Mansbridge et al.
Autochthonous tick-borne encephalitis in the United Kingdom: A second probable human case and local eco-epidemiological findings
Ticks Tick Borne Dis. 2022;13:101853. doi: 10.1016/j.ttbdis.2021.101853.

In 2019, the first probable autochthonous TBE case in the UK was reported. A second case has now been observed in the district of Hampshire in southern England close to the New Forest National Park where the first TBE case had been observed. A 42-year-old male tradesman, who has not been abroad for 10 years and had never been vaccinated against flaviviruses, became severely ill with progressive headache, photophobia, and vertigo. He was tested negative for a variety of pathogens but positive for TBE serum IgM and IgG (with increase of titer), and intrathecal IgG antibody production could also be shown.

In a 10 km radius around the suspected tick bite, 64 blood samples from culled dear were analyzed, and 9% were ELISA TBE positive, 11% were borderline and 80% were negative. Interpretation of deer seroprevalence is complicated in the UK, because TBE is serologically indistinguishable from louping ill virus, but louping ill-related neurological disease in livestock in the area analyzed (Hampshire) is absent.

These findings highlight the need for clinicians to consider the diagnosis of unexplained meningoencephalitis with epidemiological risk factors or history of preceding tick bites in the United Kingdom.

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