Foreword to the 7th Edition of THE TBE BOOK:
A comprehensive guide to Tick-Borne Encephalitis

Dear Readers!

It is with great pleasure that we present to you the 7th edition of THE TBE BOOK, a comprehensive guide to Tick-Borne Encephalitis (TBE). Over the past two years, this book has reached an astonishing milestone of over 1 million readers worldwide, and our TBE News including newsletter accompanying The TBE BOOK in April 2024 reached more than 20,000 readers in the United States alone – although not a single autochthonous case of TBE has ever been reported from that country. We are immensely encouraged by the overwhelming response and continue our commitment to providing the most up-to-date information on TBE with this latest edition.

Embracing the E-CDC definition

In this edition, we have fully embraced the European Centre for Disease Prevention and Control (ECDC) definition of “arbovirus disease risk”, where regions are classified as “predisposed” [climate and territory would allow TBE-virus (TBEV) circulation], “imperiled” (TBEV detected, but no case in a human), “affected” (single sporadic autochthonous TBE cases reported), or “endemic” (annual documentation of several human TBE cases). This appears to us to be the currently best scientifically sound approach to document the risk for TBEV-infections, as to date testing for the disease is largely incomplete, even in endemic countries and even for patients with symptoms of encephalitis during the active tick season.

Major updates and new chapters

The 7th edition of THE TBE BOOK features significant updates to the main chapters, including:

Historical perspective: We delve into the roots of TBE, exploring the discovery of the TBEV in the Soviet Union in the early 1900s and the social and political circumstances that precipitated this discovery. Additionally, we provide a general summary of the TBE-associated work of the six main scientists who unraveled the mysteries surrounding TBE in Europe, including the recently “rediscovered” ground-breaking epidemiological work by Dr. Hans Schneider, elucidating TBE infections by types of exposures.

Microbial species transmitted by ticks:  We have added a comprehensive chapter on the ever-increasing number of pathogens transmitted by ticks, as they are relevant for differential diagnostic considerations. This chapter will assist physicians in their efforts to make accurate and timely diagnoses based on clinical findings and microbiological confirmation.

TBE in children: We have included more comprehensive data on TBE in children, with a focus on long-term adverse outcomes. Different from the current general belief, TBE is NOT a mild and neglectable disease in the young but frequently results in long-term cognitive and psychological impairments – even if the initial disease is just a “mild encephalitis”.

Epidemiology and public health aspects

The epidemiology section has been updated to reflect the increase in TBE cases in Northern and Central Europe, as well as the spreading (or just the “recent detection”) of the virus to Africa (Tunisia). We also discuss the concept of “risk areas” – predisposed, imperiled, affected, and endemic – as proposed by the ECDC, and how “incidence data” may be misleading in judging the risk of contracting the disease. Additionally, we explore the potential reasons behind the increase in reported cases, despite increasing vaccine uptake, and whether this is due to increased awareness and testing, increased exposure, or other factors.

Furthermore, we provide detailed information on the public health aspects of TBE, emphasizing that it has been a vaccine-preventable disease for more than 50 years. Recent studies have documented high and long-lasting vaccine effectiveness, leading countries like Switzerland and Finland to recommend a simplified (2+1) vaccination schedule with extended 10-year boosters for the two vaccines licensed in Europe. Information on the Russian and Chinese TBE vaccines has also been updated.

Underdiagnosis and the way forward

Despite the availability of vaccines, TBE – even severe cases – remains hugely underdiagnosed in Europe and Asia, and we are far from systematic testing for this disease. This 7th edition of THE TBE BOOK aims at raising awareness and providing valuable insights to combat these challenges by further research.

We hope that this comprehensive guide will prove valuable to healthcare professionals, public health officers, travel medicine colleagues, researchers, travelers and anyone interested in understanding, diagnosing and preventing TBE. Join us on this journey as we continue to unravel the mysteries surrounding this important disease.

We thank all authors for their valuable time, work and dedication; we thank all members of the publishing team with Global Health Press in Singapore for their hard and focused work; the language editor for finding and correcting all the big and small errors in each manuscript and finally we thank the publisher for her commitment to this work.

Munich, Nierstein, Marburg (Germany), Vienna (Austria), Singapore

June, 2024
The Editors


Publication of this book was funded by Pfizer Inc.

ISSN: 2661-3980 | Published online on June 28, 2024

Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording, scanning, or otherwise), without the prior written permission of both the copyright owners and publisher of this book. The greatest care has been taken in compiling this book. However, no responsibility can be accepted by the publisher or compilers for the accuracy of the information presented. Where opinion is expressed it is that of the author and does not necessarily coincide with the editorial views of Global Health Press. While every effort has been made to contact copyright-holders of material produced or cited in this book, in the case of those it has not been possible to contact successfully, the editors, authors, and the publisher will be glad to make amendments in further editions. Copyright © Global Health Press Pte Ltd, 2024

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