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Mathews-Martin L, Gonzalez G, Dheilly NM, Amaral-Moraes R, Dumarest M, Helle T, Migne C, Caillot C, Lacour SA, Pérelle S, Beck C, Metras R, Bournez L. Exposure of cattle to tick-borne encephalitis virus in the historical endemic zone in north-eastern France. BMC Vet Res 2024; 20:228. [PMID: 38796429 PMCID: PMC11127440 DOI: 10.1186/s12917-024-04079-8] [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: 10/24/2023] [Accepted: 05/13/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Tick-borne encephalitis (TBE) is a severe human neuroinfection caused by TBE virus (TBEV). TBEV is transmitted by tick bites and by the consumption of unpasteurized dairy products from infected asymptomatic ruminants. In France, several food-borne transmission events have been reported since 2020, raising the question of the level of exposure of domestic ungulates to TBEV. In this study, our objectives were (i) to estimate TBEV seroprevalence and quantify antibodies titres in cattle in the historical endemic area of TBEV in France using the micro virus neutralisation test (MNT) and (ii) to compare the performance of two veterinary cELISA kits with MNT for detecting anti-TBEV antibodies in cattle in various epidemiological contexts. A total of 344 cattle sera from four grid cells of 100 km² in Alsace-Lorraine (endemic region) and 84 from western France, assumed to be TBEV-free, were investigated. RESULTS In Alsace-Lorraine, cattle were exposed to the virus with an overall estimated seroprevalence of 57.6% (95% CI: 52.1-62.8%, n = 344), varying locally from 29.9% (95% CI: 21.0-40.0%) to 92.1% (95% CI: 84.5-96.8%). Seroprevalence did not increase with age, with one- to three-year-old cattle being as highly exposed as older ones, suggesting a short-life duration of antibodies. The proportion of sera with MNT titres lower than 1:40 per grid cell decreased with increased seroprevalence. Both cELISA kits showed high specificity (> 90%) and low sensitivity (less than 78.1%) compared with MNT. Sensitivity was lower for sera with neutralising antibodies titres below 1:40, suggesting that sensitivity of these tests varied with local virus circulation intensity. CONCLUSIONS Our results highlight that cattle were highly exposed to TBEV. Screening strategy and serological tests should be carefully chosen according to the purpose of the serological study and with regard to the limitations of each method.
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Affiliation(s)
- Laure Mathews-Martin
- ANSES, Nancy Laboratory for Rabies and Widlife, Malzéville, F-54220, France.
- VetAgro Sup, ENSV-FVI, Marcy-L'Étoile, F-69280, France.
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France.
- ANSES, Laboratory for Food Safety, UVE, Maisons-Alfort, F-94700, France.
| | - Gaëlle Gonzalez
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Nolwenn M Dheilly
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Rayane Amaral-Moraes
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Marine Dumarest
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Teheipuaura Helle
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Camille Migne
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Christophe Caillot
- ANSES, Nancy Laboratory for Rabies and Widlife, Malzéville, F-54220, France
| | - Sandrine A Lacour
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Sylvie Pérelle
- ANSES, Laboratory for Food Safety, UVE, Maisons-Alfort, F-94700, France
| | - Cécile Beck
- ANSES, INRAE, ENVA, UMR Virology, ANSES Animal Health Laboratory, Maisons-Alfort, F-94700, France
| | - Raphaëlle Metras
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health (IPLESP, UMRS, 1136), Paris, F-75012, France
| | - Laure Bournez
- ANSES, Nancy Laboratory for Rabies and Widlife, Malzéville, F-54220, France.
