Nygren et al.
Tick-borne encephalitis risk increases with dog ownership, frequent walks, and gardening: A case-control study in Germany 2018-2020
Microorganisms. 2022;10(4):690. doi:10.3390/microorganisms10040690

In Germany, more than 80% of TBE cases occur in the two federal states Bavaria and Baden-Wuerttemberg. Nevertheless, vaccination coverage is rather low in southern Germany, and therefore it may be useful to make use of additional preventive measures to protect against TBE. Consequently, the knowledge and application of tick-protective strategies and risk factors to acquire TBE have been analyzed by a case/control study conducted from 2018 to 2020 in these two federal states.

Of 1220 eligible cases, 581 (48%) participated in the study, and 90% of these individuals had been hospitalized with a duration time of 12.3 mean days of stay. The total number of controls was N=975.

More than a third of cases or controls did not know that they lived in a TBE risk region. Among the risk factors associated with TBE were dog ownership (doubled odds for TBE), taking walks, gardening, not staying on paths, other outdoor activities and rural residence in settlements with fewer than 5000 inhabitants. Dose response effects were often seen, e.g., walks more than four times a week, and dog owners tended to report more tick bites than non-dog owners. Knowing the activities during which tick bites can occur are informative for public health awareness campaigns.

While most individuals were well informed about tick-protective strategies and removed ticks quickly, substantial potential remains for increasing the application of protective strategies.

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