Hellenbrand et al.
Epidemiology of tick-borne encephalitis (TBE) in Germany, 2001-2018
Pathogens 2019, 8, 42; doi 10.3390/pathogens8020042
The first case of TBE in the Federal Republic of Germany has been described near Passau in Bavaria in 1964, while in Eastern Germany, in the German Democratic Republic, TBE had already been reported much earlier, in 1959. In the mid-1990s public health authorities decided to define TBE risk areas on basis of administrative districts, the counties, and in 2001, TBE was made a statutorily notifiable disease in Germany. Most cases from 2001 to 2018 (6063 in total) were reported from the two Federal States Baden-Wurttemberg and Bavaria (89.0%). There was a yearly fluctuation of reported TBE cases from 195 up to 583 in 2018. Most cases occurred from May to October (91.1%) and 49.4% occurred in the two months June and July alone. The number of risk areas increased from 129 in 2007 to 161 in 2019. There is an expansion of risk areas northeastward in Saxony and northwestward to Lower Saxony where the first risk area has been defined in 2019. Vaccination coverage in children is yet unsatisfactory with 39.4% for the 5-year period 2012 to 2016 in risk areas and is lower in non-risk areas with 28.1%. Of the 1636 TBE cases reported from 2015 to 2018, meningitis was reported in 31.5% of cases and encephalitis or myelitis in 21.5% and myelitis was rare (3.7%). The authors broadly discuss various aspects at the end of the article.