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Ruzek D, Kaucka K. A brief tale of two pioneering moments: Europe's first discovery of Tick-Borne Encephalitis (TBE) virus beyond the Soviet Union and the largest alimentary TBE outbreak in history. Ticks Tick Borne Dis 2024; 15:102314. [PMID: 38290295 DOI: 10.1016/j.ttbdis.2024.102314] [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: 12/02/2023] [Revised: 01/05/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
The emergence of tick-borne encephalitis (TBE) in Europe marked several significant milestones. The discovery of TBE in Czechoslovakia in 1948, with Gallia and Krejčí simultaneously isolating the TBE virus (TBEV) from human samples for the first time in Europe outside the Soviet Union, was pivotal. Subsequent TBEV isolation from ticks suggested the viral transmission via this vector. In 1951, the outbreak in Rožňava in Slovakia (Czechoslovakia) revealed an unexpected mode of transmission, unpasteurized milk from a local dairy, challenging existing understanding. Investigations exposed illicit practices of mixing cow's milk with goat's milk for economic gains. Laboratory research confirmed the outbreak was caused by TBEV, which was substantiated by serological analyses. This was the first and largest documented alimentary TBE outbreak in history. In this review, we delve into both published sources and unpublished archival data, offering a comprehensive understanding of these historic accomplishments and shedding light on these pivotal moments.
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Affiliation(s)
- Daniel Ruzek
- Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic; Laboratory of Emerging Viral Diseases, Veterinary Research Institute, Brno, Czech Republic.
| | - Kristyna Kaucka
- Masaryk Institute and Archives of the Czech Academy of Sciences, Prague, Czech Republic
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Chakraborty S, Kopsco H, Evans C, Mateus-Pinilla N, Smith R. Assessing knowledge gaps and empowering Extension workers in Illinois with information on ticks and tickborne diseases through KAP surveys. Heliyon 2024; 10:e25789. [PMID: 38352775 PMCID: PMC10862665 DOI: 10.1016/j.heliyon.2024.e25789] [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: 10/19/2023] [Revised: 01/19/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Tickborne diseases (TBDs) are increasingly prevalent in Illinois and the Upper Midwest region. People who work in occupations that require time outdoors in agricultural or natural settings, such as some Extension workers, are at risk of tick bites and TBDs. Additionally, Extension workers are often a primary source of information about ticks and TBDs in rural communities. However, there is limited information on the level of awareness about ticks and TBDs in the Extension community. The goals of this study were to sequentially i) determine the baseline awareness of Extension workers in Illinois about ticks and TBDs using a knowledge, attitudes, and practices (KAP) survey tool, ii) provide comprehensive training on ticks and TBDs to this demographic, and iii) measure the uptake of knowledge after the training intervention through a post-training survey. The study period was from June 2022 until May 2023. We received 233 pre-training and 93 paired post-training survey responses. Most survey respondents were Extension volunteers, identified as women, and were over 50 years old. Knowledge about ticks and TBDs varied. We identified several gaps in their current tick awareness, most importantly, in tick prevention measures, tick identification, and TBDs in general. TBD knowledge, attitude, and practice scores all significantly improved after training (p < 0.001), with a mean difference of 10.47, 1.49, and 2.64 points, respectively. Additionally, both Extension professionals (79.2 %) and Extension volunteers (66.7 %) were more likely to feel confident in engaging with their stakeholders on ticks and TBDs after participating in training. Poisson models revealed that higher attitude and practice scores and greater self-reported knowledge were the factors most significantly associated with higher TBD knowledge. We found that greater concern for ticks and TBD (attitudes) and adherence to science-based prevention and management methods (practices) were also associated with higher knowledge scores. To our knowledge, this is the first study in Illinois to capture Extension workers' awareness of ticks and TBDs. The results highlight Extension workers' interest in filling knowledge gaps through learning, and the importance of training Extension workers to disseminate reliable and updated information on ticks and TBDs to their constituents, a critical step in preventing TBDs.
