Ilic et al.
Tick-borne encephalitis outbreak following raw goat milk consumption in a new micro-location, Croatia, June 2019
Ticks Tick Borne Dis. 2020, 101513
In Croatia, about 45 TBE cases have been reported annually during the last decade, and most of these cases have occurred in the northwestern and northeastern part of the country. Here, an outbreak is described as having been caused by the consumption of non-pasteurized goat milk in 2019. In the Gorski Kotar region, six patients suffered from TBE from late May into June 2019. Five of them had consumed raw goat milk from the same farm with 12 milk-producing goats, two male goats and 12 goat kids (one patient reported a tick bite).
Some of the goats had enlarged axillary and inguinal lymph nodes, and had neutralizing TBE antibodies, which were also documented in one dog and two horses on that farm. TBE virus RNA could neither be detected in milk samples nor in 65 ticks harvested from the goats. One female reported breastfeeding her 8-month-old infant during the febrile phase of disease. However, the infant did not show any symptoms and remained TBE antibody negative.
After this outbreak was identified, public health advised to cease distribution and consumption of raw dairy products and farmers were educated about the pathways for TBE transmission. In addition, an educational article about TBE was posted on the web page of the regional public health institute.