of TBEV-specific antibodies (p = 0.024) were more likely to experience worse outcomes of the disease. The results of the present study demonstrate that TBEV is a common and clinically important pathogen in dogs in such endemic countries as Lithuania.
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Affiliation(s)
- Evelina Simkute
- Laboratory of Immunology, Department of Anatomy and Physiology, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, (J.G.)
| | - Arnoldas Pautienius
- Laboratory of Immunology, Department of Anatomy and Physiology, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, (J.G.)
- Institute of Microbiology and Virology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania
| | - Juozas Grigas
- Laboratory of Immunology, Department of Anatomy and Physiology, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, (J.G.)
- Institute of Microbiology and Virology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania
| | - Paulina Urbute
- Laboratory of Immunology, Department of Anatomy and Physiology, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, (J.G.)
| | - Arunas Stankevicius
- Laboratory of Immunology, Department of Anatomy and Physiology, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, (J.G.)
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Hills SL, Poehling KA, Chen WH, Staples JE. Tick-Borne Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023. MMWR Recomm Rep 2023; 72:1-29. [PMID: 37943707 PMCID: PMC10651317 DOI: 10.15585/mmwr.rr7205a1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Tick-borne encephalitis (TBE) virus is focally endemic in parts of Europe and Asia. The virus is primarily transmitted to humans by the bites of infected Ixodes species ticks but can also be acquired less frequently by alimentary transmission. Other rare modes of transmission include through breastfeeding, blood transfusion, solid organ transplantation, and slaughtering of viremic animals. TBE virus can cause acute neurologic disease, which usually results in hospitalization, often permanent neurologic or cognitive sequelae, and sometimes death. TBE virus infection is a risk for certain travelers and for laboratory workers who work with the virus. In August 2021, the Food and Drug Administration approved Ticovac TBE vaccine for use among persons aged ≥1 year. This report summarizes the epidemiology of and risks for infection with TBE virus, provides information on the immunogenicity and safety of TBE vaccine, and summarizes the recommendations of the Advisory Committee on Immunization Practices (ACIP) for use of TBE vaccine among U.S. travelers and laboratory workers. The risk for TBE for most U.S. travelers to areas where the disease is endemic is very low. The risk for exposure to infected ticks is highest for persons who are in areas where TBE is endemic during the main TBE virus transmission season of April–November and who are planning to engage in recreational activities in woodland habitats or who might be occupationally exposed. All persons who travel to areas where TBE is endemic should be advised to take precautions to avoid tick bites and to avoid the consumption of unpasteurized dairy products because alimentary transmission of TBE virus can occur. TBE vaccine can further reduce infection risk and might be indicated for certain persons who are at higher risk for TBE. The key factors in the risk-benefit assessment for vaccination are likelihood of exposure to ticks based on activities and itinerary (e.g., location, rurality, season, and duration of travel or residence). Other risk-benefit considerations should include 1) the rare occurrence of TBE but its potentially high morbidity and mortality, 2) the higher risk for severe disease among certain persons (e.g., older persons aged ≥60 years), 3) the availability of an effective vaccine, 4) the possibility but low probability of serious adverse events after vaccination, 5) the likelihood of future travel to areas where TBE is endemic, and 6) personal perception and tolerance of risk ACIP recommends TBE vaccine for U.S. persons who are moving or traveling to an area where the disease is endemic and will have extensive exposure to ticks based on their planned outdoor activities and itinerary. Extensive exposure can be considered based on the duration of travel and frequency of exposure and might include shorter-term (e.g., <1 month) travelers with daily or frequent exposure or longer-term travelers with regular (e.g., a few times a month) exposure to environments that might harbor infected ticks. In addition, TBE vaccine may be considered for persons who might engage in outdoor activities in areas where ticks are likely to be found, with a decision to vaccinate made on the basis of an assessment of their planned activities and itinerary, risk factors for a poor medical outcome, and personal perception and tolerance of risk. In the laboratory setting, ACIP recommends TBE vaccine for laboratory workers with a potential for exposure to TBE virus
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Lindman M, Angel JP, Estevez I, Chang NP, Chou TW, McCourt M, Atkins C, Daniels BP. RIPK3 promotes brain region-specific interferon signaling and restriction of tick-borne flavivirus infection. PLoS Pathog 2023; 19:e1011813. [PMID: 38011306 PMCID: PMC10703404 DOI: 10.1371/journal.ppat.1011813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 12/07/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
Innate immune signaling in the central nervous system (CNS) exhibits many remarkable specializations that vary across cell types and CNS regions. In the setting of neuroinvasive flavivirus infection, neurons employ the immunologic kinase receptor-interacting kinase 3 (RIPK3) to promote an antiviral transcriptional program, independently of the traditional function of this enzyme in promoting necroptotic cell death. However, while recent work has established roles for neuronal RIPK3 signaling in controlling mosquito-borne flavivirus infections, including West Nile virus and Zika virus, functions for RIPK3 signaling in the CNS during tick-borne flavivirus infection have not yet been explored. Here, we use a model of Langat virus (LGTV) encephalitis to show that RIPK3 signaling is specifically required in neurons of the cerebellum to control LGTV replication and restrict disease pathogenesis. This effect did not require the necroptotic executioner molecule mixed lineage kinase domain like protein (MLKL), a finding similar to previous observations in models of mosquito-borne flavivirus infection. However, control of LGTV infection required a unique, region-specific dependence on RIPK3 to promote expression of key antiviral interferon-stimulated genes (ISG) in the cerebellum. This RIPK3-mediated potentiation of ISG expression was associated with robust cell-intrinsic restriction of LGTV replication in cerebellar granule cell neurons. These findings further illuminate the complex roles of RIPK3 signaling in the coordination of neuroimmune responses to viral infection, as well as provide new insight into the mechanisms of region-specific innate immune signaling in the CNS.
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Affiliation(s)
- Marissa Lindman
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
| | - Juan P. Angel
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
| | - Irving Estevez
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
| | - Nydia P. Chang
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
| | - Tsui-Wen Chou
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
| | - Micheal McCourt
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
| | - Colm Atkins
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
| | - Brian P. Daniels
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey, United States of America
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12
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Dagostin F, Tagliapietra V, Marini G, Cataldo C, Bellenghi M, Pizzarelli S, Cammarano RR, Wint W, Alexander NS, Neteler M, Haas J, Dub T, Busani L, Rizzoli A. Ecological and environmental factors affecting the risk of tick-borne encephalitis in Europe, 2017 to 2021. Euro Surveill 2023; 28:2300121. [PMID: 37855903 PMCID: PMC10588310 DOI: 10.2807/1560-7917.es.2023.28.42.2300121] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/11/2023] [Indexed: 10/20/2023] Open
Abstract
BackgroundTick-borne encephalitis (TBE) is a disease which can lead to severe neurological symptoms, caused by the TBE virus (TBEV). The natural transmission cycle occurs in foci and involves ticks as vectors and several key hosts that act as reservoirs and amplifiers of the infection spread. Recently, the incidence of TBE in Europe has been rising in both endemic and new regions.AimIn this study we want to provide comprehensive understanding of the main ecological and environmental factors that affect TBE spread across Europe.MethodsWe searched available literature on covariates linked with the circulation of TBEV in Europe. We then assessed the best predictors for TBE incidence in 11 European countries by means of statistical regression, using data on human infections provided by the European Surveillance System (TESSy), averaged between 2017 and 2021.ResultsWe retrieved data from 62 full-text articles and identified 31 different covariates associated with TBE occurrence. Finally, we selected eight variables from the best model, including factors linked to vegetation cover, climate, and the presence of tick hosts.DiscussionThe existing literature is heterogeneous, both in study design and covariate types. Here, we summarised and statistically validated the covariates affecting the variability of TBEV across Europe. The analysis of the factors enhancing disease emergence is a fundamental step towards the identification of potential hotspots of viral circulation. Hence, our results can support modelling efforts to estimate the risk of TBEV infections and help decision-makers implement surveillance and prevention campaigns.
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Affiliation(s)
- Francesca Dagostin
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige (TN), Italy
| | - Valentina Tagliapietra
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige (TN), Italy
| | - Giovanni Marini
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige (TN), Italy
| | - Claudia Cataldo
- Centre for Gender-specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Bellenghi
- Centre for Gender-specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Scilla Pizzarelli
- Knowledge Unit (Documentation, Library), Istituto Superiore di Sanità, Rome, Italy
| | | | - William Wint
- Environmental Research Group Oxford Ltd, Oxford, United Kingdom
| | | | | | | | - Timothée Dub
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Luca Busani
- Centre for Gender-specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Annapaola Rizzoli
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige (TN), Italy
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13
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Nygren TM, Pilic A, Böhmer MM, Wagner-Wiening C, Wichmann O, Hellenbrand W. Recovery and sequelae in 523 adults and children with tick-borne encephalitis in Germany. Infection 2023; 51:1503-1511. [PMID: 37022643 PMCID: PMC10078068 DOI: 10.1007/s15010-023-02023-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/13/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE Despite being vaccine-preventable, tick-borne encephalitis (TBE) continues to cause considerable morbidity in Germany. Limited insight into potentially debilitating consequences of TBE may partially underly low (~ 20%) TBE vaccine uptake. We aimed to systematically assess TBE sequelae and other consequences. METHODS Routinely notified TBE patients from 2018 to 2020 from Southern Germany were invited to telephone interviews acutely and again after 18 months. Duration of acute symptoms was prospectively assessed. Recovery was defined as score 0 on the modified RANKIN scale. Determinants of time to recovery were analysed with cox regression, adjusted for covariates identified using directed acyclic graphs, yielding hazard ratios (HR) and 95% confidence intervals (CI). RESULTS Of 558 cases, 523 (93.7%) completed follow-up. Full recovery was reported by 67.3% (children: 94.9%, adults: 63.8%). Sequelae included fatigue (17.0%), weakness (13.4%), concentration deficit (13.0%), and impaired balance (12.0%). Compared with 18-39-year-olds, recovery rates were 44% lower in ≥ 50-year-olds (HR: 0.56, 95%CI 0.42-0.75) and 79% higher in children (HR: 1.79, 95%CI 1.25-2.56). The recovery rate was 64% lower after severe TBE (compared to mild; HR: 0.36, 95%CI 0.25-0.52) and 22% lower with comorbidities (HR: 0.78, 95%CI 0.62-0.99). Substantial health-care use was reported (90.1% hospitalisation, 39.8% rehabilitation). Of employed cases, 88.4% required sick leave; 10.3% planned/reported premature retirement due to sequelae. CONCLUSION Half the adult and 5% of paediatric patients reported persisting sequelae after 18 months. Improved prevention could alleviate both individual (morbidity) and societal TBE burden (health-care costs, productivity losses). Insights into sequelae can help guide at-risk populations towards tick-avoidant strategies and encourage TBE vaccination.