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Affiliation(s)
- S. Chakraborty
- Program in Ecology, Evolution & Conservation Biology, University of Illinois, Urbana Champaign, 505 S Goodwin Avenue, Urbana, IL, 61801, USA
| | - H. Kopsco
- Department of Ecology, Evolution and Environmental Biology, Columbia University, 10th floor Schermerhorn Ext., 1200 Amsterdam Ave, New York, NY, 10027, USA
- Prairie Research Institute, Illinois Natural History Survey, University of Illinois, Urbana Champaign, 1816 S Oak, Champaign, IL, 61820, USA
| | - C. Evans
- Department of Natural Resources and Environmental Sciences, University of Illinois, Urbana Champaign, 354 State Highway 145 N, Simpson, IL, 62985, USA
| | - N. Mateus-Pinilla
- Department of Natural Resources and Environmental Sciences, University of Illinois, Urbana Champaign, 354 State Highway 145 N, Simpson, IL, 62985, USA
- Prairie Research Institute, Illinois Natural History Survey, University of Illinois, Urbana Champaign, 1816 S Oak, Champaign, IL, 61820, USA
| | - R.L. Smith
- Department of Pathobiology, University of Illinois, Urbana Champaign, 2001 S Lincoln Ave, Urbana, IL, 61802, USA
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Park SM, Choi C, Rhee MS. One Health approach for prioritization of potential foodborne pathogens: Risk-ranking, Delphi survey, and criteria evaluation pre- and post-COVID-19 pandemic. Compr Rev Food Sci Food Saf 2024; 23:e13258. [PMID: 38284613 DOI: 10.1111/1541-4337.13258] [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: 06/01/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 01/30/2024]
Abstract
Frequent foodborne illnesses with unknown causative agents highlight the need to explore zoonotic potential foodborne pathogens (PFPs). An effective PFP prioritization tool is indispensable, especially after experiencing the recent pandemic caused by zoonotic SARS-CoV-2. Risk information on pathogens (excluding 30 known foodborne pathogens) provided by governmental and international organizations was reviewed to generate a list of PFPs. Risk-ranking of PFPs was conducted based on a literature review of food poisoning or detection cases, and the ranks were determined with a decision tree. PFPs were prioritized by infectious disease (ID), veterinary medicine (VET), and food safety (FS) experts through a pre- and postpandemic Delphi survey, and key criteria in their decisions were illuminated. Among 339 PFPs, 32 rank-1 PFPs were involved in the foodborne outbreak(s). Discrepancies in opinions on prioritization between experts in different fields deepened after the pandemic. Only VET and FS experts valued the plausibility of foodborne transmission in evaluating bacteria and viruses, and a significant correlation between their selection of PFPs was found (p < .05). The impact of the pandemic induced all fields to focus more on human transmission and severity/fatality in prioritizing viruses, and only FS experts emphasized the plausibility of foodborne transmission after the pandemic. In contrast to prioritizing bacteria or viruses, ID and VET experts are unusually focused on foodborne transmission when prioritizing parasites. Criteria of consensus deduced by interdisciplinary experts with different interests and the criteria directly related to foodborne transmission should be acknowledged for adequate PFP prioritization.
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Affiliation(s)
- Sun Min Park
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea
| | - Changsun Choi
- Department of Food and Nutrition, College of Biotechnology and Natural Resources, Chung-Ang University, Anseong-si, Gyeonggi, Republic of Korea
| | - Min Suk Rhee
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea
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Satapathy P, Kumar P, Chand K, Gahtori P, Rustagi S, Sah R, Neyazi A. The rising tide of tick-borne encephalitis across European nations. QJM 2023; 116:973-975. [PMID: 37792484 DOI: 10.1093/qjmed/hcad226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Indexed: 10/06/2023] Open
Affiliation(s)
- P Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - P Kumar
- Global Center for Evidence Synthesis, Chandigarh 160036, India
- EvidenceSynthesis Lab, Kolkata 700156, India
| | - K Chand
- Global Center for Evidence Synthesis, Chandigarh 160036, India
- EvidenceSynthesis Lab, Kolkata 700156, India
| | - P Gahtori
- School of Pharmacy, Graphic Era Hill University, Dehradun 24800, India
| | - S Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - R Sah
- Tribhuvan University Teaching Hospital, Kathmandu 46000, Nepal
- Department of Clinical Microbiology, DY Patil Medical College, Hospital and Research Centre, DY Patil Vidyapeeth, Pune, Maharashtra 411000, India
| | - A Neyazi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan
- Herat Regional Hospital, Herat, Afghanistan
- ACES Chapter, Medical Faculty, Ghalib University
