TBE in Ukraine
Iryna Kolesnikova, Khrysthyna Hrynkevych
E-CDC risk status: endemic
(last edited on 16.03.2024, data as of end December 2023)
History and current situation
The Ukrainian Scientific and Methodological Center for Tick-borne Viral Encephalitis and Natural Focal Diseases of Arboviral Etiology founded in the year 2005 was established in the Laboratory of Vector-borne Viral Infections of the Lviv Research Institute of Epidemiology and Hygiene. Prevention of TBE is based on the Guidelines “Nonspecific prevention of vector-borne natural focal infections transmitted by ixodid ticks” (Table 1).5
The presence of active natural foci of TBE infection in the Ukraine was determined by regions, where single cases or outbreaks of human diseases were registered (Figure 2). The main vector of TBE virus in the Ukraine is the European forest tick I. ricinus, from which 68.4% of domestic strains were isolated. TBE virus has also been isolated from D. reticulatus and H. plumbeum (plumbeum) ticks. Potential vectors of TBE virus in Ukraine include I. crenulatus, I. hexagonus, I. lividus, I. trianguliceps, D.marginatus. (https://ecdc.europa.eu/en/disease-vectors/surveillance-and-disease-data/tick-maps)
In the Ukraine, vaccination against TBE is recommended for individuals visiting endemic areas during the period of highest tick activity (April to November) (Table 1). It is recommended to start vaccination in the fall (September – November), when there is enough time to develop vaccine-protection before potential exposures to the TBEV.
Between 1955 and 2013, a total of 596 cases of TBE (all encephalitis) were registered in the Ukraine (population about 41 million), including 74 (12.5%) imported cases and 522 (87.5%) local cases. The highest number of the 522 autochthonous cases was reported from Crimea (265 cases; 50.7%), followed by Volyn (196 cases; 37.5%), Zakarpattia (24 cases, 4.6%), Dnipro and Ivano-Frankivsk (8 cases each (1.5%), Lviv (4 cases, 0.76%), Vinnytsia, Donetsk, Kharkiv (3 cases, 0,75% each), Mykolaiv and Khmelnytsky (2 cases each, 0,3%) and from Kyiv, Sevastopol, Odesa, and Sumy (1 case each, 0.19%).3
From 2011 to 2019 only 2 cases of TBE-encephalitis were detected, 1 in the Kharkiv region and another in the Chernihiv region.4
According to the Public Health Centre of the Ministry of Health of Ukraine,5 2 cases of viral encephalitis were recorded in Ukraine in 2020.
Overview of TBE in Ukraine
| Table 1: TBE in Ukraine | |
|---|---|
| Viral subtypes isolated | All 3 major TBEV subtypes are circulating in the Ukraine.7 |
| Reservoir animals | Cows, buffaloes and goats4 |
| Infected tick species (%) | Unknown |
| Dairy product transmission | Raw milk and milk products from cows and goats4 |
| Case definition used by authorities | Clinical criteria Any person with symptoms of CNS inflammation (e.g. meningitis, meningoencephalitis, encephalomyelitis, encephalo-radiculitis). Laboratory criteria Serologic results should be interpreted according to vaccination and previous exposure to other flavivirus infections. Confirmed cases in such situations should be confirmed by neutralization reaction or other equivalent tests.2 |
| Type of reporting | Mandatory |
| Other TBE-surveillance | Tick infection with various pathogens is monitored by the regional Centers for Disease Control and Prevention. Regional Centers for Disease Control and Prevention annually conduct a study of tick populations – to identify species found in a given territory.6 |
| Special clinical features | Risk groups: military, foresters, tourists, fishermen, shepherds1 |
| Licensed vaccines | TicoVac vaccine (0.5 ml) is indicated for active (prophylactic) immunization of persons aged 16 years and older against TBE. The TicoVac Junior vaccine (0.25 ml) is indicated for active (prophylactic) immunization of children aged 1 to 15 years5 |
