Litvová et al.
A lethal tick-borne encephalitis from an active endemic area in Slovakia. Smrteľná kliešťová encefalitída z aktívnej endemickej oblasti Slovenska. Epidemiol Mikrobiol Imunol. 2025;74(2):126-130. doi:10.61568/emi/11-6492/20250428/140418
Slovakia has one of the highest tick-borne encephalitis (TBE) incidence rates in Europe, with the highest age-specific incidence observed in individuals aged 45–54 years (5.52/100,000) and 15–19 years (4.99/100,000). Most infections (99.4%) occur in the unvaccinated population. Recently, a TBE case was reported in Slovakia with severe long-term sequelae and a fatal outcome.
A previously healthy 45-year-old man was admitted to hospital with fever, weakness, loss of appetite, and limb dyskinesia. His condition deteriorated, presenting with impaired consciousness, snoring respirations, and intermittent agitation. This was followed by dysphagia, loss of palatal reflexes, apnea, severe left-sided hemiparesis, dysarthria, and other symptoms consistent with bulbar palsy, accompanied by persistent signs of meningeal irritation. The patient developed severe meningoencephalitis with an organic psychosyndrome, marked decline in memory and cognitive function, and severe depressive symptoms.
After 12 weeks of hospitalization, he was transferred to a long-term care facility due to complete dependence in daily activities. In the 47th week after disease onset, during a readmission, he developed cardiopulmonary insufficiency, which resulted in death.
This fatal case in a previously healthy middle-aged man highlights the severe, long-lasting sequelae that can result from TBE and underscores the urgent need to raise public awareness of its risk factors and to promote vaccination as an effective preventive measure.