Hofhuis et al.
Exposure to tick-borne encephalitis virus among nature management workers in the Netherlands
Ticks Tick Borne Dis. 2021;12:101762. doi:10.1016/j.ttbdis.2021.101762

In the Netherlands, TBE virus was first detected in ticks in 2015, with the first autochthonous TBE case being reported in 2016. Since then, a few more cases have been reported. It is generally thought that human exposure to TBE virus is very low in the Netherlands. To get more knowledge about the risk to get infected among nature management workers, who have an occupational risk for tick bites, a cross-sectional study has been carried out among nature management organizations in the Netherlands.

Among 963 invited participants, online questionnaires were completed by 674 individuals (70%): most were voluntary workers (55%) in nature management organizations, a majority (71%) reported tick bites during the last 12 months before the study, and one third reported weekly to monthly tick bites during the tick bite season.

Ten sera tested positive for TBE IgG (ELISA; 0.5% seropositivity), of which three were confirmed positive in neutralization assay. The three NT positive individuals had reported travelling abroad, also to TBE endemic countries.

In total, the very low seroprevalence found in this study is consistent with the low number of reported TBE cases in the Netherlands. Neither the low incidence of clinical TBE in the Netherlands as a whole, nor the incidence within TBE virus affected provinces meet the WHO criteria for recommendations of TBE vaccination for the general population. However, some nature management organizations recommend vaccination to employees and volunteers who work in or nearby where TBE virus has been detected.

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