| Vaccination recommendations | Vaccination is indicated in TBEV-endemic areas: Crimea (Simferopol, Sudatsky, Biloghirsky, Bakhchysaray, Alushty, Kirovsky, Krasnogvardiysky districts; Great Yalta, Laspi Bay of the Sevastopol district), Volhynia (Ratnivskyi, Rozhishchenskyi, Kovelskyi, Kivertsivskyi, Starovyzhivskyi, Kamin-Kashirskyi districts, Lutsk city, Kovel city), Lviv (Yavorivskyi district), Odessa (Balta city) oblasts.3 |
| Vaccine uptake | Vaccination is not mandatory |
| National Reference center for TBE | Ukrainian Scientific and Methodological Center for Tick-borne Viral Encephalitis and Natural Focal Diseases of Arboviral Etiology located at the Laboratory of Vector-borne Viral Infections of the Lviv Research Institute of Epidemiology and Hygiene.5 |
| Additional relevant information | The full course with 3 vaccine doses should be started in the fall (September – November), to give enough time to develop immune protection against TBEV. The second dose is administered in spring (in March – April), the third dose one year after the second dose. Further revaccinations are carried out 3 years later and then every 5 years (every 3 years for individuals above age > 65 years).3 |
| Table 2: Reported cases of TBE encephalitis in the Ukraine by period 1955-20203,4,5 | |
|---|---|
| Time period | Cases (TBE encephalitis) |
| 1955-2013 | 522 autochthonous cases 74 imported cases |
| 2011-2019 | 2 reported cases |
| 2020 | 2 reported cases |
Figure 1: Enzootic territories (natural foci) for tick-borne viral encephalitis as of 01.01.2020 in Ukraine
Source: https://phc.org.ua/sites/default/files/users/user90/risk_2020_38.pdf
Acknowledgments
The author acknowledges the kind support from Dr. Khrystyna Hrynkevych for translation and editing.
Contact
Iryna Kolesnikova
liltairyna@gmail.com
Authors
Iryna Kolesnikova, Khrysthyna Hrynkevych
Citation
Kolesnikova I, Hrynkevych K. TBE in Ukraine. Chapter 13. In: Dobler G, Erber W, Bröker M, Chitimia-Dobler L, Schmitt HJ, eds. The TBE Book. 7th ed. Singapore: Global Health Press; 2024. doi:10.33442/26613980_13-35-7
References
- Ministry of Health of Ukraine. [How not to get sick if bitten by a tick?]. 2023. Accessed 29 March, 2024. https://moz.gov.ua/article/health/jak-ne-zahvoriti-jakscho-vkusiv-klisch
- Ministry of Health of Ukraine. [Criteria for determining cases of infectious and parasitic diseases subject to registration]. 2015. Accessed 29 March, 2024. https://moz.gov.ua/uploads/3/15840-pro_20200115_3_dod_1.pdf
- Ministry of Health of Ukraine. [On the approval of Methodological recommendations “Non-specific prevention of transmissible natural foci infections transmitted by ixodid ticks”]. 2013;369. Accessed 29 March, 2024. https://zakononline.com.ua/documents/show/65573___65573
- Publications of the Department of Epidemiology. [Functioning of the combined natural center of especially dangerous infections in western Ukraine. Collection of scientific papers]. Accessed 29 March, 2024. https://new.meduniv.lviv.ua/uploads/repository/kaf/kaf_epidemiology/05.%D0%92%D0%B8%D0%B4%D0%B0%D0%B2%D0%BD%D0%B8%D1%87%D0%B0_%D0%B4%D1%96%D1%8F%D0%BB%D1%8C%D0%BD%D1%96%D1%81%D1%82%D1%8C/Publikacii.pdf
- Ministry of Health of Ukraine. [On improvement of prevention measures tick-borne viral encephalitis in Ukraine]. 2005;431. Accessed 29 March, 2024. https://zakononline.com.ua/documents/show/53697___53697.
- State Institution “Kharkiv Regional Center for Disease Control and Prevention of the Ministry of Health of Ukraine”. Accessed 29 March, 2024. https://labcenter.kh.ua/?page=68&paged=64
- Yurchenko OO, Dubina DO, Vynograd NO, Gonzalez JP. Partial Characterization of Tick-Borne Encephalitis Virus Isolates from Ticks of Southern Ukraine. Vector Borne Zoonotic Dis. 2017;17(8):550-557. doi: 10.1089/vbz.2016.2094.