Page 302 - TBE_Book_V2_2019

Chapter 12b

TBE in Hungary

András Lakos, Enikő Bán, Ferenc Schneider,

Anna Nagy and Eszter Mezei

History and Current Situation

Hungarian scientists were among the pioneers 2. The incidence data from the Hungarian
in Europe as the tick-borne encephalitis virus military are similar to that of the civilian
1
(TBEV) was isolated in 1952. However, most population: no case has been reported
4
of their observations were published in the since 2003. ‘Underreporting’ in this
Hungarian language, and therefore not easily context would be practically impossible.
accessed by the international medical The reporting system for TBE has not
community. Here the relevant Hungarian data changed, and a reduction of cases (most
are summarized. probably due to vaccination) sufficiently
explains why the use of TBE serology was
Before 1997, the average annual number of subsequently reduced.
tick-borne encephalitis (TBE) cases reported to
authorities was around 300, and as of that
year it has decreased to fewer than 20
patients per year (Figures 1, 2). It has been
speculated that the decrease is a result of
underreporting of TBE, following a change in

the reimbursement system for payments
2-4
related to serologic TBE diagnosis. However,
two main arguments contradict the

‘underreporting hypothesis’:

1. During the 5 years before 1997, a total of
1,800,000 FSME vaccine doses were sold
by pharmacies (Figure 1), and this
convincingly explains the observed
reduction of TBE cases. Furthermore, after

1997, lethal TBE cases decreased in

parallel with decreased incidence. If lower
incidences had resulted from
underreporting, then lethal cases would
not have changed since the etiology of a
lethal case is regularly determined by
mandatory autopsy and other diagnostic
tests.

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