Page 365 - TBE_Book_V2_2019

Chapter 12b: TBE in Poland

served in 2003, 2006, and 2009. TBE cases Prevention of TBE is based on decreasing the
were identified in all regions of Poland except probability of infection by limiting exposure to
one: there was no diagnosed or reported TBE infected ticks (wearing appropriate clothing,
case in Lubuskie Province, which is located at use of insect repellents, etc.), by vaccination,
the Western border region along the banks of and by appropriate preparation of milk
the Odra River. In contrast, more than 70% of (pasteurization, boiling). Since 1952 in Poland,
the reported cases in each year were commercial sale of milk is only allowed after
diagnosed in two provinces in the thermal preparation. Fresh milk has only been
northeastern part of Poland: Podlaskie available in local markets. 14,15
(Białystok) with >45% reported TBE cases and
an incidence >6/100,000, and Warmińsko- Vaccination against TBEV started in the 1970s
Mazurskie (Olsztyn) with 25% cases and an in Poland. At the beginning of this campaign,
incidence >1.5/100,000. Also, outbreaks of vaccination was done using the Russian
TBE were observed in those same regions Vaccinum Encephalitis Ixodice, which
during spring-summer time. 13 consisted of a formalin-inactivated TBEV-
Siberian type. Since 1993, the vaccines have
In contrast to Central European countries been directed against TBEV-EU, using 2
(Germany, Czech Republic, Austria, Switzer- available vaccines: FMSE-Immun (Pfizer) and
land) the reported Polish TBE case numbers in Encepur (GSK). 2,16–17 Both vaccines are
2018 did not significantly increase in summer available for use in children and adults.
time. Also the total number of 197 TBE cases Vaccination against TBEV is recommended in
is ~30% lower than in the previous years (279 Poland, especially for forest workers, foragers
cases in 2017, 283 cases in 2016) (Figure 3). of forest undergrowth, and tourists. The costs
However, a similar phenomenon of increased of vaccination are not reimbursed, except
number of the reported TBE cases during the through campaigns paid for by employers or
summer time was observed in 2016, but the local communities (medical service, forest
total number of TBE cases this year was workers etc.). In Poland, 27,849 persons were
comparable to those reported in 2017 but vaccinated in 2015, among them 11,516 below
18
higher than the number of TBE cases reported the age of 19 years. The rather low rate of
20
in 2015 (149 cases). vaccination against TBE among people in
Poland has no effect on the number of
The age of patients with diagnosed TBE reported TBE cases and epidemiological
ranged from 3 to 80 years, but the majority of characteristics of TBEV infection.
13
patients were >20 years old. Almost 20% of
all reported TBE cases were associated with
work or visits in the area where TBEV-infected
ticks were found. Moreover, food-borne
transmission was documented in 1975 and
1995. The source of infection was fresh, non-
pasteurized milk of cows (1975) or goats
(1995) contaminated with TBEV. 14,15

The mortality rate observed for the reported
TBE cases in Poland ranged from 0.5% to 2.8%
and was similar to that observed in other
European countries where European subtype
of TBEV (TBEV-EU) variants have been con-
firmed. 5,13

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