Velay et al.
Tick-borne encephalitis in pregnant woman and long-term-sequelae
Emerg Infect Dis. 2023;29(3):669-671. doi:10.3201/eid2903.221328
Data during pregnancy are scarce and some have been presented previously in TBE News, for example, in Snapshot 40/2022 and Snapshot 28/2020. Recently, a severe TBE case has been reported with long-term sequelae in a pregnant woman.
In July 2020, a 34-year-old woman at 20 weeks of gestation was admitted to an emergency department in Strasbourg, France. The patient lived in Berlin, Germany, and had traveled to the Black Forest (known as a TBE risk region in Germany), the Provence (France) and Alsace (known as a TBE risk region in France).
On day 3, the patient was IgM positive, but negative for IgG. The patient progressed with severe hyperactive delirium, requiring sedation and intubation. At the beginning of August, the patient was transferred to a university clinic in Berlin. Magnetic resonance imaging showed progression to deep cerebral nuclei and thalamic hemorrhagic transformation and cerebral atrophy. The woman was discharged to a neurologic rehabilitation center after 85 days of hospitalization and had tetraparesis and polyradiculitis. The patient gave birth to a healthy boy by cesarian delivery at term.
The patient was not vaccinated against TBE. This case illustrates the need of TBE vaccination for those living in and/or traveling to TBE-endemic areas.