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Banović P, Mijatović D, Bogdan I, Simin V, Meletis E, Kostoulas P, Resman Rus K, Knap N, Korva M, Avšič-Županc T, Cabezas-Cruz A. Evidence of tick-borne encephalitis virus neutralizing antibodies in Serbian individuals exposed to tick bites. Front Microbiol 2023; 14:1314538. [PMID: 38156013 PMCID: PMC10754514 DOI: 10.3389/fmicb.2023.1314538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/14/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Tick-borne encephalitis (TBE) is an emerging vector-borne and food-borne disease caused by the tick-borne encephalitis virus (TBEV; Orthoflavivirus encephalitidis), with a distribution spanning the Eurasian continent. Despite its significant public health impact in various European regions, TBE remains largely underdiagnosed in Serbia due to limited awareness and diagnostic challenges. In response to this, our study aimed to comprehensively assess TBEV exposure in individuals infested with ticks and to identify potential TBEV foci within Serbia. Materials and methods From 2019 to 2021, we conducted an observational study involving 450 patients who reported tick infestations. Results Our demographic analysis revealed a median age of 38 years, with a slight male predominance among the participants. We documented tick infestations in 38 municipalities across 14 districts of Serbia, with a notable concentration in proximity to Fruška Gora Mountain. The ticks most frequently removed were Ixodes ricinus, with nymphs and adult females being the predominant stages. On average, nymphs were removed after about 27.1 hours of feeding, while adult females remained attached for approximately 44.4 hours. Notably, we found age as a significant predictor of infestation time for both nymphs and adult females. Furthermore, we detected TBEV-neutralizing antibodies in 0.66% of the serum samples, shedding light on potential TBEV foci, particularly in Fruška Gora Mountain and other regions of Serbia. Conclusion Our study emphasizes the urgent need for active TBE surveillance programs, especially in areas suspected of hosting TBEV foci, in order to assess the true TBE burden, identify at-risk populations, and implement effective preventive measures.
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Affiliation(s)
- Pavle Banović
- Clinic for Lyme Borreliosis and Other Tick-Borne Diseases, Pasteur Institute Novi Sad, Novi Sad, Serbia
- Department of Microbiology with Parasitology and Immunology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia
| | - Dragana Mijatović
- Department for Research and Monitoring of Rabies and Other Zoonoses, Pasteur Institute Novi Sad, Novi Sad, Serbia
| | - Ivana Bogdan
- Department of Microbiology, Pasteur Institute Novi Sad, Novi Sad, Serbia
| | - Verica Simin
- Department of Microbiology, Pasteur Institute Novi Sad, Novi Sad, Serbia
| | - Eleftherios Meletis
- Faculty of Public and One Health, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - Polychronis Kostoulas
- Faculty of Public and One Health, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alejandro Cabezas-Cruz
- Anses, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort, France
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Angulo FJ, Zhang P, Halsby K, Kelly P, Pilz A, Madhava H, Moïsi JC, Jodar L. A systematic literature review of the effectiveness of tick-borne encephalitis vaccines in Europe. Vaccine 2023; 41:6914-6921. [PMID: 37858450 DOI: 10.1016/j.vaccine.2023.10.014] [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: 09/07/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Tick-borne encephalitis (TBE) is an infectious disease caused by the tick-borne encephalitis virus (TBEV) in patients with symptoms of central nervous system (CNS) inflammation. More than 25 European countries have one or more TBE-endemic areas. Although two TBE vaccines, FSME-IMMUN® and Encepur®, are commonly used in Europe, there are no published reviews of the real-world effectiveness of TBE vaccines in Europe or elsewhere. METHODS We searched PubMed for TBE vaccine effectiveness (VE) articles and extracted information on country, study design, study period, study population, number of TBEV-infected cases, number of participants, and VE against TBEV infection and outcomes. RESULTS We identified 13 studies, conducted in Austria, the Czech Republic, Latvia, Germany, and Switzerland, published in 2003-2023. One study was a cohort investigation of a milk-borne outbreak. In the other studies, 11 (91.7%) used the screening method and two (16.7%) used a case-control design (one study used both). TBE vaccines were highly effective (VE estimates >92%) against TBEV infection in all age groups. Vaccines were also highly protective against mild infections (i.e., infections in patients without symptoms of CNS inflammation), and against infections resulting in TBE and hospitalization. Vaccines were also highly protective against the most serious outcomes such as hospitalization greater than 12 days. Product-specific VE estimates were also high, though limited data were available. Studies in Austria, the Czech Republic, Latvia, and Switzerland estimated that TBE vaccines prevented >1,000 TBE cases a year, avoiding many hospitalizations and deaths, in these countries combined. CONCLUSIONS Published VE studies demonstrate a high real-world effectiveness of the commercially available TBE vaccines in Europe. Although cases averted have been estimated in only four countries, TBE vaccination prevents thousands of cases in Europe each year. To prevent life-threatening TBE, TBE vaccine uptake and compliance with the vaccination schedule should be increased in residents of, and travelers to, TBE-endemic countries in Europe.
