Izurieta-Pacheco et al.
Encefalitis centroeuropea. descripción del primer caso importado en España en un paciente pediátrico
[Tick-borne encephalitis. Description of the first imported case in Spain in a paediatric patient]
An. Pediatr. 2020, in press, doi 10.1016/j.anpedi.2020.10.026

So far, no autochthonic TBE case has been observed in Spain. Recently, the first imported TBE case (in an 18-year-old man) has been described (see Snapshot week 21/2020).

Now, the first imported TBE case in a Spanish child has been reported. A 2-year-old child, not vaccinated by parental decision, was admitted to the emergency department of the university hospital in Barcelona due to drowsiness and fever of 7 days of evolution with headache, photophobia and sonophobia, starting 5 days after returning to Spain after a 2-month trip to a rural region of northeast Austria.

During this trip, he had presented some tick bites, and one month before the current episode, fever without self-limited focus, remaining asymptomatic during the following 3 weeks. The patient was PCR negative for herpes simplex virus and enterovirus as well sero-negative for Borrelia burgdorferi and Rickettsia conorii. Positive IgG SARS-Cov-2 was detected, with negative IgM.

Due to the epidemiological background and the biphasic clinical course, TBE was taken into consideration. An increase of IgG titer of more than 4 times against TBE in serum paired samples, with positive IgM, and without cross reactivity against West Nile virus and Japanese encephalitis virus was detected.

TBE vaccination is recommended in Spain since 2008 for travelers to endemic areas.

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