Page 268 - TBE_Book_V2_2019

Chapter 12b

TBE in the Czech Republic*

Petr Pazdiora

History and Current Situation

The TBE virus (TBEV) was first isolated in the computerized. TBE surveillance was laid down
Czech Republic (together in all Central Europe) by Regulation No. 275/2010, Annex No. 28.
by Czech specialists in 1948-1949 from both a
patient and also from Ixodes ricinus ticks. The Czech Republic is a highly TBE endemic
However, even before 1948, unclear summer country. Many cases are associated with
cases of viral meningoencephalitis, at least in outdoor activities (camping, living in secondary
part likely attributable to the TBE virus, were residences in the countryside, hiking, hunting,
reported. These cases were reported mostly fishing, mushrooming), while the risk of
from patients in districts Beroun (Central occupational transmission has decreased over
Bohemia), Hradec Králové (East Bohemia), the last years. Numbers of imported cases
Vyškov (South Moravia), and occasionally in from abroad are very low with only 3 cases
the neighborhood of Prague. The official (0.4%) in 2017. The geographical distribution
reports of these probable cases of ”tick-borne of TBE is changing. The gradual spread of TBE
encephalitis” start in the database of National into formerly unaffected districts, namely in
Institute of Public Health in Prague since 1945. the border districts of the country at higher
altitudes is highlighted. Long-term observa-
The first TBE virus isolation was from a patient tions confirm a shift of age-specific incidence
with meningoencephalitis from blood and rates to older age groups. The period of the
from cerebrospinal fluid. Other successful transmission of TBE is changing, too. The “TBE-
isolations were from subjects with a history of season” with detection of cases is longer than
a tick bite. The first successful attempt of 30-50 years ago and lasts from February to
isolation of the TBE virus from the different December. These changes of basic epidemiol-
developmental stages of I. ricinus ticks ogical characteristics may be associated with
collected in forests of the district Beroun was climatic changes, changes of environmental
in 1949. The analysis of an outbreak of and other factors. These factors are affecting
meningoencephalitis in Rožňava in south- the different interactions between TBEV, its
eastern Slovakia in 1951 from Czech and vectors and vertebrate hosts, too.
Slovak specialists ended with the discovery of
the alimentary transmission of the TBE virus. Vaccine uptake is very low, the highest rate is
reached in the age group of 10-19 year-olds,
The definition of reported cases of infectious the lowest among older people, however there
diseases including tick-borne encephalitis is no central vaccination registry. Data from 4
changed in the following decades. According international telephone surveys in 2009, 2013,
to a ministerial decree of 1970, only clinically- 2015, and 2018 which covered the whole
manifested, laboratory-confirmed cases of TBE Czech population and defined a “vaccinated
should be reported to the central surveillance person” as someone having received ≥1 dose
center. The number of case characteristics vaccine uptake, was estimated to be 16, 23,
collected from TBE patients has gradually 24, and 25%, respectively. Unpublished data
increased ever since 1982. Since 1993, the from some Czech regions indicate that vaccine
national reporting system (EPIDAT) has been uptake with ≥3 dose is even lower.

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