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Affiliation(s)
| | - Antonia Pilic
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Merle M Böhmer
- Bavarian Health and Food Safety Authority (LGL), Munich, Germany
- Institute of Social Medicine and Health Systems Research, Otto-Von-Guericke-University Magdeburg, Magdeburg, Germany
| | | | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin, Germany
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14
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Ganbold D, Uudus B, Nyamdavaa N, Chultemsuren Y, Zagd A, Tangad M, Badrakh B, Baldandorj B, Dogsom O, Lkunrev R, Baasandagva U, Nyamdorj T, Myadagsuren N. Seroprevalence and risk factors of tick-borne encephalitis in Mongolia between 2016 and 2022. Parasite Epidemiol Control 2023; 22:e00318. [PMID: 37592927 PMCID: PMC10430574 DOI: 10.1016/j.parepi.2023.e00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/19/2023] Open
Abstract
The tick-borne encephalitis virus (TBEV) is a zoonotic agent that causes severe encephalitis in humans and is transmitted through the bites of infected ticks. Ixodes ticks are the primary vector for TBEV in Mongolia, and approximately 3.4% carry the TBEV. The ticks are capable of not only transmitting these viruses but also serve as excellent reservoir hosts. The Dermacenter tick species may have similar properties. TBEV is a significant cause of virus-related diseases of the central nervous system in many European countries as well as in China, Russia, and Mongolia. Our objectives were to investigate TBEV seroprevalence and infection risk factors in different biogeographical zones and provinces, especially in the highly endemic areas of Mongolia. Serum samples were collected from individuals who experienced tick bites (n = 993) in Mongolia between 2016 and 2022. Enzyme-linked immunosorbent assay of the samples was performed to evaluate for TBEV-specific immunoglobulin (Ig)M and IgG. We analyzed the risk factors and seroprevalence of TBEV infection among these individuals using a cross-sectional, questionnaire-based study. Statistical analyses were performed using a multistage cluster sampling survey design, and all data were analyzed using the R software. TBEV IgM and IgG antibodies were detected in 8.1% (80/993) and 20.2% (201/993) of all serum samples, respectively. The seroprevalence was significantly higher in men (68%, 95% confidence interval [CI]: 1.63-3.13, odds ratio [OR]: 2.25) than in women (p < 0.001). Additionally, the seroprevalence was significantly higher among unemployed (35.0%, 95% CI: 0.31-0.84, OR: 0.51) than employed individuals (p < 0.001). The seroprevalence was the highest among the 25-29 and 35-39-year age groups (11%, 95% CI: 1.29-5.51, OR: 2.65 and 11%, 95% CI: 0.94-3.87, OR: 1.9, respectively), and the lowest in the 65-69-year age group (4%, 95% CI: 0.46-6.15, OR: 1.83) (p < 0.001). Furthermore, the seroprevalence was the highest in Selenge province and the capital city Ulaanbaatar (40%, 95% CI: 1.73-21.7, OR: 5.07 and 28%, 95% CI: 0.51-6.89, OR: 1.57, respectively) and the lowest in Bayan-Ulgii and Dornod provinces (0.5%, 95% CI: 0.06-12.4, OR: 1.33 and 0.5%, 95% CI: 0.03-6.24, OR: 0.72, respectively). TBEV infection incidence remained low in most regions of Mongolia but increased in endemic areas. Furthermore, in the univariate subgroup analysis, age, occupation status, and residential area were significantly associated with TBEV seroprevalence.
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Affiliation(s)
- Dashdavaa Ganbold
- Department of Biology, School of Biomedicine, Mongolian National University of Medical Sciences, Zorig Street 3, 14210 Ulaanbaatar, Mongolia
| | - Bayarsaikhan Uudus
- Department of Biology, School of Sciences and Art Science, National University of Mongolia, Zaluuchuud Avenue 1, 14201 Ulaanbaatar, Mongolia
| | - Naranbat Nyamdavaa
- Gyals Medical Center, Peace Avenue-61A, Bayangol, 210351 Ulaanbaatar, Mongolia
| | - Yeruult Chultemsuren
- Department of Pharmacology, School of Biomedicine, Mongolian National University of Medical Sciences, S. Zorig Street 3, 14210 Ulaanbaatar, Mongolia
| | - Amarbayasgalan Zagd
- Department of Biology, School of Biomedicine, Mongolian National University of Medical Sciences, S. Zorig Street 3, 14210 Ulaanbaatar, Mongolia
| | - Mungunzaya Tangad
- Department of Biology, School of Biomedicine, Mongolian National University of Medical Sciences, S. Zorig Street 3, 14210 Ulaanbaatar, Mongolia
| | - Burmaa Badrakh
- Department of Cardiology, School of Medicine, Mongolian National University of Medical Sciences, S. Zorig Street 3, 14210 Ulaanbaatar, Mongolia
| | - Bolorchimeg Baldandorj
- Department of Laboratory, National Center of Mental Health, Bayarzurkh District, IX Khoroo, Sharkhad, 13020 Ulaanbaatar, Mongolia
| | - Ochgerel Dogsom
- Department of Obstetrics and Gynecology, School of Medicine, Mongolian National University of Medical Sciences, S. Zorig Street 3, 14210 Ulaanbaatar, Mongolia
| | - Rolomjav Lkunrev
- National Center for Zoonotic Disease, Songinokhairkhan District, 20 Khoroo, 18131 Ulaanbaatar, Mongolia
| | - Uyanga Baasandagva
- National Center for Zoonotic Disease, Songinokhairkhan District, 20 Khoroo, 18131 Ulaanbaatar, Mongolia
| | - Tsogbadrakh Nyamdorj
- National Center for Zoonotic Disease, Songinokhairkhan District, 20 Khoroo, 18131 Ulaanbaatar, Mongolia
| | - Narankhajid Myadagsuren
- Department of Biology, School of Biomedicine, Mongolian National University of Medical Sciences, Zorig Street 3, 14210 Ulaanbaatar, Mongolia
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15
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Geißlreiter B, Kluger G, Eschermann K, Kiwull L, Staudt M, Dobler G, Wolf GK. High neutralizing antibody mismatch as a possible reason for vaccine failure in two children with severe tick-borne encephalitis. Ticks Tick Borne Dis 2023; 14:102158. [PMID: 36989602 DOI: 10.1016/j.ttbdis.2023.102158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/02/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023]
Abstract
We describe two adolescents (13 and 16 years old) with severe tick-borne encephalitis (TBE) and vaccination breakthrough (VBT). Both suffer from severe persistent neurologic sequelae. Both patients had high TBE-IgG-titers after vaccination at the beginning of the infection and a low or missing TBE-IgM response (Type 2 vaccine failure). Neutralization tests show low titers against the respective infecting TBE virus strain and higher titers against the vaccine strain at the beginning of the infection implying an individual weak or impaired immune response to the respective virus as possible cause of TBE vaccine failure. We do not know of any similar observation or explanation for the phenomenon and at the moment can only speculate of a severe course correlated to highly mismatched IgG. This constellation of high TBE IgGs, the lack of immune response and a severe course strongly resembles the severe TBE courses that occurred in the past after TBE immunoglobulin administration. To our knowledge differentiation between structural and functional antibodies by neutralization tests with a) the affecting TBE virus strain and b) the vaccine virus strain in TBE vaccine failures has never been described before. We conclude (1) to consider a TBE virus infection also in vaccinated children presenting with meningoencephalitis, (2) to perform a broad immunological work-up in severe TBE especially after VBT, (3) to further study if high mismatch IgG's are a possible reason for vaccine failure.
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Affiliation(s)
- Bernd Geißlreiter
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Klinik, Vogtareuth, Krankenhausstr. 20, Vogtareuth 83569, Germany.
| | - Gerhard Kluger
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Klinik, Vogtareuth, Krankenhausstr. 20, Vogtareuth 83569, Germany; Paracelsus Privatuniversität Salzburg, Research Institute for Rehabilitation, Transition and Palliation, Paracelsus Medical University, Strubergasse 21, Salzburg 5020, Austria
| | - Kirsten Eschermann
- Paracelsus Privatuniversität Salzburg, Research Institute for Rehabilitation, Transition and Palliation, Paracelsus Medical University, Strubergasse 21, Salzburg 5020, Austria; Berlin Centre for Travel & Tropical Medicine, Friedrichstr. 134, Berlin 10117, Germany
| | - Lorenz Kiwull
- Paracelsus Privatuniversität Salzburg, Research Institute for Rehabilitation, Transition and Palliation, Paracelsus Medical University, Strubergasse 21, Salzburg 5020, Austria; Berlin Centre for Travel & Tropical Medicine, Friedrichstr. 134, Berlin 10117, Germany; Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics and Epilepsy Center, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Lindwurmstr. 4, Munich 80337, Germany; Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Lindwurmstr. 4, Munich 80337, Germany
| | - Martin Staudt
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Klinik, Vogtareuth, Krankenhausstr. 20, Vogtareuth 83569, Germany; Department for Pediatric Neurology and Developmental Medicine, University Children's Hospital Hoppe-Seyler-Straße 1, Tübingen, Germany
| | - Gerhard Dobler
- Department of Virology and Rickettsiology, Bundeswehr Institute of Microbiology, Neuherbergstr. 11, Munich 80937, Germany
| | - Gerhard K Wolf
- Department of Paediatrics, Kliniken Südostbayern AG, Cuno-Niggl-Straße 3, Traunstein 83278, Germany
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16
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Lindman M, Angel JP, Estevez I, Chang NP, Chou TW, McCourt M, Atkins C, Daniels BP. RIPK3 promotes brain region-specific interferon signaling and restriction of tick-borne flavivirus infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.23.525284. [PMID: 36747672 PMCID: PMC9900788 DOI: 10.1101/2023.01.23.525284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Innate immune signaling in the central nervous system (CNS) exhibits many remarkable specializations that vary across cell types and CNS regions. In the setting of neuroinvasive flavivirus infection, neurons employ the immunologic kinase receptor-interacting kinase 3 (RIPK3) to promote an antiviral transcriptional program, independently of the traditional function of this enzyme in promoting necroptotic cell death. However, while recent work has established roles for neuronal RIPK3 signaling in controlling mosquito-borne flavivirus infections, including West Nile virus and Zika virus, functions for RIPK3 signaling in the CNS during tick-borne flavivirus infection have not yet been explored. Here, we use a model of Langat virus (LGTV) encephalitis to show that RIPK3 signaling is specifically required in neurons of the cerebellum to control LGTV replication and restrict disease pathogenesis. This effect did not require the necroptotic executioner molecule mixed lineage kinase domain like protein (MLKL), a finding similar to previous observations in models of mosquito-borne flavivirus infection. However, control of LGTV infection required a unique, region-specific dependence on RIPK3 to promote expression of key antiviral interferon-stimulated genes (ISG) in the cerebellum. This RIPK3-mediated potentiation of ISG expression was associated with robust cell-intrinsic restriction of LGTV replication in cerebellar granule cell neurons. These findings further illuminate the complex roles of RIPK3 signaling in the coordination of neuroimmune responses to viral infection, as well as provide new insight into the mechanisms of region-specific innate immune signaling in the CNS.
