Parfut et al.
Incidence of tick-borne encephalitis (TBE) in the pediatric population at the University Hospital of Strasbourg (HUS) and characterization of confirmed cases. J. Neurovirol, 2024. Doi: 10.1007/s13365-024-01233-8
Data on pediatric tick-borne encephalitis (TBE) in France remain limited. A monocentric retrospective study was conducted at the University Hospital of Strasbourg (HUS) to determine the incidence of TBE in pediatric patients (aged 0–15 years) presenting with neurological symptoms and for whom cerebrospinal fluid (CSF) samples (462 patients in total) were available between January 2020 and December 2022.
During initial hospitalization, TBE serological screening was performed in only 26.4% of cases. Retrospective testing detected TBE-specific IgM and IgG antibodies in four CSF samples. None of these patients had been vaccinated against TBE, and the positive results were subsequently confirmed using a serum neutralization assay.
The overall seropositivity rate between 2020 and 2022 was calculated at 0.87%. When reporting this average number to the number of 0-14-year-olds living in the urban community of Strasbourg, an estimated incidence of 1.51 cases per 100,000 inhabitants was obtained, which is 1.9 to 5 times higher than most recent ECDC data.
Some studies have investigated the role of markers in the acute phase, such as cytokines that predict incomplete recovery. High concentrations of proinflammatory cytokines like interleukin-6 (IL-6) in CSF might indicate a risk for incomplete recovery from childhood TBE. IL-6 doses were administered to three of the four patients, and intrathecal IL-6 concentrations were increased in two patients, agreeing with the literature that high values may indicate long-term complications. For one patient, the IL-6 concentration was significantly higher than values found in control cases.
Enhanced communication regarding the importance of TBE vaccination is warranted, particularly for children exposed to risk factors in endemic regions such as Alsace. Improved awareness and preventive measures could help mitigate the impact of this disease.