Cocchio et al.
Do we know the true burden of tick-borne encephalitis? A cross-sectional study.
Neuroepidemiology, in press, doi: 10.1159/000503236
In Italy, the first TBE cases were reported in Tuscany in the 1970’s. Nowadays, most cases are recorded in the north-east (but also in central parts) of the country. A population-based descriptive cross-sectional study (capture-recapture method) has been carried out from January 2007 to December 2018, based on data from mandatory notification systems (MNS) and from hospital discharge records (HDR) regarding TBE cases in residents of the Veneto Region in north-east Italy. The analyzed territory was grouped into geographical zones: mountains, hills and lowlands.
During the 12-year period, 192 TBE cases have been reported, according to the HDRs, and 244 cases to MNS. A total of 281 patients were specifically diagnosed with TBE and 55.2% of them were identified from both systems, while 32.7% only emerged in the MNS and 13.2% only in the HDRs. Capture-recapture analysis estimated a total of 302 cases. When the sample of 281 patients was divided by geographical group, the mountainous areas had the highest number of TBE cases. In the Veneto Region as a whole, the annual incidence during the 12-year period was 0.48 per 100,000 population, and the highest rate was in the province of Belluno (5.95 per 100,000). The incidence for TBE by geographical area was 4.39, 0.89 and 0.20 per 100,000 population in the mountains, hills and lowlands, respectively. A rise in the reported frequency of TBE was reported for the last four years. The capture-recapture method yielded a total of 302 TBE cases in the Veneto region in the last 12 years, indicating that pooling the data from the two sources provides a fairly complete picture of the situation.
The authors discussed the underreporting of TBE cases and how to optimize the recording system. In the high-risk area of Belluno, a resolution was passed to offer TBE vaccination free of charge and at a reduced price also to residents of other areas of the province with less TBE endemicity.