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Affiliation(s)
- Marissa Lindman
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Juan P Angel
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Irving Estevez
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Nydia P Chang
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Tsui-Wen Chou
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Micheal McCourt
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Colm Atkins
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Brian P. Daniels
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
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17
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Nygren TM, Pilic A, Böhmer MM, Wagner-Wiening C, Went SB, Wichmann O, Hellenbrand W. Tick-borne encephalitis: Acute clinical manifestations and severity in 581 cases from Germany, 2018-2020. J Infect 2023; 86:369-375. [PMID: 36796679 DOI: 10.1016/j.jinf.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Tick-borne encephalitis (TBE) is a growing public health problem with an average of 361 cases notified annually to Germany's passive surveillance system since 2001. We aimed to assess clinical manifestations and identify covariates associated with severity. METHODS We included cases notified 2018-2020 in a prospective cohort study and collected data with telephone interviews, questionnaires to general practitioners, and hospital discharge summaries. Covariates' causal associations with severity were evaluated with multivariable logistic regression, adjusted for variables identified via directed acyclic graphs. RESULTS Of 1220 eligible cases, 581 (48%) participated. Of these, 97.1% were not (fully) vaccinated. TBE was severe in 20.3% of cases (children: 9.1%, ≥70-year-olds: 48.6%). Routine surveillance data underreported the proportion of cases with central nervous system involvement (56% vs. 84%). Ninety percent required hospitalization, 13.8% intensive care, and 33.4% rehabilitation. Severity was most notably associated with age (odds ratio (OR): 1.04, 95% confidence interval (CI): 1.02-1.05), hypertension (OR: 2.27, 95%CI: 1.37-3.75), and monophasic disease course (OR: 1.67, 95%CI: 1.08-2.58). CONCLUSIONS We observed substantial TBE burden and health service utilization, suggesting that awareness of TBE severity and vaccine preventability should be increased. Knowledge of severity-associated factors may help inform patients' decision to get vaccinated.
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Affiliation(s)
| | - Antonia Pilic
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Merle M Böhmer
- Bavarian Health and Food Safety Authority (LGL), Munich, Germany; Institute of Social Medicine and Health Systems Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | | | | | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin, Germany
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18
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Pascoe EL, de Vries A, Esser HJ, Koenraadt CJM, Sprong H. Detection of tick-borne encephalitis virus in ear tissue and dried blood spots from naturally infected wild rodents. Parasit Vectors 2023; 16:103. [PMID: 36927723 PMCID: PMC10018976 DOI: 10.1186/s13071-023-05717-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Tick-borne encephalitis virus (TBEV) can cause severe neurological disease in humans. Its geographical distribution is expanding in Western Europe with unresolved causes and spatial patterns, necessitating enhanced surveillance. Monitoring the virus in the environment is complicated, as it usually relies on destructive sampling of small rodents to test organs for TBEV, which in addition to ethical considerations also raises issues for long-term monitoring or longitudinal studies. Moreover, even when the virus is not detected in the blood or organs of the rodent, TBEV can still be transmitted from an infected tick to uninfected ticks feeding nearby. This is due to the ability of TBEV to replicate and migrate locally within the epidermis of small mammals, including those that do not appear to have systemic infection. This suggests that the virus may be detectable in skin biopsies, which has been confirmed in experimentally infected laboratory rodents, but it remains unknown if this sample type may be a viable alternative to destructively obtained samples in the monitoring of natural TBEV infection. Here we test ear tissue and dried blood spot (DBS) samples from rodents to determine whether TBEV-RNA can be detected in biological samples obtained non-destructively. METHODS Rodents were live-trapped and sampled at three woodland areas in The Netherlands where presence of TBEV has previously been recorded. Ear tissue (n = 79) and DBSs (n = 112) were collected from a total of 117 individuals and were tested for TBEV-RNA by real-time RT-PCR. RESULTS TBEV-RNA was detected in five rodents (4.3% of tested individuals), all of which had a TBEV-positive ear sample, while only two out of four of these individuals (for which a DBS was available) had a positive DBS. This equated to 6.3% of ear samples and 1.8% of DBSs testing positive for TBEV-RNA. CONCLUSIONS We provide the first evidence to our knowledge that TBEV-RNA can be detected in samples obtained non-destructively from naturally infected wild rodents, providing a viable sampling alternative suitable for longitudinal surveillance of the virus.
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Affiliation(s)
- Emily L Pascoe
- Laboratory of Entomology, Department of Plant Sciences, Wageningen University & Research, 6708 PB, Wageningen, The Netherlands.
| | - Ankje de Vries
- Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, P.O. Box 1, Bilthoven, The Netherlands
| | - Helen J Esser
- Wildlife Ecology & Conservation Group, Wageningen University & Research, 6708 PB, Wageningen, The Netherlands
| | - Constantianus J M Koenraadt
- Laboratory of Entomology, Department of Plant Sciences, Wageningen University & Research, 6708 PB, Wageningen, The Netherlands
| | - Hein Sprong
- Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Antonie Van Leeuwenhoeklaan 9, P.O. Box 1, Bilthoven, The Netherlands
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19
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Schley K, Friedrich J, Pilz A, Huang L, Balkaran BL, Maculaitis MC, Malerczyk C. Evaluation of under-testing and under-diagnosis of tick-borne encephalitis in Germany. BMC Infect Dis 2023; 23:139. [PMID: 36882704 PMCID: PMC9990549 DOI: 10.1186/s12879-023-08101-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Tick-borne encephalitis (TBE), a viral infectious disease affecting the central nervous system, potentially resulting in prolonged neurological symptoms and other long-term sequelae. Case identification can be challenging as TBE can be associated with non-specific symptoms, and even in cases consistent with typical TBE symptoms, the rate of laboratory testing to confirm cases is unknown. This study assessed real-world TBE laboratory testing rates across Germany. METHODS In this retrospective cross-sectional study, physicians provided data on TBE decision-making, laboratory testing (serological), and diagnostics behavior via in-depth qualitative interviews (N = 12) or a web-based quantitative survey of their patient medical records (N = 166). Hospital-based physicians who specialized in infectious disease, intensive care unit, emergency room, neurology, or pediatrics with experience managing and ordering testing for patients with meningitis, encephalitis, or non-specific central nervous system symptoms in the past 12 months were included. Data were summarized via descriptive statistics. TBE testing and positivity rates were assessed for the aggregate sample of 1400 patient charts and reported by presenting symptoms, region, and tick bite exposure. RESULTS TBE testing rates ranged from 54.0% (non-specific neurological symptoms only) to 65.6% (encephalitis symptoms only); the percentage of TBE positive results ranged from 5.3% (non-specific neurological symptoms only) to 36.9% (meningitis symptoms only). TBE testing rates were higher among those with a tick bite history and/or who presented with headache, high fever, or flu-like symptoms. CONCLUSIONS The findings of this study suggest that patients with typical TBE symptoms are likely under-tested, thus likely leading to under-diagnosis in Germany. To ensure appropriate case identification, TBE testing should be consistently integrated into routine practice for all patients who present with relevant symptoms or exposure to common risk factors.
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Affiliation(s)
| | | | - Andreas Pilz
- Pfizer Corporation, Austria Gesellschaft M.B.H., Floridsdorfer Hauptstraße 1, 1210, Vienna, Austria
| | - Liping Huang
- Pfizer Inc., 235 East 42Nd Street, New York, NY, USA
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20
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Van Heuverswyn J, Hallmaier-Wacker LK, Beauté J, Gomes Dias J, Haussig JM, Busch K, Kerlik J, Markowicz M, Mäkelä H, Nygren TM, Orlíková H, Socan M, Zbrzeźniak J, Žygutiene M, Gossner CM. Spatiotemporal spread of tick-borne encephalitis in the EU/EEA, 2012 to 2020. Euro Surveill 2023; 28:2200543. [PMID: 36927718 PMCID: PMC10021474 DOI: 10.2807/1560-7917.es.2023.28.11.2200543] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
BackgroundTick-borne encephalitis (TBE) is a vaccine-preventable disease involving the central nervous system. TBE became a notifiable disease on the EU/EEA level in 2012.AimWe aimed to provide an updated epidemiological assessment of TBE in the EU/EEA, focusing on spatiotemporal changes.MethodsWe performed a descriptive analysis of case characteristics, time and location using data of human TBE cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease onset in 2012-2020. We analysed data at EU/EEA, national, and subnational levels and calculated notification rates using Eurostat population data. Regression models were used for temporal analysis.ResultsFrom 2012 to 2020, 19 countries reported 29,974 TBE cases, of which 24,629 (98.6%) were autochthonous. Czechia, Germany and Lithuania reported 52.9% of all cases. The highest notification rates were recorded in Lithuania, Latvia, and Estonia (16.2, 9.5 and 7.5 cases/100,000 population, respectively). Fifty regions from 10 countries, had a notification rate ≥ 5/100,000. There was an increasing trend in number of cases during the study period with an estimated 0.053 additional TBE cases every week. In 2020, 11.5% more TBE cases were reported than predicted based on data from 2016 to 2019. A geographical spread of cases was observed, particularly in regions situated north-west of known endemic regions.ConclusionA close monitoring of ongoing changes to the TBE epidemiological situation in Europe can support the timely adaption of vaccination recommendations. Further analyses to identify populations and geographical areas where vaccination programmes can be of benefit are needed.
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Affiliation(s)
| | | | - Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Joana M Haussig
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Jana Kerlik
- Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia
| | | | - Henna Mäkelä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Hana Orlíková
- National Institute of Public Health, Prague, Czechia
| | - Maja Socan
- National Institute of Public Health, Ljubljana, Slovenia
| | - Jakub Zbrzeźniak
- National Institute of Public Health - NIH - National Research Institute, Warsaw, Poland
| | - Milda Žygutiene
- National Public Health Center under the Ministry of Health, Vilnius, Lithuania
| | - Céline M Gossner
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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21
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Parfut A, Laugel E, Baer S, Gonzalez G, Hansmann Y, Wendling MJ, Fafi-Kremer S, Velay A. Tick-borne encephalitis in pediatrics: An often overlooked diagnosis. Infect Dis Now 2023; 53:104645. [PMID: 36642097 DOI: 10.1016/j.idnow.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
Tick-borne encephalitis (TBE) is a vector-borne disease caused by a flavivirus, the tick-borne encephalitis virus (TBEV), and transmitted by the bite of infected Ixodes ricinus ticks. The European subtype (TBEV-Eu) is endemic in 27 European countries. During the last decade, increased TBE incidence was observed in many countries, including some of those believed to be of low endemicity/devoid of TBEV circulation. However, data dealing with TBE in children are far less profuse than with adults. Historically, children are known to have mild TBEV infection with favorable outcomes. That said, recent case reports and observational studies on pediatric cohorts have challenged this point of view. Like adults, children may present severe forms and fail to completely recover following TBE infection, at times leading to long-term cognitive impairment. In this review, we comprehensively describe the incidence, exposure factors, and transmission routes of TBEV in children, as well as the clinical and biological manifestations of TBE and imaging findings in this population. We also harness new data on long-term outcomes and sequelae in pediatric cohorts. Finally, we provide an overview of vaccination recommendations for children in European countries.