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Affiliation(s)
- Frederick J Angulo
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Collegeville, PA, United States.
| | - Pingping Zhang
- Medical Affairs Evidence Generation Statistics, Pfizer Research and Development, Collegeville, PA, United States.
| | - Kate Halsby
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, London, England.
| | - Patrick Kelly
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Collegeville, PA, United States.
| | - Andreas Pilz
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Vienna, Austria.
| | - Harish Madhava
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, London, England.
| | - Jennifer C Moïsi
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Paris, France.
| | - Luis Jodar
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Collegeville, PA, United States.
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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: 0] [Impact Index Per Article: 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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Worku DA. Tick-Borne Encephalitis (TBE): From Tick to Pathology. J Clin Med 2023; 12:6859. [PMID: 37959323 PMCID: PMC10650904 DOI: 10.3390/jcm12216859] [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: 09/07/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Tick-borne encephalitis (TBE) is a viral arthropod infection, endemic to large parts of Europe and Asia, and is characterised by neurological involvement, which can range from mild to severe, and in 33-60% of cases, it leads to a post-encephalitis syndrome and long-term morbidity. While TBE virus, now identified as Orthoflavivirus encephalitidis, was originally isolated in 1937, the pathogenesis of TBE is not fully appreciated with the mode of transmission (blood, tick, alimentary), viral strain, host immune response, and age, likely helping to shape the disease phenotype that we explore in this review. Importantly, the incidence of TBE is increasing, and due to global warming, its epidemiology is evolving, with new foci of transmission reported across Europe and in the UK. As such, a better understanding of the symptomatology, diagnostics, treatment, and prevention of TBE is required to inform healthcare professionals going forward, which this review addresses in detail. To this end, the need for robust national surveillance data and randomised control trial data regarding the use of various antivirals (e.g., Galidesivir and 7-deaza-2'-CMA), monoclonal antibodies, and glucocorticoids is required to improve the management and outcomes of TBE.
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Affiliation(s)
- Dominic Adam Worku
- Infectious Diseases, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, UK;
- Public Health Wales, 2 Capital Quarter, Cardiff CF10 4BZ, UK
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Hills SL, Wong JM, Staples JE. Arboviral vaccines for use in pregnant travelers. Travel Med Infect Dis 2023; 55:102624. [PMID: 37517630 DOI: 10.1016/j.tmaid.2023.102624] [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: 05/12/2023] [Revised: 06/20/2023] [Accepted: 07/26/2023] [Indexed: 08/01/2023]
Abstract
Pregnant women traveling abroad can be exposed to a variety of arboviruses, primarily spread by mosquitoes or ticks. Some arboviral infections can be of particular concern for pregnant women or their fetuses. Vaccination is one preventive measure that can reduce the risk for infection. Several arboviral vaccines have been licensed for many years and can be used to prevent infection in travelers, namely Japanese encephalitis, yellow fever, and tick-borne encephalitis vaccines. Recommendations on use of these vaccines in pregnancy vary. Other arboviral vaccines have been licensed but are not indicated for use in pregnant travelers (e.g., dengue vaccines) or are in development (e.g., chikungunya, Zika vaccines). This review describes arboviral vaccines for travelers, focusing on women who are pregnant and those planning travel during pregnancy.
