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Chapter 12b: TBE in Italy

Giulia and Veneto. Incidence ranged from 0.16 be translated into a direct human risk, and
per 100,000 in Friuli-Venezia Giulia to 1.48 in other factors should be considered in order to
the Trento province where, regional address public health efforts toward TBE
surveillance has detected increases in the hazard. For example, since the ‘90s, rising
annual number of TBE cases, with cervid population numbers and changes in
transmission spreading outside the historically forest structure in the north-eastern regions
recognised foci. 5,16 and provinces of Italy were observed in
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conjuction with an increase in TBE incidence,
Vaccination for TBE is currently recommended but this relationship is not always positive and
in Italy among residents and professionally at a threshold density level of ungulates TBEV
exposed groups, in particular in rural endemic prevalence decreases. Also seroprevalence
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17
areas. In affected regions and provinces, TBE in domestic animals, showed a good spatial
is offered free of charge to risk groups and the correlation with TBE incidence in humans and
resident population since 2013 in Friuli might also uncover presently unknown TBEV
Venezia Giulia and since 2018 in the foci distribution.
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Autonomous Provinces of Trento and Bolzano.
Affected regions and provinces have also In conclusion, the incidence of TBE in Italy is
made information on TBE vaccination relatively low, and the risk appears to be
available on websites. 18-21 geographically restricted to the pre-alpine and
alpine regions of the country. More studies
TBE increase has been shown to be associated are necessary to disentangle the complex
with the expansion of tick populations factors that are involved in the circulation and
resulting from climatic factors, increasing maintainance of TBEV in an endemic focus and
abundance of ungulates, and changes in early-warning predictors should be better
human behaviour and land use, in addition to assessed. Human cases are currently reported
increased recognition and reporting of TBE from northeastern regions (Friuli-Venezia
cases. 22-23 Although the distribution of human Giulia, Veneto and in the Provinces of Trento
cases is consistent with that of the competent and Bolzano), with the highest incidence rates
tick vector, the overdispersed distribution of being reported in areas between 400 and 600
ticks in the environment and their very low m a.s.l. TBE vaccine (TICOVAC) is offered to
TBEV prevalence (usually below 1%), make resident people living in high-risk areas, but its
them an unsuitable indicator of TBEV infection impact on disease occurrence in the affected
risk. For these reasons, entomological studies, communities is not yet evaluated.
even if performed in endemic regions, cannot

Overview of TBE in Italy

Table 1: Virus, vector, transmission of TBE in Italy (Northeastern)
European TBEV subtype; north east regions:
Viral subtypes, distribution
Friuli-Venezia Giulia, Veneto, Trentino-Alto Adige (Figure 3)
Ticks and small rodents. Consumption of milk and milk products
Reservoir animals
from infected goats, sheep, or cows
Infected tick species (%) Ixodes ricinus

Dairy product transmission Not documented

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