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Affiliation(s)
- Assilina Parfut
- Virology Laboratory, University Hospital of Strasbourg, Strasbourg, F-67000, France
| | - Elodie Laugel
- Virology Laboratory, University Hospital of Strasbourg, Strasbourg, F-67000, France; INSERM, UMR_S1109, LabEx Transplantex, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Sarah Baer
- CHU de Strasbourg, Service de Pédiatrie Spécialisée et Générale, Unité de Neurologie Pédiatrique, Strasbourg, France
| | - Gaëlle Gonzalez
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Yves Hansmann
- CHU de Strasbourg, Service des maladies infectieuses et tropicales, Strasbourg, France
| | - Marie-Josée Wendling
- Virology Laboratory, University Hospital of Strasbourg, Strasbourg, F-67000, France
| | - Samira Fafi-Kremer
- Virology Laboratory, University Hospital of Strasbourg, Strasbourg, F-67000, France; INSERM, UMR_S1109, LabEx Transplantex, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Aurélie Velay
- Virology Laboratory, University Hospital of Strasbourg, Strasbourg, F-67000, France; INSERM, UMR_S1109, LabEx Transplantex, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.
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22
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Machicao MF, Yashar-Gershman S, Romero JR, Bernstein HH. International Travel Vaccine Recommendations for Children. Pediatr Ann 2023; 52:e106-e113. [PMID: 36881794 DOI: 10.3928/19382359-20230118-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Children are at risk of contracting diseases while traveling internationally. Beyond the importance of receiving routine vaccinations, physicians should also discuss with parents the effectiveness of vaccination as a strategy to protect their child against disease before travel. This article (1) explores the universally recommended routine vaccines that are particularly important for children to be up to date before travel (ie, measles, mumps, rubella; hepatitis A and B; polio; meningococcal; coronavirus disease 2019 [COVID-19]; and influenza) and (2) explains the travel-specific vaccination recommendations (ie, dengue, cholera, typhoid, tick-borne encephalitis, yellow fever, Japanese encephalitis, and rabies). Physicians can encourage parents to consult the Centers for Disease Control and Prevention website for travel vaccine recommendations (https://wwwnc.cdc.gov/travel). Children must remain up to date on universally recommended vaccines and receive the appropriate vaccines before international travel to prevent serious illness and limit the spread of diseases in the United States. [Pediatr Ann. 2023;52(3):e106-e113.].
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23
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Santonja I, Stiasny K, Essl A, Heinz FX, Kundi M, Holzmann H. Tick-Borne Encephalitis in Vaccinated Patients: A Retrospective Case-Control Study and Analysis of Vaccination Field Effectiveness in Austria From 2000 to 2018. J Infect Dis 2023; 227:512-521. [PMID: 35235953 DOI: 10.1093/infdis/jiac075] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/01/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There are discrepant observations on the severity of tick-borne encephalitis (TBE) in vaccinated persons. We, therefore, analyzed the occurrence of severe and mild disease in hospitalized vaccinated and nonvaccinated patients with TBE and determined the field effectiveness (FE) of vaccination against these forms of disease. METHODS The study covered all patients hospitalized with TBE in Austria from 2000 to 2018. Clinical diagnoses in vaccinated and age- and sex-matched nonvaccinated patients were compared in a nested case-control study. FE was calculated based on vaccination coverage and incidences in the nonvaccinated and vaccinated population. RESULTS Of 1545 patients hospitalized with TBE, 206 were vaccinated. In those, a higher proportion of severe TBE was observed, especially in children. FE was high in all age groups and against all forms of disease. The higher proportion of severe TBE can be explained by a lower FE against severe than against mild disease, a difference especially pronounced in children (FE, 82.7% for severe vs 94.7% for mild disease). CONCLUSIONS The FE of TBE vaccination is excellent. The observed higher proportion of severe disease in vaccinated persons with TBE does not reflect a higher risk associated with vaccination but is rather due to a somewhat lower FE against severe TBE. Because this effect was more pronounced in children, we recommend adapting the immunization schedule.
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Affiliation(s)
- Isabel Santonja
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Karin Stiasny
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Astrid Essl
- Astrid Essl Consulting-Gesundheitsforschung, Wiener Neustadt, Austria
| | - Franz X Heinz
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Michael Kundi
- Center for Public Health, Medical University of Vienna, Vienna, Austria
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24
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Zverev SA, Andreev SV, Sakharov KA, Akhmetshina MB, Istomina LI, Verzhutskaya YA, Shashina NI. Evaluation of the efficacy of permethrin- and cypermethrin-based textile against taiga tick, Ixodes persulcatus. EXPERIMENTAL & APPLIED ACAROLOGY 2023; 89:275-286. [PMID: 37017750 DOI: 10.1007/s10493-023-00785-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
A comparison of the efficacy of permethrin- and cypermethrin-based textile against taiga ticks (Ixodes persulcatus) was carried out in a tick-borne viral encephalitis hotspot in the Irkutsk Region (Russia) using model samples of impregnated textiles. We demonstrated that permethrin- and cypermethrin-treated model samples have similar protective parameters in terms of maximum height reached by the tick when climbing up the treated textile (20.9-38.7 cm for cypermethrin, 27.6-39.3 cm for permethrin, depending on concentration) and knockdown time (i.e., the time until a female tick falls off the treated textile; 3.52-4.31 min for cypermethrin, 5.02-8.25 min for permethrin, depending on concentration). In contrast, when evaluating the 'biting speed' index (which is the ratio of the average attaching time of ticks contacting untreated textiles and ticks contacting treated textiles), it has been shown that permethrin-treated textiles accelerate biting. So, using permethrin-treated protective clothing against the taiga tick could be risky because it increases the likelihood of being bitten and thus getting infected. In contrast, cypermethrin-treated textiles appear to block the ability of ticks to attack warm-blooded animals and humans - after contact with cypermethrin-treated textiles none of the ticks attached to a rabbit. So cypermethrin-based textiles could be an alternative to permethrin for tick-bite protection clothing production if there is no toxic effect on humans of textile materials based on it.
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Affiliation(s)
- Sergey A Zverev
- Disinfectology institute of Federal Scientific Center of Hygiene named after F.F. Erisman of the Federal Service on Surveillance for Consumer Rights Protection and Human Well-being, Moscow region, Russian Federation
| | - Sergey V Andreev
- Disinfectology institute of Federal Scientific Center of Hygiene named after F.F. Erisman of the Federal Service on Surveillance for Consumer Rights Protection and Human Well-being, Moscow region, Russian Federation
| | - Konstantin A Sakharov
- School of Materials Science and Engineering, Nanyang Technological University (NTU), 50 Nanyang Avenue, Singapore, 639798, Republic of Singapore.
| | - Marina B Akhmetshina
- Disinfectology institute of Federal Scientific Center of Hygiene named after F.F. Erisman of the Federal Service on Surveillance for Consumer Rights Protection and Human Well-being, Moscow region, Russian Federation
| | - Liudmila I Istomina
- Disinfectology institute of Federal Scientific Center of Hygiene named after F.F. Erisman of the Federal Service on Surveillance for Consumer Rights Protection and Human Well-being, Moscow region, Russian Federation
| | - Yulia A Verzhutskaya
- Irkutsk Antiplague Research Institute of Siberia and Far East, Irkutsk, Russian Federation
| | - Natalia I Shashina
- Disinfectology institute of Federal Scientific Center of Hygiene named after F.F. Erisman of the Federal Service on Surveillance for Consumer Rights Protection and Human Well-being, Moscow region, Russian Federation
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25
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Morsli M, Salipante F, Kerharo Q, Boudet A, Stephan R, Dunyach-Remy C, Zandotti C, Lavigne JP, Drancourt M. Dynamics of community-acquired meningitis syndrome outbreaks in southern France. Front Microbiol 2023; 13:1102130. [PMID: 36777029 PMCID: PMC9909019 DOI: 10.3389/fmicb.2022.1102130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/30/2022] [Indexed: 01/27/2023] Open
Abstract
In southern France, cases of community-acquired meningitis syndrome (CAM) are typically clustered as outbreaks with determinants which remain unknown. This 61-month retrospective investigation in Nîmes and Marseille university hospital laboratories, yielded 2,209/20,779 (10.63%) documented CAM cases caused by 62 different micro-organisms, represented by seasonal viral etiologies (78.8%), including Enterovirus, Herpes Simplex Virus (HSV), and Varicella-Zoster Virus (VZV; 1,620/2,209 = 73.4%). Multi correspondence analysis revealed an association of infection with age and sex, with the risk of infection being relatively higher in young men, as confirmed by Fisher's exact test (p < 10-3). Bacterial meningitis accounted for 20% of cases, mostly caused by Streptococcus pneumoniae (27.4% of cases), Neisseria meningitidis (12.5%), and Haemophilus influenzae (9.5%) with bacteria/virus coinfection (0.9%), and only six cases of documented fungal meningitis. In total, 62.6% of cases, of which 88.7% were undocumented, arose from 10 outbreaks. 33.2% of undocumented cases were aged >60 years compared to 19.2% of documented cases (p < 0.001), and viral infection was more common in the summer (87.5%) compared to other seasons (72.3%; p < 0.001). Outbreaks most often started in Nîmes and moved eastward toward Marseille at a speed of ~9 km/day, and these dynamics significantly correlated with atmospheric temperature, especially during summer outbreaks. In particular, the incidence of Enterovirus-driven outbreaks correlated with temperature, revealing correlation coefficients of 0.64 in Nîmes and 0.72 in Marseille, and its occurrence in Marseille lagged that in Nîmes by 1-2 weeks. Tracing the dynamics of CAM outbreak during this retrospective investigation in southern France yielded a speed of displacement that correlated with the variation in temperature between both cities, and these results provide clues for the next occurrence of undocumented outbreaks.
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Affiliation(s)
- Madjid Morsli
- IHU Méditerranée Infection, Marseille, France,Aix-Marseille-Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Florian Salipante
- Laboratoire de biostatistique, Épidémiologie Clinique, Santé Publique, Innovation et Méthodologie, CHU de Nîmes, Université de Montpellier, Nîmes, France
| | - Quentin Kerharo
- Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Marseille, IHU Méditerranée Infection, Marseille, France
| | - Agathe Boudet
- VBIC, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, Nîmes, France
| | - Robin Stephan
- VBIC, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, Nîmes, France
| | - Catherine Dunyach-Remy
- VBIC, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, Nîmes, France
| | - Christine Zandotti
- IHU Méditerranée Infection, Marseille, France,Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Marseille, IHU Méditerranée Infection, Marseille, France
| | - Jean-Philippe Lavigne
- VBIC, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, Nîmes, France
| | - Michel Drancourt
- IHU Méditerranée Infection, Marseille, France,Aix-Marseille-Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France,Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Marseille, IHU Méditerranée Infection, Marseille, France,*Correspondence: Michel Drancourt, ✉
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26
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Esser HJ, Lim SM, de Vries A, Sprong H, Dekker DJ, Pascoe EL, Bakker JW, Suin V, Franz E, Martina BEE, Koenraadt CJM. Continued Circulation of Tick-Borne Encephalitis Virus Variants and Detection of Novel Transmission Foci, the Netherlands. Emerg Infect Dis 2022; 28:2416-2424. [PMID: 36288572 PMCID: PMC9707572 DOI: 10.3201/eid2812.220552] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Tick-borne encephalitis virus (TBEV) is an emerging pathogen that was first detected in ticks and humans in the Netherlands in 2015 (ticks) and 2016 (humans). To learn more about its distribution and prevalence in the Netherlands, we conducted large-scale surveillance in ticks and rodents during August 2018-September 2020. We tested 320 wild rodents and >46,000 ticks from 48 locations considered to be at high risk for TBEV circulation. We found TBEV RNA in 3 rodents (0.9%) and 7 tick pools (minimum infection rate 0.02%) from 5 geographically distinct foci. Phylogenetic analyses indicated that 3 different variants of the TBEV-Eu subtype circulate in the Netherlands, suggesting multiple independent introductions. Combined with recent human cases outside known TBEV hotspots, our data demonstrate that the distribution of TBEV in the Netherlands is more widespread than previously thought.