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Affiliation(s)
- S L Hills
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA.
| | - J M Wong
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - J E Staples
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
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Pustijanac E, Buršić M, Talapko J, Škrlec I, Meštrović T, Lišnjić D. Tick-Borne Encephalitis Virus: A Comprehensive Review of Transmission, Pathogenesis, Epidemiology, Clinical Manifestations, Diagnosis, and Prevention. Microorganisms 2023; 11:1634. [PMID: 37512806 PMCID: PMC10383662 DOI: 10.3390/microorganisms11071634] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Tick-borne encephalitis virus (TBEV), a member of the Flaviviridae family, can cause serious infection of the central nervous system in humans, resulting in potential neurological complications and fatal outcomes. TBEV is primarily transmitted to humans through infected tick bites, and the viral agent circulates between ticks and animals, such as deer and small mammals. The occurrence of the infection aligns with the seasonal activity of ticks. As no specific antiviral therapy exists for TBEV infection, treatment approaches primarily focus on symptomatic relief and support. Active immunization is highly effective, especially for individuals in endemic areas. The burden of TBEV infections is increasing, posing a growing health concern. Reported incidence rates rose from 0.4 to 0.9 cases per 100,000 people between 2015 and 2020. The Baltic and Central European countries have the highest incidence, but TBE is endemic across a wide geographic area. Various factors, including social and environmental aspects, improved medical awareness, and advanced diagnostics, have contributed to the observed increase. Diagnosing TBEV infection can be challenging due to the non-specific nature of the initial symptoms and potential co-infections. Accurate diagnosis is crucial for appropriate management, prevention of complications, and effective control measures. In this comprehensive review, we summarize the molecular structure of TBEV, its transmission and circulation in natural environments, the pathogenesis of TBEV infection, the epidemiology and global distribution of the virus, associated risk factors, clinical manifestations, and diagnostic approaches. By improving understanding of these aspects, we aim to enhance knowledge and promote strategies for timely and accurate diagnosis, appropriate management, and the implementation of effective control measures against TBEV infections.
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Affiliation(s)
- Emina Pustijanac
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, 52100 Pula, Croatia
| | - Moira Buršić
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, 52100 Pula, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Tomislav Meštrović
- University Centre Varaždin, University North, 42000 Varaždin, Croatia
- Institute for Health Metrics and Evaluation and the Department of Health Metrics Sciences, University of Washington, Seattle, WA 98195, USA
| | - Dubravka Lišnjić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
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12
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Saegerman C, Humblet MF, Leandri M, Gonzalez G, Heyman P, Sprong H, L’Hostis M, Moutailler S, Bonnet SI, Haddad N, Boulanger N, Leib SL, Hoch T, Thiry E, Bournez L, Kerlik J, Velay A, Jore S, Jourdain E, Gilot-Fromont E, Brugger K, Geller J, Studahl M, Knap N, Avšič-Županc T, Růžek D, Zomer TP, Bødker R, Berger TFH, Martin-Latil S, De Regge N, Raffetin A, Lacour SA, Klein M, Lernout T, Quillery E, Hubálek Z, Ruiz-Fons F, Estrada-Peña A, Fravalo P, Kooh P, Etore F, Gossner CM, Purse B. First Expert Elicitation of Knowledge on Possible Drivers of Observed Increasing Human Cases of Tick-Borne Encephalitis in Europe. Viruses 2023; 15:v15030791. [PMID: 36992499 PMCID: PMC10054665 DOI: 10.3390/v15030791] [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] [Received: 02/04/2023] [Revised: 03/11/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Tick-borne encephalitis (TBE) is a viral disease endemic in Eurasia. The virus is mainly transmitted to humans via ticks and occasionally via the consumption of unpasteurized milk products. The European Centre for Disease Prevention and Control reported an increase in TBE incidence over the past years in Europe as well as the emergence of the disease in new areas. To better understand this phenomenon, we investigated the drivers of TBE emergence and increase in incidence in humans through an expert knowledge elicitation. We listed 59 possible drivers grouped in eight domains and elicited forty European experts to: (i) allocate a score per driver, (ii) weight this score within each domain, and (iii) weight the different domains and attribute an uncertainty level per domain. An overall weighted score per driver was calculated, and drivers with comparable scores were grouped into three terminal nodes using a regression tree analysis. The drivers with the highest scores were: (i) changes in human behavior/activities; (ii) changes in eating habits or consumer demand; (iii) changes in the landscape; (iv) influence of humidity on the survival and transmission of the pathogen; (v) difficulty to control reservoir(s) and/or vector(s); (vi) influence of temperature on virus survival and transmission; (vii) number of wildlife compartments/groups acting as reservoirs or amplifying hosts; (viii) increase of autochthonous wild mammals; and (ix) number of tick species vectors and their distribution. Our results support researchers in prioritizing studies targeting the most relevant drivers of emergence and increasing TBE incidence.
