Page 433 - TBE_Book_V2_2019

Chapter 13

TBE as a matter of

public health

Michael Kunze and Martin Haditsch
Key Points
5
• The incidence of TBE ranges from ‘only single sporadic cases’ to >10/10 per year depending on
the region and on the year of analysis.

• This number may be considered as ‘low’ – not only for individual risk but also from a public health
perspective.

• If an individual does contract TBE, the disease may deeply change her/his life due to the need for
acute hospital care and due to potentially severe and long-term sequelae. In 1–2% (-20%) of
cases, TBE may even result in death.

• No specific treatments exist for TBE. The severity of the disease and high frequency of long-
term sequelae result in high public awareness and concerns about tick bites in endemic
areas. Public health officials in TBE-endemic areas need to address these concerns; moreover,
they need to address the concerns of potential travelers to their region.
• The principal public health measures aim at reducing TBE cases and at reduction of exposure and
preventive vaccination.

Introduction
Descriptive epidemiology is the cornerstone of the burden of disease of TBE and perhaps
information for public health considerations. even the presence of the TBE virus (TBEV)
In this regard, as outlined in various chapters have not been fully studied. In some
of this book, tick-borne encephalitis (TBE) countries, even the costs and limited
poses specific challenges: availability of serological testing for TBE
serve as barriers to reaching a correct
1. TBE presents as a non-specific CNS disease diagnosis.
to family physicians, general practitioners,
pediatricians, internal medicine special- 2. In many countries, incomplete reporting
ists, neurologists, and other medical of TBE is likely. This fact starts a vicious
specialists. Especially outside of endemic cycle in which low TBE incidences or even
areas, TBE is often not diagnosed because lack of TBE cases result in low awareness
physicians are not aware of the and further underdiagnosis of the disease.
differential diagnosis, and they do not Some ‘official maps’ published by govern-
order the appropriate test to confirm TBE mental bodies do not in fact show that
infection. This phenomenon is particularly there is any risk for TBE in a specific
important in countries or regions where country or region because a special

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