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27
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Garcia-Vozmediano A, Bellato A, Rossi L, Hoogerwerf MN, Sprong H, Tomassone L. Use of Wild Ungulates as Sentinels of TBEV Circulation in a Naïve Area of the Northwestern Alps, Italy. Life (Basel) 2022; 12:1888. [PMID: 36431023 PMCID: PMC9699112 DOI: 10.3390/life12111888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
Wild and domestic animals can be usefully employed as sentinels for the surveillance of diseases with an impact on public health. In the case of tick-borne encephalitis virus (TBEV), the detection of antibodies in animals can be more effective than screening ticks for detecting TBEV foci, due to the patchy distribution of the virus. In the Piedmont region, northwestern Italy, TBEV is considered absent, but an increase in tick densities, of Ixodes ricinus in particular, has been observed, and TBEV is spreading in bordering countries, e.g., Switzerland. Therefore, we collected sera from wild ungulates during the hunting season (October-December) from 2017 to 2019 in the Susa Valley, Italian western Alps, and screened them for TBEV antibodies by a commercial competitive ELISA test. We collected 267 serum samples by endocranial venous sinuses puncture from red deer, roe deer and northern chamois carcasses. The animals were hunted in 13 different municipalities, at altitudes ranging between 750 and 2800 m a.s.l. The serological survey for TBEV yielded negative results. Borderline results for five serum samples were further confirmed as negative for TBEV by a plaque reduction neutralisation test. To date, our results indicate that TBEV is not circulating in western Piedmont. However, monitoring of TBEV should continue since TBEV and its vector are spreading in Europe. The wide-range distribution of wild ungulates and their role as feeding hosts, make them useful indicators of the health threats posed by Ixodid ticks.
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Affiliation(s)
- Aitor Garcia-Vozmediano
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, TO, Italy
| | - Alessandro Bellato
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, TO, Italy
| | - Luca Rossi
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, TO, Italy
| | - Marieke N. Hoogerwerf
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3720 MA Bilthoven, The Netherlands
| | - Hein Sprong
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3720 MA Bilthoven, The Netherlands
| | - Laura Tomassone
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, TO, Italy
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28
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Marini G, Pugliese A, Wint W, Alexander NS, Rizzoli A, Rosà R. Modelling the West Nile virus force of infection in the European human population. One Health 2022; 15:100462. [DOI: 10.1016/j.onehlt.2022.100462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022] Open
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29
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Lang D, Chitimia-Dobler L, Bestehorn-Willmann M, Lindau A, Drehmann M, Stroppel G, Hengge H, Mackenstedt U, Kaier K, Dobler G, Borde J. The Emergence and Dynamics of Tick-Borne Encephalitis Virus in a New Endemic Region in Southern Germany. Microorganisms 2022; 10:2125. [PMID: 36363717 PMCID: PMC9693875 DOI: 10.3390/microorganisms10112125] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 06/11/2024] Open
Abstract
Tick-borne encephalitis (TBE) is the most important viral tick-borne infection in Europe and Asia. It is emerging in new areas. The mechanisms of emergence are fairly unknown or speculative. In the Ravensburg district in southern Germany, TBE emerged, mainly over the last five years. Here, we analyzed the underlying epidemiology in humans. The resulting identified natural foci of the causal TBE virus (TBEV) were genetically characterized. We sampled 13 potential infection sites at these foci and detected TBEV in ticks (Ixodes ricinus) at eight sites. Phylogenetic analysis spurred the introduction of at least four distinct TBEV lineages of the European subtype into the Ravensburg district over the last few years. In two instances, a continuous spread of these virus strains over up to 10 km was observed.
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Affiliation(s)
- Daniel Lang
- National Reference Laboratory for TBEV, Bundeswehr Institute for Microbiology, 80937 Munich, Germany
| | - Lidia Chitimia-Dobler
- National Reference Laboratory for TBEV, Bundeswehr Institute for Microbiology, 80937 Munich, Germany
| | - Malena Bestehorn-Willmann
- National Reference Laboratory for TBEV, Bundeswehr Institute for Microbiology, 80937 Munich, Germany
| | - Alexander Lindau
- Department of Parasitology, University of Hohenheim, 70599 Stuttgart, Germany
| | - Marco Drehmann
- Department of Parasitology, University of Hohenheim, 70599 Stuttgart, Germany
| | - Gabriele Stroppel
- Public Health Office, District Ravensburg, 88212 Ravensburg, Germany
| | - Helga Hengge
- Public Health Office, District Ravensburg, 88212 Ravensburg, Germany
| | - Ute Mackenstedt
- Department of Parasitology, University of Hohenheim, 70599 Stuttgart, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics (IMBI), University Medical Center Freiburg im Breisgau, 79106 Freiburg im Breisgau, Germany
| | - Gerhard Dobler
- National Reference Laboratory for TBEV, Bundeswehr Institute for Microbiology, 80937 Munich, Germany
- Department of Parasitology, University of Hohenheim, 70599 Stuttgart, Germany
| | - Johannes Borde
- Praxis Prof. Borde & Kollegen, Gesundheitszentrum Oberkirch, 77704 Oberkirch, Germany
- Division of Infectious Diseases, Department of Internal Medicine, University Medical Center Freiburg im Breisgau, 79106 Freiburg im Breisgau, Germany
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30
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Elbaz M, Gadoth A, Shepshelovich D, Shasha D, Rudoler N, Paran Y. Systematic Review and Meta-analysis of Foodborne Tick-Borne Encephalitis, Europe, 1980-2021. Emerg Infect Dis 2022; 28. [PMID: 36149234 PMCID: PMC9514354 DOI: 10.3201/eid2810.220498] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Most cases were associated with ingesting unpasteurized dairy products from goats; the clinical attack rate was 14%. Tick-borne encephalitis (TBE) is a viral infection of the central nervous system that occurs in many parts of Europe and Asia. Humans mainly acquire TBE through tick bites, but TBE occasionally is contracted through consuming unpasteurized milk products from viremic livestock. We describe cases of TBE acquired through alimentary transmission in Europe during the past 4 decades. We conducted a systematic review and meta-analysis of 410 foodborne TBE cases, mostly from a region in central and eastern Europe. Most cases were reported during the warmer months (April–August) and were associated with ingesting unpasteurized dairy products from goats. The median incubation period was short, 3.5 days, and neuroinvasive disease was common (38.9%). The clinical attack rate was 14% (95% CI 12%–16%), and we noted major heterogeneity. Vaccination programs and public awareness campaigns could reduce the number of persons affected by this potentially severe disease.
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31
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Tick-Borne Encephalitis Virus RNA Found in Frozen Goat's Milk in a Family Outbreak. Int J Mol Sci 2022; 23:ijms231911632. [PMID: 36232930 PMCID: PMC9570086 DOI: 10.3390/ijms231911632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/09/2022] Open
Abstract
Tick-borne encephalitis (TBE) is one of the commonest arthropod-borne viral diseases in Middle-East Europe and North Asia. The main reservoir of the virus is comprised of small rodents and domestic mammals with the common tick (Ixodes) being the usual vector. The clinical spectrum of TBE ranges from mild meningitis to severe meningoencephalomyelitis. This disease can lead to severe sequelae and has a mortality up to 2% in Europe. Even though the majority of cases are transmitted through bites of infected ticks, infections through ingestion of contaminated milk and dairy products from farms in endemic areas have been reported. We report a family outbreak of a febrile disease, initially suggestive of human-to-human infection, during the early summertime in Austria. Tick-borne encephalitis was diagnosed following consumption of unpasteurised goat’s milk and the virus was subsequently detected in frozen milk samples. Although this is a rare manifestation of TBE, this case series shows that TBE should be included in the differential diagnosis of an outbreak of febrile disease, and a careful clinical history with reference to unpasteurized dairy products is crucial in order to prevent further disease spread. The best preventive measure is active immunisation of people living in, or travelling to, endemic areas.
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Magouras I, Schoster A, Fouché N, Gerber V, Groschup MH, Ziegler U, Fricker R, Griot C, Vögtlin A. Neurological disease suspected to be caused by tick-borne encephalitis virus infection in 6 horses in Switzerland. J Vet Intern Med 2022; 36:2254-2262. [PMID: 36093849 DOI: 10.1111/jvim.16533] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Reports on acute tick-borne encephalitis virus (TBEV) infections with signs of neurologic disease in horses are limited. OBJECTIVES To describe the epidemiological, clinical, and laboratory findings of suspected acute TBEV infections in 6 horses. ANIMALS Six horses originating from TBEV endemic regions of Switzerland were presented to equine hospitals with acute onset of neurologic disease between 2011 and 2019. METHODS Retrospective case series. Horses with acute onset of signs of neurologic disease that were subjected to clinical and microbiological examinations to rule out infectious diseases affecting the central nervous system. RESULTS All horses exhibited acute signs of neurologic disease including ataxia and proprioceptive deficits. Horses tested positive for TBEV using virus neutralization test and samples were further tested for TBEV-specific IgM. The presence of TBEV-specific IgM antibodies was confirmed in 5 horses (cases 1-5, Laboratory Unit [LU] values ranging from 30 to 56). One horse (case no. 6) with an LU value just below the test threshold (LU = 22.3) was also included under the hypothesis that the horse was transitioning from acute to chronic infection. All horses originated from areas where humans with confirmed tick-borne encephalitis reported to have been bitten by ticks. CONCLUSIONS AND CLINICAL IMPORTANCE Acute TBEV infection should be a differential diagnosis in horses with signs of neurologic disease and originating from TBEV endemic areas. The establishment of harmonized diagnostic criteria would help to overcome the diagnostic challenges associated with TBEV and other Flavivirus infections in horses.