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Affiliation(s)
- Claude Saegerman
- Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, 4000 Liege, Belgium
- Correspondence:
| | - Marie-France Humblet
- Department for Occupational Protection and Hygiene, Unit Biosafety, Biosecurity and Environmental Licences, University of Liege, 4000 Liege, Belgium
| | - Marc Leandri
- UMI SOURCE, Université Paris-Saclay—UVSQ, 78000 Versailles, France
| | - Gaëlle Gonzalez
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | | | - Hein Sprong
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 MA Bilthoven, The Netherlands
| | - Monique L’Hostis
- Ecole Nationale Vétérinaire Agroalimentaire et de l’Alimentation Nantes-Atlantique, Oniris, 44307 Nantes, France
| | - Sara Moutailler
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Sarah I. Bonnet
- UMR 2000 Institut Pasteur-CNRS-Université Paris-Cité, Ecology and Emergence of Arthropod-borne Pathogens, 75015 Paris, France
- Animal Health Department, INRAE, 37380 Nouzilly, France
| | - Nadia Haddad
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Nathalie Boulanger
- UR7290: VBP: Borrelia Group, France and French Reference Centre on Lyme Borreliosis, CHRU, Unversity of Strasbourg, 67000 Strasbourg, France
| | - Stephen L. Leib
- Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
| | | | - Etienne Thiry
- Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, 4000 Liege, Belgium
| | - Laure Bournez
- ANSES, Nancy Laboratory for Rabies and Wildlife, 54220 Malzéville, France
| | - Jana Kerlik
- Department of Epidemiology, Regional Authority of Public Health in Banská Bystrica, 497556 Banská Bystrica, Slovakia
| | - Aurélie Velay
- Unité Mixte de Recherché Immunorhumathologie Moléculaire (UMR IRM_S) 1109, Université de Strasbourg, INSERM, 67000 Strasbourg, France
| | - Solveig Jore
- Zoonotic, Water and Foodborne Infections, The Norwegian Institute for Public Health (NIPH), 0213 Oslo, Norway
| | - Elsa Jourdain
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, Route de Theix, 63122 Saint-Genès-Champanelle, France
| | | | - Katharina Brugger
- Competence Center Climate and Health, Austrian National Institute of Public Health, 1010 Vienna, Austria
| | - Julia Geller
- Department of Virology and Immunology, National Institute for Health Development, 11619 Tallinn, Estonia
| | - Marie Studahl
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, 41685 Gothenburg, Sweden
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, 1000 Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, 1000 Ljubljana, Slovenia
| | - Daniel Růžek
- Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, 37005 Ceske Budejovice, Czech Republic
- Department of Experimental Biology, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, 62100 Brno, Czech Republic
| | - Tizza P. Zomer
- Lyme Center Apeldoorn, Gelre Hospital, 7300 DS Apeldoorn, The Netherlands
| | - René Bødker
- Animal Welfare and Disease Control, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg, Denmark
| | - Thomas F. H. Berger
- Agroscope, Risk Evaluation and Risk Mitigation, Schwarzenburgstrasse, 3003 Bern-Liebefeld, Switzerland
| | - Sandra Martin-Latil
- Laboratory for Food Safety, ANSES, University of Paris-EST, 94700 Maisons-Alfort, France
| | - Nick De Regge
- Operational Direction Infectious Diseases in Animals, Unit of Exotic and Vector-borne Diseases, Sciensano, 1180 Brussels, Belgium
| | - Alice Raffetin
- Reference Centre for Tick-Borne Diseases, Paris and Northern Region, Department of Infectious Diseases, General Hospital of Villeneuve-Saint-Georges, 94100 Villeneuve-Saint-Georges, France
| | - Sandrine A. Lacour
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Matthias Klein
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, LMU München, Marchioninistraße 15, 81377 München, Germany
| | - Tinne Lernout
- Scientific Directorate of Epidemiology and Public Health, Sciensano, 1180 Brussels, Belgium
| | - Elsa Quillery
- ANSES, Risk Assessment Department, 94700 Maisons-Alfort, France
| | - Zdeněk Hubálek
- Institute of Vertebrate Biology, Czech Academy of Sciences, Květná 8, 60365 Brno, Czech Republic
| | - Francisco Ruiz-Fons
- Health & Biotechnology (SaBio) Group, Instituto de Investigación en Recursos Cinegéticos (IREC), CSIC-UCLM-JCCM, 13071 Ciudad Real, Spain
| | - Agustín Estrada-Peña
- Deptartment of Animal Health, Faculty of Veterinary Medicine, 50013 Zaragoza, Spain
| | - Philippe Fravalo
