Mease et al.
Case report: Tick-borne encephalitis virus infection on beneficiaries of the U.S. Military Healthcare System in Southern Germany
Medical Surveillance Monthly Report 2019, 26: 12-15
Three cases of TBE have been reported among U.S. service members or beneficiaries living in the Federal State of Baden-Wurttemberg, Germany, in 2017 and 2018. All patients had some degree of sequelae following resolution of the TBE virus infection. These cases highlight the potential for underdiagnosis of TBE in the U.S. population stationed in Germany, because there is lack of education and awareness of TBE in the U.S healthcare system. Although TBE ELISA assays are available, these are not standard tests and require direct coordination with the laboratory and a specific request for the test, and in fact, for two of the three patients there was a delay in appropriate diagnosis. No TBE vaccines are approved by the U.S. Food and Drug Administration (FDA), so purchase or administration by the U.S. government is legally restricted. It is administered only at the level of individual patients but is now covered by insurance for U.S. military members in Europe. However, a multistep process is still required for the military population to get the vaccine and the drawback of this approach is explained in detail in the article.