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Affiliation(s)
- Ioannis Magouras
- Veterinary Public Health Institute, Department of Clinical Research and Veterinary Public Health, University of Bern, Bern, Switzerland.,Centre for Applied One Health Research and Policy Advice, Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong, China
| | - Angelika Schoster
- Clinic for Equine Internal Medicine, Equine Department, University of Zurich, Zurich, Switzerland
| | - Nathalie Fouché
- Swiss Institute of Equine Medicine, University of Bern, Bern, Switzerland
| | - Vinzenz Gerber
- Swiss Institute of Equine Medicine, University of Bern, Bern, Switzerland
| | - Martin H Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald, Insel Riems, Germany
| | - Ute Ziegler
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald, Insel Riems, Germany
| | - Raffael Fricker
- Institute for Virology and Immunology IVI, Department of Infectious Diseases and Pathobiology, University of Bern, Mittelhäusern and Bern, Switzerland
| | - Christian Griot
- Institute for Virology and Immunology IVI, Department of Infectious Diseases and Pathobiology, University of Bern, Mittelhäusern and Bern, Switzerland
| | - Andrea Vögtlin
- Institute for Virology and Immunology IVI, Department of Infectious Diseases and Pathobiology, University of Bern, Mittelhäusern and Bern, Switzerland
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Anindita PD, Halbeisen M, Řeha D, Tuma R, Franta Z. Mechanistic insight into the RNA stimulated-ATPase activity of tick-borne encephalitis virus helicase. J Biol Chem 2022; 298:102383. [PMID: 35987382 PMCID: PMC9490040 DOI: 10.1016/j.jbc.2022.102383] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/05/2022] Open
Abstract
The helicase domain of nonstructural protein 3 (NS3H) unwinds the double-stranded RNA replication intermediate in an ATP-dependent manner during the flavivirus life cycle. While the ATP hydrolysis mechanism of Dengue and Zika viruses NS3H has been extensively studied, little is known in the case of the tick-borne encephalitis virus NS3H. We demonstrate that ssRNA binds with nanomolar affinity to NS3H and strongly stimulates the ATP hydrolysis cycle, whereas ssDNA binds only weakly and inhibits ATPase activity in a noncompetitive manner. Thus, NS3H is an RNA-specific helicase, whereas DNA might act as an allosteric inhibitor. Using modeling, we explored plausible allosteric mechanisms by which ssDNA inhibits the ATPase via nonspecific binding in the vicinity of the active site and ATP repositioning. We captured several structural snapshots of key ATP hydrolysis stages using X-ray crystallography. One intermediate, in which the inorganic phosphate and ADP remained trapped inside the ATPase site after hydrolysis, suggests that inorganic phosphate release is the rate-limiting step. Using structure-guided modeling and molecular dynamics simulation, we identified putative RNA-binding residues and observed that the opening and closing of the ATP-binding site modulates RNA affinity. Site-directed mutagenesis of the conserved RNA-binding residues revealed that the allosteric activation of ATPase activity is primarily communicated via an arginine residue in domain 1. In summary, we characterized conformational changes associated with modulating RNA affinity and mapped allosteric communication between RNA-binding groove and ATPase site of tick-borne encephalitis virus helicase.
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Affiliation(s)
| | - Marco Halbeisen
- Department of Chemistry, Faculty of Science, University of South Bohemia, Czech Republic
| | - David Řeha
- Department of Chemistry, Faculty of Science, University of South Bohemia, Czech Republic
| | - Roman Tuma
- Department of Chemistry, Faculty of Science, University of South Bohemia, Czech Republic
| | - Zdenek Franta
- Department of Chemistry, Faculty of Science, University of South Bohemia, Czech Republic.
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The Prevalence of Asymptomatic Infections with Tick-Borne Encephalitis Virus and Attitude towards Tick-Borne Encephalitis Vaccine in the Endemic Area of Northeastern Poland. Vaccines (Basel) 2022; 10:vaccines10081294. [PMID: 36016182 PMCID: PMC9412675 DOI: 10.3390/vaccines10081294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022] Open
Abstract
In Poland, tick-borne encephalitis (TBE) vaccination rate is low despite high incidence of severe infections with TBE virus (TBEV). However, infection with TBEV can be asymptomatic or mild, which makes the total number of cases difficult to assess. We aimed at assessing asymptomatic TBEV infections and describing attitudes towards the TBE vaccine. We studied 298 healthy adult blood donors and 180 children from the TBE endemic area of northeastern Poland for the presence of anti-TBEV IgG antibodies. We also surveyed a separate cohort of 444 adults. Thirty-eight blood donors (13%) and 38 survey respondents (9%) reported a history of a prior anti-TBEV vaccination. Forty respondents (9%) reported vaccinating their child in the past. Fourteen unvaccinated blood donors (5%) and four children (2%) were seropositive for specific anti-TBEV antibodies, suggesting a history of an undiagnosed TBEV infection. In the surveyed cohort, 130 (32%) expressed their intention to be vaccinated and 144 (36%) expressed their intention to vaccinate their child. This intention was significantly higher in respondents with a recent tick-bite, a diagnosis of tick-borne disease in a close relative, and in males. Our study shows that asymptomatic TBEV infections are common. The acceptance of TBE vaccine is low, but might be increased by communicating risks associated with tick bites.
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First Human Case of Tick-Borne Encephalitis in Non-Endemic Region in Italy: A Case Report. Pathogens 2022; 11:pathogens11080854. [PMID: 36014975 PMCID: PMC9412648 DOI: 10.3390/pathogens11080854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 12/30/2022] Open
Abstract
Tick-borne encephalitis (TBE), a human viral infectious disease caused by the tick-borne encephalitis virus (TBEV), is emerging in Italy, especially in the north-eastern area. No human cases of autochthonous TBE have been reported in Italy’s central regions (such as Emilia-Romagna, Italy). However, here we describe the first human case of TBEV infection in this region, pointing to endemic transmission of TBEV, supporting the concept of circulation of TBEV and of the presence of a possible hot spot in the Serramazzoni region in the Emilian Apennines.
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Abstract
We assessed standardized mortality ratio in tick-borne encephalitis (TBE) in Sweden, 2004–2017. Standardized mortality ratio for TBE was 3.96 (95% CI 2.55–5.90); no cases in patients <40 years of age were fatal. These results underscore the need for further vaccination efforts in populations at risk for TBE.
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Salat J, Strakova P, Ruzek D. Dynamics of Whole Virus and Non-Structural Protein 1 (NS1) IgG Response in Mice Immunized with Two Commercial Tick-Borne Encephalitis Vaccines. Vaccines (Basel) 2022; 10:vaccines10071001. [PMID: 35891164 PMCID: PMC9320558 DOI: 10.3390/vaccines10071001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 01/27/2023] Open
Abstract
The presence of a non-structural protein 1 (NS1) in tick-borne encephalitis (TBE) vaccines and the possible induction of an NS1-specific immune response in vaccinated individuals remains a somewhat controversial topic. Previously, we detected the presence of NS1 in the Encepur TBE vaccine by mass spectrometry and found the induction of NS1-specific IgG antibodies in mice vaccinated with the FSME-Immun TBE vaccine. Here, in this follow-up study, we examined the dynamics and extent of the NS1-specific IgG response in mice vaccinated with these two vaccines in more detail and compared it with the IgG response to the whole virus (WV). Mice were vaccinated at two-week intervals with a total of six doses of each vaccine, and levels of IgG antibodies to TBE virus WV and NS1 were measured by ELISA after each dose. Both vaccines elicited a robust anti-WV IgG response after two doses. The Encepur vaccine did not elicit NS1-specific IgG even after all six doses. In contrast, the FSME-Immun vaccine triggered the production of NS1-specific IgG after four doses. The results indicate that FSME-Immun is the only vaccine that elicits an NS1-specific antibody response in mice. However, compared to WV-specific IgG, the NS1-specific response is weaker, and a higher number of doses is required to induce detectable levels of NS1-specific IgG antibodies.
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Affiliation(s)
- Jiri Salat
- Laboratory of Emerging Viral Infections, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic;
- Laboratory of Arbovirology, Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Branisovska 31, CZ-37005 Ceske Budejovice, Czech Republic
- Correspondence: (J.S.); (D.R.)
| | - Petra Strakova
- Laboratory of Emerging Viral Infections, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic;
- Laboratory of Arbovirology, Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Branisovska 31, CZ-37005 Ceske Budejovice, Czech Republic
| | - Daniel Ruzek
- Laboratory of Emerging Viral Infections, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic;
- Laboratory of Arbovirology, Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Branisovska 31, CZ-37005 Ceske Budejovice, Czech Republic
- Department of Experimental Biology, Faculty of Science, Masaryk University, Kamenice 735/5, CZ-62500 Brno, Czech Republic
- Correspondence: (J.S.); (D.R.)
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Virome of Ixodes ricinus, Dermacentor reticulatus, and Haemaphysalis concinna Ticks from Croatia. Viruses 2022; 14:v14050929. [PMID: 35632671 PMCID: PMC9146755 DOI: 10.3390/v14050929] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
Tick-borne diseases are a serious threat to both public and veterinary health. In this study, we used high-throughput sequencing to characterize the virome of three tick species implicated in the spread of vector-borne disease throughout Croatia. Ten viruses were identified, including seven potential novel species within the viral families Flaviviridae, Nyamiviridae, Rhabdoviridae, Peribunyaviridae, Phenuiviridae, and Nairoviridae.
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Schmidt AJ, Altpeter E, Graf S, Steffen R. Tick-borne encephalitis (TBE) in Switzerland: does the prolongation of vaccine booster intervals result in an increased risk of breakthroughs? J Travel Med 2022; 29:6377255. [PMID: 34581402 DOI: 10.1093/jtm/taab158] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND In 2006, the Swiss Federal Office of Public Health (FOPH) decided recommending a prolongation of vaccine booster intervals after the third dose for the prevention of tick-borne encephalitis (TBE) from 3 to 10 years. METHODS To ascertain whether this amendment resulted in an increased rate of vaccine breakthroughs, we conducted a retrospective analysis of surveillance data collected 2000-19 by mandatory reporting to the Swiss FOPH. Fractions of breakthroughs [with 95% confidence intervals (CIs)]-0-3 years vs >3-10 years after the third vaccination dose-were compared across time periods and age groups. RESULTS Among 3205 notified TBE cases, known vaccination status was reported in 2562 (79.9%), including 103 patients with ≥3 vaccine doses (4.0%). Among those, there were 39 patients who had received the last dose within 3 years and 48 patients in the >3-10 years group. During the 2010-19 period in which the new booster strategy was implemented there were 23 and 38 breakthroughs, respectively, and the annual breakthrough rate was 7.7 (95% CI 5.0-11.7) cases during the first 3 years after the last dose, and 5.4 (95% CI 3.9-7.5) cases in following 7 years. We observed no significant trend of TBE breakthroughs with increasing age. Increasing numbers of TBE and of vaccine breakthroughs over time have been associated with spreading endemicity and higher vaccination coverage in Switzerland. CONCLUSIONS There is no indication that extended booster intervals resulted in an increased rate of breakthroughs, but there was a marked public health benefit with respect to increased acceptability of TBE immunization in the general population.
