Van Heuverswyn et al.
Spatiotemporal spread of tick-borne encephalitis in the EU/EEA, 2012 to 2020
Euro Surveill. 2023;28(11):2200543. doi:10.2807/1560-7917.ES.2023.28.11.2200543

TBE became a notifiable disease at the EU level in 2012. In 2018, a descriptive analysis has been published based on data from 2012–2016 in Eurosurveillance highlighting the regions with the highest notification rates.

Now, an updated analysis of the epidemiological situation of TBE in EU/EEA has been presented with the focus on geographical and temporal changes since 2012 (by extraction of data from the European Surveillance System TESSy) with the aim to provide useful information for the review and refinement of risk areas and prevention policies.

Between 2012 and 2020, 19 countries reported a total of 24,974 TBE cases, and most of them were autochthonous (98.6%). The median age of the patients was 49 years. There were 93 deaths (case fatality rate: 0.4%). A total of 403 patients were fully vaccinated (1.6%), 72.6% had received their last vaccine dose within 5 years before the infection and 89.5% within 10 years. Most cases occurred from April to November (98.8%).

The highest number of TBE cases were reported by Czechia (n=5,522), Lithuania (n=4,196; notification rate: 24.3 cases per 100,000) and Germany (n=3,309).  The mean notification rate was 0.8 per 100,000. Fifty regions had a notification rate of at least 5.0 per 100,000 with the highest notification rate of 62.4 per 100,000 in Utena county, Lithuania, in 2020.

The lowest number of cases and notification rates were registered in 2015. Since then, there has been a gradual increase in the number of cases in most countries.

Throughout the study period, 130 regions were considered as newly affected by the TBE virus compared to 2012–2013.

The WHO recommends that TBE vaccination should be offered to all inhabitants of regions with a notification rate of at least 5 per 100,000 population. In fact, in most of these identified 50 regions, TBE vaccination is recommended by the national authorities. Offering the vaccine at a reduced cost or even free of charge has been demonstrated to increase the willingness to be vaccinated.

TBE Book