Taseva et al.
Is there an outbreak of tick-borne encephalitis in Pernik district, Bulgaria? Four cases registered for a period of four years – clinical manifestations and epidemiological relations.
Probl. Inf. Parasit. Dis. 2021; 49:18-25
In Bulgaria, the first TBE cases have been reported in 1953. However, there is no systematic survey system in place and therefore, TBE cases are reported only sporadically in the country.
In Pernik, a district in Western Bulgaria close to Serbia (see Snapshot week 14/2021), the first TBE case has been identified in 2015. Between 2017 and 2020, four TBE cases have been notified in Pernik in individuals from 26 to 86 years of age, and who all were tested positive in a commercial TBE IgM and IgG ELISA. The clinical symptoms have been analyzed and presented in detail. The authors assume that alimentary infections by goat milk may have caused disease and discussed that increased control by the Bulgarian Food Safety Agency is warranted.
It is concluded that the true number of TBE cases in Bulgaria remains unknown due to insufficient testing and reporting activities.