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Affiliation(s)
- Axel J Schmidt
- Communicable Diseases Division, Swiss Federal Office of Public Health, 3003 Bern, Switzerland.,Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Ekkehardt Altpeter
- Communicable Diseases Division, Swiss Federal Office of Public Health, 3003 Bern, Switzerland
| | - Simone Graf
- Communicable Diseases Division, Swiss Federal Office of Public Health, 3003 Bern, Switzerland
| | - Robert Steffen
- Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Traveller's Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX, USA
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Banović P, Díaz-Sánchez AA, Đurić S, Sević S, Turkulov V, Lendak D, Mikić SS, Simin V, Mijatović D, Bogdan I, Potkonjak A, Savić S, Obregón D, Cabezas-Cruz A. Unexpected TBEV Seropositivity in Serbian Patients Who Recovered from Viral Meningitis and Encephalitis. Pathogens 2022; 11:pathogens11030371. [PMID: 35335695 PMCID: PMC8951648 DOI: 10.3390/pathogens11030371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/12/2022] Open
Abstract
The tick-borne encephalitis virus (TBEV) causes a life-threatening disease named Tick-borne encephalitis (TBE). The clinical symptoms associated with TBE range from non-specific to severe inflammation of the central nervous system and are very similar to the clinical presentation of other viral meningitis/encephalitis. In consequence, TBE is often misclassified by clinical physicians, mainly in the non-identified high-risk areas where none or only a few TBE cases have been reported. Considering this situation, we hypothesized that among persons from northern Serbia who recovered from viral meningitis or encephalitis, there would be evidence of TBEV infection. To test this hypothesis, in this observational study, we evaluated the seroreactivity against TBEV antigens in patients from northern Serbia who were hospitalized due to viral meningitis and/or viral encephalitis of unknown etiology. Three cases of seroreactivity to TBEV antigens were discovered among convalescent patients who recovered from viral meningitis and/or encephalitis and accepted to participate in the study (n = 15). The clinical and laboratory findings of these patients overlap with that of seronegative convalescent patients. Although TBE has been a notifiable disease in Serbia since 2004, there is no active TBE surveillance program for the serologic or molecular screening of TBEV infection in humans in the country. This study highlights the necessity to increase the awareness of TBE among physicians and perform active and systematic screening of TBEV antibodies among patients with viral meningitis and/or encephalitis.
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Affiliation(s)
- Pavle Banović
- Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia;
- Department of Microbiology with Parasitology and Immunology, Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
- Correspondence: (P.B.); (A.C.-C.)
| | | | - Selena Đurić
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (S.Đ.); (S.S.); (V.T.); (D.L.); (S.S.M.)
| | - Siniša Sević
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (S.Đ.); (S.S.); (V.T.); (D.L.); (S.S.M.)
- Clinic for Infectious Diseases, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Vesna Turkulov
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (S.Đ.); (S.S.); (V.T.); (D.L.); (S.S.M.)
- Clinic for Infectious Diseases, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Dajana Lendak
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (S.Đ.); (S.S.); (V.T.); (D.L.); (S.S.M.)
- Clinic for Infectious Diseases, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Sandra Stefan Mikić
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (S.Đ.); (S.S.); (V.T.); (D.L.); (S.S.M.)
- Clinic for Infectious Diseases, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Verica Simin
- Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia; (V.S.); (I.B.)
| | - Dragana Mijatović
- Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia;
| | - Ivana Bogdan
- Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia; (V.S.); (I.B.)
| | - Aleksandar Potkonjak
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Sara Savić
- Scientific Veterinary Institute “Novi Sad”, 21000 Novi Sad, Serbia;
| | - Dasiel Obregón
- School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Alejandro Cabezas-Cruz
- Anses, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, F-94700 Maisons-Alfort, France
- Correspondence: (P.B.); (A.C.-C.)
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Friedsam AM, Brady OJ, Pilic A, Dobler G, Hellenbrand W, Nygren TM. Geo-Spatial Characteristics of 567 Places of Tick-Borne Encephalitis Infection in Southern Germany, 2018-2020. Microorganisms 2022; 10:643. [PMID: 35336218 PMCID: PMC8953713 DOI: 10.3390/microorganisms10030643] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 12/30/2022] Open
Abstract
Tick-borne encephalitis (TBE) is a growing public health problem with increasing incidence and expanding risk areas. Improved prevention requires better understanding of the spatial distribution and ecological determinants of TBE transmission. However, a TBE risk map at sub-district level is still missing for Germany. We investigated the distribution and geo-spatial characteristics of 567 self-reported places of probable TBE infection (POI) from 359 cases notified in 2018-2020 in the study area of Bavaria and Baden-Wuerttemberg, compared to 41 confirmed TBE foci and 1701 random comparator places. We built an ecological niche model to interpolate TBE risk to the entire study area. POI were distributed heterogeneously at sub-district level, as predicted probabilities varied markedly across regions (range 0-93%). POI were spatially associated with abiotic, biotic, and anthropogenic geo-spatial characteristics, including summer precipitation, population density, and annual frost days. The model performed with 69% sensitivity and 63% specificity at an optimised probability threshold (0.28) and an area under the curve of 0.73. We observed high predictive probabilities in small-scale areas, consistent with the known circulation of the TBE virus in spatially restricted microfoci. Supported by further field work, our findings may help identify new TBE foci. Our fine-grained risk map could supplement targeted prevention in risk areas.
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Affiliation(s)
- Amelie M Friedsam
- Immunization Unit (FG33), Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Oliver J Brady
- Centre of Mathematical Modelling for Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Antonia Pilic
- Immunization Unit (FG33), Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Gerhard Dobler
- Department of Microbiology of the German Armed Forces, 80937 Munich, Germany
| | - Wiebke Hellenbrand
- Immunization Unit (FG33), Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Teresa M Nygren
- Immunization Unit (FG33), Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
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Vaccination against Tick-Borne Encephalitis (TBE) in Italy: Still a Long Way to Go. Microorganisms 2022; 10:microorganisms10020464. [PMID: 35208918 PMCID: PMC8880353 DOI: 10.3390/microorganisms10020464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023] Open
Abstract
Tick-borne encephalitis (TBE) is endemic in several European countries, and its incidence has recently increased. Various factors may explain this phenomenon: social factors (changes in human behavior, duration and type of leisure activities and increased tourism in European high-risk areas), ecological factors (e.g., effects of climate change on the tick population and reservoir animals), and technological factors (improved diagnostics, increased medical awareness). Furthermore, the real burden of TBE is not completely known, as the performance of surveillance systems is suboptimal and cases of disease are under-reported in several areas. Given the potentially severe clinical course of the disease, the absence of any antiviral therapy, and the impossibility of interrupting the transmission of the virus in nature, vaccination is the mainstay of prevention and control. TBE vaccines are effective (protective effect of approximately 95% after completion of the basic vaccination—three doses) and well tolerated. However, their uptake in endemic areas is suboptimal. In the main endemic countries where vaccination is included in the national/regional immunization program (with reimbursed vaccination programs), this decision was driven by a cost-effectiveness assessment (CEA), which is a helpful tool in the decision-making process. All CEA studies conducted have demonstrated the cost-effectiveness of TBE vaccination. Unfortunately, CEA is still lacking in many endemic countries, including Italy. In the future, it will be necessary to fill this gap in order to introduce an effective vaccination strategy in endemic areas. Finally, raising awareness of TBE, its consequences and the benefit of vaccination is critical in order to increase vaccination coverage and reduce the burden of the disease.
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Food-Borne Transmission of Tick-Borne Encephalitis Virus—Spread, Consequences, and Prophylaxis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031812. [PMID: 35162837 PMCID: PMC8835261 DOI: 10.3390/ijerph19031812] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022]
Abstract
Tick-borne encephalitis (TBE) is the most common viral neurological disease in Eurasia. It is usually transmitted via tick bites but can also occur through ingestion of TBEV-infected milk and dairy products. The present paper summarises the knowledge of the food-borne TBEV transmission and presents methods for the prevention of its spread. The incidence of milk-borne TBE outbreaks is recorded in central, eastern, and north-eastern Europe, where Ixodes ricinus, Ixodes persulcatus, and/or Dermacentor reticulatus ticks, i.e., the main vectors of TBEV, occur abundantly. The growing occurrence range and population size of these ticks increases the risk of infection of dairy animals, i.e., goats, sheep, and cows, with viruses transmitted by these ticks. Consumers of unpasteurised milk and dairy products purchased from local farms located in TBE endemic areas are the most vulnerable to alimentary TBEV infections. Familial infections with these viruses are frequently recorded, mainly in children. Food-transmitted TBE can be monophasic or biphasic, and some of its neurological and psychiatric symptoms may persist in patients for a long time. Alimentary TBEV infections can be effectively prevented by consumption of pasteurised milk and the use of TBEV vaccines. It is recommended that milk and dairy products should be checked for the presence of TBE viruses prior to distribution. Protection of dairy animals against tick attacks and education of humans regarding the epidemiology and prophylaxis of TBE are equally important.
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Incidence of Tick-Borne Encephalitis during the COVID-19 Pandemic in Selected European Countries. J Clin Med 2022; 11:jcm11030803. [PMID: 35160255 PMCID: PMC8836726 DOI: 10.3390/jcm11030803] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 02/06/2023] Open
Abstract
Ixodes ricinus ticks are one of the most important vectors and reservoirs of infectious diseases in Europe, and tick-borne encephalitis (TBE) is one of the most dangerous human diseases transmitted by these vectors. The aim of the present study was to investigate the TBE incidence in some European countries during the COVID-19 pandemic. To this end, we analyzed the data published by the European Center for Disease Prevention and Control (ECDC) and Eurostat on the number of reported TBE and COVID-19 cases in 2020 and TBE cases in 2015–2019 (reference period). Significant differences in the TBE incidence were found between the analyzed countries. The highest TBE incidence was found in Lithuania (25.45/100,000 inhabitants). A high TBE incidence was also observed in Central European countries. In 12 of the 23 analyzed countries, there was significant increase in TBE incidence during the COVID-19 pandemic during 2020 compared to 2015–2019. There was no correlation between the incidence of COVID-19 and TBE and between the availability of medical personnel and TBE incidence in the studied countries. In conclusion, Central Europe and the Baltic countries are areas with a high risk of TBE infection. Despite the COVID-19 pandemic and imposed restrictions, the incidence of TBE is increasing in more than half of the analyzed countries.
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Abstract
In recent decades, the incidence of tick-borne encephalitis (TBE) in Sweden has increased. To calculate the burden of disease over a 17-year period, we analyzed data from the Swedish National Health Data Register for TBE cases diagnosed during 1998–2014. We compared healthcare use and sick leave associated with 2,429 persons with TBE with a referent cohort of 7,287 persons without TBE. Patients with TBE were hospitalized for significantly more days during the first year after disease onset (11.5 vs. 1.1 days), logged more specialist outpatient visits (3.6 vs. 1.2 visits), and logged more sick leave days (66 vs. 10.7 days). These differences generally increased over time. The case-fatality rate for TBE was 1.1%. Our calculated cost of TBE to society provides a baseline for decisions on immunization programs. Analyzing register data, our study adds to clinical studies of smaller cohorts and model-based studies that calculate disease burden.
