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Chapter 7: TBE in special situations

of gestation. The mother gave birth to twins at Some other less well-documented TBE cases
term. Both infants did not show any sero- during pregnancy resulted in healthy neonates
logical evidence or signs of active TBE with no evidence of infection or neurological
infection. symptoms.

In conclusion there are few reports on TBE in These cases also show that pregnancy may be
pregnancy. The two cases of TBE in the late associated with a more severe course of TBE,
second trimester from 2018 show that a which may result from the immunological
diaplacental infection could not be detected. situation during pregnancy, where there is a
kind of physiological immuno-suppression.
This observation is confirmed by a case early
in the 1960s where the infection in week 24 of
gestation resulted in a healthy child with no Alimentary TBE
evidence of TBE or any neurological symp-
toms.
It has been known for a long time that TBE can
There are two early reports from an outbreak be transmitted by contaminated milk. In fact,
in 1961 where two pregnant females were the first larger outbreak of TBE (in 1953) in
infected early during the 1st trimester. Both Europe was milk-borne, described in Roznov,
gave birth to children (one of them pre-term) Czech Republic with more than 600 human
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with brain bleeding. The infection in these cases. At that time TBEV-transmission by
cases was via contaminated milk, however, milk was more important than transmission by
which might modulate the clinical course of ticks and TBE was named „Biphasic milk
TBE. Further-more, it is unclear whether the fever“. With increasing industrialization in milk
neuro-logical symptoms resulted from TBE production and dairy production the alimen-
infection or from possible other causes. tary route of infection of TBE was more and
more forgotten in industrialized European
countries.

Table 2: Summary of three TBE cases during pregnancy during a milk-borne
outbreak of TBE in the former German Democratic Republic in 1961.

Clinical course Outcome Age of Neutralization Outcome of newborn
of mother of mother gestation test

Pre-term (gestational
fever healthy week 8 positive week not provided) with
intracranial bleeding

Birth at week 40 of
myelitis healthy week 10 positive gestation with intra-
cranial bleeding

meningoencephal Birth at week 40 of a
healthy week 24 positive
omyelitis healthy newborn

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