Egyed et al.
Tick-borne encephalitis epidemic in Hungary 1951-2021. The story and lessons learned
Zoonoses Public Health. 2023;70(1):81-92. doi:10.1111/zph.13003

It was in 1931, that Hans Schneider, a local physician in Neukirchen in East Austria, only about 25 km away from Hungary, described an acute “meningitis serosa” (most probably TBE) epidemic in 24 patients. Later, in 1971, a TBE virus strain was isolated in Neudörfl about 20 km northeast of Neukirchen. Likewise, more than 300 cases of meningitis serosa cases were reported in Hungary in the 1930s/1940s, partially close to the eastern Austrian border. The first Hungarian TBE virus strain (KEM-19) was isolated in eastern Hungary in 1954. Between 1970 and 1978, an average of 174 TBE cases were reported yearly.

In autumn 1974, a vaccination program started with a Russian vaccine among forest workers, and in 1977 it was decided to replace the Russian vaccine with the Austrian vaccine FSME-Immun Inject. Broader use of FSME-Immun Inject (based on the Neudörfl strain) started in 1991 and use of Encepur (based on strain K23) in 2001. A TBE vaccination program was initiated in the 1990s in Hungarian risk regions (mostly in western and northern districts with about 16% of the whole population). Along with the extensive vaccination program, the number of yearly reported TBE cases decreased significantly (from 2–4/100,000 between 1975 to 1996 to 0.06–0.45/100,000 since 2010).

The Hungarian TBE endemic areas seem to be stable and only one new focus appeared in the center of Hungary.

The Hungarian vaccination program, concentrating on the population living in endemic areas, has shown to be effective and led to a significant decrease in yearly reported TBE cases and a negligible level of human TBE cases during the few last years.

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