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Knowledge, Attitudes, and Practices on Tick-Borne Encephalitis Virus and Tick-Borne Diseases within Professionally Tick-Exposed Persons, Health Care Workers, and General Population in Serbia: A Questionnaire-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020867. [PMID: 35055686 PMCID: PMC8775684 DOI: 10.3390/ijerph19020867] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 02/05/2023]
Abstract
This study assessed the level of knowledge, attitudes, and practices (KAP) regarding tick-borne encephalitis virus (TBEV) and tick-borne diseases (TBDs) among different groups of people in Serbia. Professionally tick-exposed persons (PTEPs), health care workers (HCWs), and the general population (GP) were subjected to an anonymous, voluntary, online questionnaire using Microsoft Forms. A total of 663 questionnaire responses were collected (February–March 2021), while 642 were included in the analysis. The significant difference in knowledge in TBDs existed between GP and PTEPs, and HCWs (p < 0.001). The perception of risk-to-tick exposure and TBDs was generally high (42.4 (95% CI: 33.6–51.2) within GP, 44.9 (95% CI: 35.8–53.9) within PTEPs and 46.2 (95% CI: 38.0–54.5) within HCWs), while fear was low (13.7 (95% CI: 7.9–19.5) within GP, 12.6 (95% CI: 7.3–19.9) within PTEPs, and 13.5 (95% CI: 7.4–19.5) within HCWs). Protective practices differed across groups (F (2639) = 12.920, p < 0.001, η2 = 0.039), with both PTEPs (t = 3.621, Cohen d = 0.332, p < 0.001) and HCWs (t = 4.644, Cohen d = 0.468, p < 0.001) adhering to more protective practices than the GP, without differences between PTEPs and HCWs (t = 1.256, Cohen d = 0.137, p = 0.421). Further education about TBDs in Serbia is required and critical points were identified in this study.
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Geeraedts F, Wertenbroek A, de Klerk J, Prick JJ, Reichman LJA, Hess D, Bosma F, Reimerink J, Skidmore B, Laverman GD. Defining a risk area for tick-borne encephalitis (TBE) in a country where TBE is emerging, the Netherlands, July 2016-October 2020. Ticks Tick Borne Dis 2022; 13:101898. [PMID: 35042080 DOI: 10.1016/j.ttbdis.2022.101898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
TBE is an emerging infectious disease in the Netherlands since July 2016, and risk areas have not been defined yet. Until October 2020 twelve autochthonous cases of TBE have been identified. In six of these cases transmission of TBE virus likely occurred in the Twente region, which therefore is the region with the highest case number and risk of contracting the disease. Here we summarize the Twente cases so far and discuss if the Twente region should be considered a risk-area using criteria of traditional TBE endemic countries, and the public health measures that may accompany such designation.
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Affiliation(s)
- Felix Geeraedts
- Laboratory for Medical Microbiology and Public Health, Hengelo, the Netherlands.
| | - Agnes Wertenbroek
- Department of Neurology, Ziekenhuis Groep Twente, Almelo/Hengelo, the Netherlands
| | - Jabke de Klerk
- Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Jan J Prick
- Department of Neurology, Ziekenhuis Groep Twente, Almelo/Hengelo, the Netherlands
| | - Loes J A Reichman
- Department of Neurology, Ziekenhuis Groep Twente, Almelo/Hengelo, the Netherlands
| | - Dorine Hess
- Laboratory for Medical Microbiology and Public Health, Hengelo, the Netherlands
| | - Froukje Bosma
- Laboratory for Medical Microbiology and Public Health, Hengelo, the Netherlands; Public Health Service, Twente, the Netherlands
| | - Johan Reimerink
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Gozewijn D Laverman
- Department of Internal Medicine, Ziekenhuis Groep Twente, Almelo/Hengelo, the Netherlands
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Izurieta-Pacheco AC, Nou-Fontanet L, Nascimento A, Martínez MJ, Velasco-Arnaiz E. Tick-borne encephalitis. Description of the first imported case in Spain in a paediatric patient. An Pediatr (Barc) 2021; 96:68-69. [PMID: 34933810 DOI: 10.1016/j.anpede.2020.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/31/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Laia Nou-Fontanet
- Servicio de Pediatría, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Andrés Nascimento
- Servicio de Neurología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Miguel J Martínez
- Servicio de Microbiología, Hospital Clínic, Barcelona, Spain; Instituto de Salud Global de Barcelona (Isglobal), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Eneritz Velasco-Arnaiz
- Unidad de Infectología, Servicio de Pediatría, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
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Napp S, Llorente F, Beck C, Jose-Cunilleras E, Soler M, Pailler-García L, Amaral R, Aguilera-Sepúlveda P, Pifarré M, Molina-López R, Obón E, Nicolás O, Lecollinet S, Jiménez-Clavero MÁ, Busquets N. Widespread Circulation of Flaviviruses in Horses and Birds in Northeastern Spain (Catalonia) between 2010 and 2019. Viruses 2021; 13:v13122404. [PMID: 34960673 PMCID: PMC8708358 DOI: 10.3390/v13122404] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022] Open
Abstract
The surveillance for West Nile virus (WNV) in Catalonia (northeastern Spain) has consistently detected flaviviruses not identified as WNV. With the aim of characterizing the flaviviruses circulating in Catalonia, serum samples from birds and horses collected between 2010 and 2019 and positive by panflavivirus competition ELISA (cELISA) were analyzed by microneutralization test (MNT) against different flaviviruses. A third of the samples tested were inconclusive by MNT, highlighting the limitations of current diagnostic techniques. Our results evidenced the widespread circulation of flaviviruses, in particular WNV, but also Usutu virus (USUV), and suggest that chicken and horses could serve as sentinels for both viruses. In several regions, WNV and USUV overlapped, but no significant geographical aggregation was observed. Bagaza virus (BAGV) was not detected in birds, while positivity to tick-borne encephalitis virus (TBEV) was sporadically detected in horses although no endemic foci were observed. So far, no human infections by WNV, USUV, or TBEV have been reported in Catalonia. However, these zoonotic flaviviruses need to be kept under surveillance, ideally within a One Health framework.
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Affiliation(s)
- Sebastian Napp
- IRTA, Animal Health Research Centre (CReSA IRTA-UAB), 08193 Bellaterra, Spain;
- Correspondence: (S.N.); (N.B.)
| | - Francisco Llorente
- Centro de Investigación en Sanidad Animal (CISA), Instituto de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), 28130 Valdeolmos, Spain; (F.L.); (P.A.-S.); (M.Á.J.-C.)
| | - Cécile Beck
- UMR 1161 Virology, ANSES, INRAE, ENVA, ANSES Animal Health Laboratory, EURL for Equine Diseases, 94704 Maisons-Alfort, France; (C.B.); (R.A.); (S.L.)
| | - Eduard Jose-Cunilleras
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
- Servei Medicina Interna Equina, Fundació Hospital Clínic Veterinari (UAB), 08193 Bellaterra, Spain
| | - Mercè Soler
- Servei de Prevenció en Salut Animal, Departament d’Acció Climàtica, Alimentació i Agenda Rural (DACC), 08007 Barcelona, Spain;
| | - Lola Pailler-García
- IRTA, Animal Health Research Centre (CReSA IRTA-UAB), 08193 Bellaterra, Spain;
| | - Rayane Amaral
- UMR 1161 Virology, ANSES, INRAE, ENVA, ANSES Animal Health Laboratory, EURL for Equine Diseases, 94704 Maisons-Alfort, France; (C.B.); (R.A.); (S.L.)
| | - Pilar Aguilera-Sepúlveda
- Centro de Investigación en Sanidad Animal (CISA), Instituto de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), 28130 Valdeolmos, Spain; (F.L.); (P.A.-S.); (M.Á.J.-C.)
| | - Maria Pifarré
- Centre de Fauna dels Aiguamolls de l’Empordà, Àrea de Gestió Ambiental Servei de Fauna i Flora, Forestal Catalana, 17486 Castelló d’Empúries, Spain;
| | - Rafael Molina-López
- Centre de Fauna de Torreferrussa, Àrea de Gestió Ambiental Servei de Fauna i Flora, Forestal Catalana, 08130 Santa Perpètua de Mogoda, Spain; (R.M.-L.); (E.O.)
| | - Elena Obón
- Centre de Fauna de Torreferrussa, Àrea de Gestió Ambiental Servei de Fauna i Flora, Forestal Catalana, 08130 Santa Perpètua de Mogoda, Spain; (R.M.-L.); (E.O.)
| | - Olga Nicolás
- Centre de Fauna de Vallcalent, Àrea de Gestió Ambiental Servei de Fauna i Flora, Forestal Catalana, 25199 Lleida, Spain;
- Parc Natural de l’Alt Pirineu, Àrea de Gestió Ambiental Servei de Fauna i Flora, Forestal Catalana, 25595 Llavorsí, Spain
| | - Sylvie Lecollinet
- UMR 1161 Virology, ANSES, INRAE, ENVA, ANSES Animal Health Laboratory, EURL for Equine Diseases, 94704 Maisons-Alfort, France; (C.B.); (R.A.); (S.L.)
| | - Miguel Ángel Jiménez-Clavero
- Centro de Investigación en Sanidad Animal (CISA), Instituto de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), 28130 Valdeolmos, Spain; (F.L.); (P.A.-S.); (M.Á.J.-C.)
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Núria Busquets
- IRTA, Animal Health Research Centre (CReSA IRTA-UAB), 08193 Bellaterra, Spain;
- Correspondence: (S.N.); (N.B.)
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Transcriptomic Studies Suggest a Coincident Role for Apoptosis and Pyroptosis but Not for Autophagic Neuronal Death in TBEV-Infected Human Neuronal/Glial Cells. Viruses 2021; 13:v13112255. [PMID: 34835061 PMCID: PMC8620470 DOI: 10.3390/v13112255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022] Open
Abstract
Tick-borne encephalitis virus (TBEV), a member of the Flaviviridae family, Flavivirus genus, is responsible for neurological symptoms that may cause permanent disability or death. With an incidence on the rise, it is the major arbovirus affecting humans in Central/Northern Europe and North-Eastern Asia. Neuronal death is a critical feature of TBEV infection, yet little is known about the type of death and the molecular mechanisms involved. In this study, we used a recently established pathological model of TBEV infection based on human neuronal/glial cells differentiated from fetal neural progenitors and transcriptomic approaches to tackle this question. We confirmed the occurrence of apoptotic death in these cultures and further showed that genes involved in pyroptotic death were up-regulated, suggesting that this type of death also occurs in TBEV-infected human brain cells. On the contrary, no up-regulation of major autophagic genes was found. Furthermore, we demonstrated an up-regulation of a cluster of genes belonging to the extrinsic apoptotic pathway and revealed the cellular types expressing them. Our results suggest that neuronal death occurs by multiple mechanisms in TBEV-infected human neuronal/glial cells, thus providing a first insight into the molecular pathways that may be involved in neuronal death when the human brain is infected by TBEV.
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