Geeraedts et al.
First paediatric case of autochthonous tick-borne encephalitis in the Netherlands, 2018 et al.
New Microbe and New Infect. 2019; 32: 100603
In the Netherlands, two TBE foci have so far been reported: the Sallandse heuvelrug and the Utrechts heuvelrug area. In July 2018, a 12-year-old boy with TBE was hospitalized. Most probably, he was infected while mountain bike tracking in the region of Twente easterly from the Sallandse heuvelrug area close to the county of Steinfurt in the Federal State of North Rhine-Westphalia (Germany). This county is not a TBE risk area according to the definition of the Robert Koch-Institut (Berlin), although spontaneous TBE cases have been reported there. This new TBE case in the Netherlands indicates a third TBE focus in the Netherlands and illustrates that the transboundary region Twente/county of Steinfurt may be a TBE risk area. Less than 40 km north of this region, TBE cases have been reported close to the city of Lingen (Federal State of Lower Saxony) and this region has recently been categorized as TBE risk area by the Robert Koch-Insitut. The triangle Twente/North-West North Rhine-Westphalia/South-West Lower Saxony deserves closer attention.