Laugesen and Stenør
Tick-borne encefalitis-associeret meningoradikuloneuritis erhvervet vet Esbjerg
(Tick-borne encephalitis-associated meningoradiculoneuritis acquired in the south-western part of Denmark)
Ugeskr. Læger 2019, 181: V03190197
A TBE case has been observed in a 68-year-old woman treated with methotrexate due to rheumatoid arthritis and who had other underlying diseases. Most probably, the patient got infected by a tick bite near a camping place close to Aabenraa near Esbjerg (Jutland, Denmark) in July 2018. Some days after the tick bite she became ill and she developed various neurological symptoms during the next weeks. Serological analyses were negative for HSV-1, HSV-2, VZV, HIV, HEV, Borrelia and syphilis. In October 2018, TBE IgM antibodies could be detected, but no IgG antibodies. Four weeks later, serological analyses revealed TBE IgM as well as IgG antibodies. The rather late IgG seroconversion may be a result of the immunosuppressive medication.
So far, TBE cases in Denmark have only been reported from the island of Bornholm, Sealand and the island of Fyn (eastern part of Denmark). The TBE case now described is westerly of the island of Fyn on the Danish mainland in Jutland (southwestern part of Denmark) about 50 km north of the Federal State of Schleswig-Holstein (Germany) which is not a TBE risk area according to the criteria defined by the Robert-Koch Institut, but where sporadic TBE cases have been recorded over the last years.
In addition, we have received a note by Anders Fomsgaard, Statens Serum Instutut, Copenhagen, that this year three additional TBE cases have been reported. The infections occurred in a forest north of Copenhagen (North Zealand). The three patients were hospitalized.