Mansbridge et al.
Autochthonous tick-borne encephalitis in the United Kingdom: a second probable human case and local eco-epidemiological findings
Ticks Tick Borne Dis. 2021, in press

Until recently, the United Kingdom was thought to be TBE free. In 2019, the first probable autochthonous TBE case in the UK has been reported. Various areas were detected where ticks harbored the TBE virus and where serum from deer was found to be TBE antibody positive.

Now, a second TBE case has been reported in southern England, in the district of Hampshire. A 42-year-old man suffered from severe headache, and he developed photophobia and worsening vertigo. At the hospital, he was febrile at 38.8°C. A variety of neurodiagnostic tests were carried out, and probable TBE was diagnosed based on positive IgM and IgG in the serum in the absence of flaviviral vaccination or travel outside of the UK for over 10 years.

In a radius of 10 km around the suspected location of the patient’s tick bite, blood samples were collected from deer, and 6/64 samples were positive in a TBE ELISA (and 11/64 were borderline). No TBE virus specific RNA could be detected in 150 ticks collected around the patient’s residence by flagging.

It should be mentioned that there is no louping-ill-related neurological disease in livestock in the district of Hampshire, and thus the authors concluded that they have described the second probable autochthonous TBE case in the UK.

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