Page 391 - TBE_Book_V2_2019

Chapter 12b

TBE in Slovakia*

Jana Kerlik

History and Current Situation

The former Czechoslovak Republic was one of forestation or newly created gardens, and the
the first countries in Europe where the tick- growing popularity of outdoor pursuits such as
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borne encephalitis virus (TBEV) was identified. hiking and fishing). Slovakia is well known in
This discovery happened in 1947, when Europe for TBE alimentary outbreaks. Over the
Rampas and Gallia observed a high incidence last few years (2007–2018), there has been a
of disease identified as ‘Czechoslovakia growing trend in the number of food-borne
encephalitis’, and TBEV was isolated from TBE outbreaks. Slovaks like to consume
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Ixodes ricinus. products made from raw goat and sheep milk.
Moreover, raw goat milk has been recently
In 1951, for the first time ever, and again in promoted as a product to improve health and
Czechoslovakia, the alimentary transmission of immunity in humans. In one case, a patient
TBEV from infected animals to humans was under immunosuppressive therapy in Slovakia
confirmed during a large outbreak in Rožňava. drank raw goat milk in order to improve his
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There were 271 hospitalized and serologically health status, and he died from TBE.
confirmed tick-borne encephalitis (TBE)
patients. Blaškovič et al. found that most Vaccination coverage in Slovakia is very low
patients had drunk milk from the local dairy, because of minimal public health messaging
which did not comply with basic sanitary on vaccination against TBE. Also, strong anti-
requirements. The milk had not been vaccination lobbying has occurred in the
pasteurized, but only stirred, equalized, and country and vaccine reimbursements from
distributed. In addition, the goat milk that had insurance companies are low or nonexistent.
been supplied to the dairy was also possibly Furthermore, Decree No 585/2008 Coll. of the
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infected. During the examination of the tick- Ministry of Health of the Slovak Republic,
borne encephalitis TBE focus in Rožňava, the which defines details on prevention and
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goats were found with high anti-TBEV titers. control of communicable diseases,
recommends vaccination only for
In the last few years, we have observed an occupationally exposed persons (i.e., forest
increasing trend of TBE cases in Slovakia, for workers), but does not make it compulsory for
which there are several potential contributing even this group of the population.
6,7
factors. First, tick populations thrive because
of non-extreme temperatures, high humidity, *Note: Readers may also wish to review the
and the presence of snow cover during the accompanying chapter for the Czech Republic, given
winter, which acts as insulation. Early springs, the geographic proximity and national history of
these countries.
as well as summers that are not too hot or dry,
also may be important positive factors for tick

survival and reproduction success. Other
factors are ecological, demographic, and
socioeconomic conditions (for instance,
changes in land usage such as increased

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