- Pôle Agroalimentaire, Conservatoire National des Arts et Métiers (Cnam), 75003 Paris, France
| | - Pauline Kooh
- ANSES, Risk Assessment Department, 94700 Maisons-Alfort, France
| | - Florence Etore
- ANSES, Risk Assessment Department, 94700 Maisons-Alfort, France
| | - Céline M. Gossner
- European Centre for Disease Prevention and Control (ECDC), 17183 Solna, Sweden
| | - Bethan Purse
- UK Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Oxfordshire OX10 8BB, UK
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13
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[Viruses present in the environment: virological considerations and examples of their impact on human health]. REVUE FRANCOPHONE DES LABORATOIRES : RFL 2023; 2023:33-43. [PMID: 36879984 PMCID: PMC9978926 DOI: 10.1016/s1773-035x(23)00053-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Animal viruses are present in most human environments. Their viability in these media is very variable and the most important element that conditions this viability is the existence or not of a phospholipid envelope surrounding the nucleocapsid. After some general considerations on the structure of viruses, their multiplication cycle and their resistance to different physico-chemical agents, some examples of the impact of animal viruses present in the environment on human health will be presented. The situations that are related concern recent epidemiological events: circulation of type 2 polioviruses derived from the Sabin vaccine strain in the wastewater of New York, London and Jerusalem; risk of transmission of Sars-CoV-2 during the spreading of sludge from wastewater treatment plants on agricultural land in the era of the Covid-19 pandemic; « new » forms of food-borne poisoning of viral origin (hepatitis E, tick-borne encephalitis, Nipah virus infection); contamination by epidemic viruses of mobile phones used by pediatricians; role of fomites in the spread of orthopoxvirus infections (smallpox, cowpox, monkeypox). The risk attached to animal viruses present in the environment must be assessed in a measured way without overestimating or underestimating their potential consequences for human health.
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Markova KV, Skripchenko EY, Skripchenko NV, Marchenko NV, Shevchenko EY, Ivanova GP, Vishnevetskaya EM. [Difficulties in diagnosing the chronic course of tick-borne encephalitis in children]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:118-122. [PMID: 37966450 DOI: 10.17116/jnevro2023123101118] [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] [Indexed: 11/16/2023]
Abstract
Infections transmitted by ixodic ticks in childhood account for about 20%, and tick-borne encephalitis accounts for up to 25% of cases. A feature of the course of tick-borne encephalitis is unpredictability and the possibility of chronization in 1-3% of cases with late diagnosis and inadequate therapy. The article presents a clinical observation of the disease in a child whose chronically progressive course of amyotrophic form was diagnosed 1 year and 8 months after the onset of the disease. The presence of anamnestic data, features of clinical manifestations in the dynamics and typical neurovirualization picture of the disease, even with negative results of serological and molecular genetic studies of blood and cerebrospinal fluid, allowed to make a diagnosis, prescribe etio-pathogenetic therapy and thereby stabilize the patient's condition. The use of complex drugs in the treatment, such as Cytoflavin, allows to optimize the course of the disease.
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Affiliation(s)
- K V Markova
- Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency, St. Petersburg, Russia
| | - E Yu Skripchenko
- Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency, St. Petersburg, Russia
- Saint-Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - N V Skripchenko
- Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency, St. Petersburg, Russia
- Saint-Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - N V Marchenko
- Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency, St. Petersburg, Russia
| | - E Yu Shevchenko
- Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency, St. Petersburg, Russia
| | - G P Ivanova
- Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency, St. Petersburg, Russia
| | - E M Vishnevetskaya
- Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical Biological Agency, St. Petersburg, Russia
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