Page 263 - TBE_Book_V2_2019

Chapter 12b

TBE in Croatia

Wilhelm Erber and Tamara Vuković Janković

History and Current Situation

Even though tick-borne encephalitis (TBE) has An average of 20 human cases of TBE is
been a notifiable disease in Croatia since 2007, reported each year (minimum 11, maximum
3,4
there are no or only limited data available on 45) i.e., 0.26–1.05 cases/100,000 persons.
the occurring tick species in the endemic The majority of cases were registered in the
areas, on the prevalence of TBE virus (TBEV) in Koprivnica-Križevci County (average annual
ticks, its distribution in Croatia, and its genetic incidence 5.2/100,000), Međimurska County
characteristics. Reporting of human cases also (5/100,000), and Bjelovar-Bilogora County
is very scarce. The Central European subtype (4.3/100,000). The average incidence rate in
of virus (TBEV-EU) appears to be present in the city of Zagreb, within the observed period,
Croatia. was 0.2/100,000 (16 cases registered). In
2015, the first outbreak of TBE after consump-
Natural foci of TBE have been found so far in tion of raw goat milk was reported in 7 out of
5
the continental area in the northwestern 10 exposed persons.
region (between the Sava River and the Drava
River, near Zagreb, Varaždin, Bjelovar,
Koprivnica, Križevci, and Vinkovci – with an
area around Slavonski Brod) and in the
northeastern region (across a small area on

the western outskirts of Osijek city). Recently,
2 new natural foci have emerged in the central
mountainous region, south of the Sava River.
Cases are reported only sporadically in the
1
Adriatic coastal region.

A recent study found a prevalence of TBEV
similar to other European countries (0.1–5%)
in ticks removed from red foxes in Varazdin
County and Zagreb County (in the vicinity of
Medvednica mountain), both well known as
TBE areas. Furthermore, a viral prevalence of
1.1% (95% CI: 0.3–3.0%) has been found in red
deer (Cervus elaphus) from 2 areas in
northeastern Croatia (Vukovar-Srijem County
and Osijek-Baranja County). The latest human
TBE cases from these 2 counties were
recorded in 2009 (1 case) and 2010 (1 case),
2
respectively.

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