1.0TBE Bookhttps://tbenews.com/tbeIThttps://tbenews.com/tbe/author/brianong/rich600338<blockquote class="wp-embedded-content" data-secret="cmB8kCyACR"><a href="https://tbenews.com/tbe/13-10-9/">Estonia</a></blockquote><iframe sandbox="allow-scripts" security="restricted" src="https://tbenews.com/tbe/13-10-9/embed/#?secret=cmB8kCyACR" width="600" height="338" title="“Estonia” — TBE Book" data-secret="cmB8kCyACR" frameborder="0" marginwidth="0" marginheight="0" scrolling="no" class="wp-embedded-content"></iframe><script> /*! This file is auto-generated */ !function(d,l){"use strict";l.querySelector&&d.addEventListener&&"undefined"!=typeof URL&&(d.wp=d.wp||{},d.wp.receiveEmbedMessage||(d.wp.receiveEmbedMessage=function(e){var t=e.data;if((t||t.secret||t.message||t.value)&&!/[^a-zA-Z0-9]/.test(t.secret)){for(var s,r,n,a=l.querySelectorAll('iframe[data-secret="'+t.secret+'"]'),o=l.querySelectorAll('blockquote[data-secret="'+t.secret+'"]'),c=new RegExp("^https?:$","i"),i=0;i<o.length;i++)o[i].style.display="none";for(i=0;i<a.length;i++)s=a[i],e.source===s.contentWindow&&(s.removeAttribute("style"),"height"===t.message?(1e3<(r=parseInt(t.value,10))?r=1e3:~~r<200&&(r=200),s.height=r):"link"===t.message&&(r=new URL(s.getAttribute("src")),n=new URL(t.value),c.test(n.protocol))&&n.host===r.host&&l.activeElement===s&&(d.top.location.href=t.value))}},d.addEventListener("message",d.wp.receiveEmbedMessage,!1),l.addEventListener("DOMContentLoaded",function(){for(var e,t,s=l.querySelectorAll("iframe.wp-embedded-content"),r=0;r<s.length;r++)(t=(e=s[r]).getAttribute("data-secret"))||(t=Math.random().toString(36).substring(2,12),e.src+="#?secret="+t,e.setAttribute("data-secret",t)),e.contentWindow.postMessage({message:"ready",secret:t},"*")},!1)))}(window,document); //# sourceURL=https://tbenews.com/tbe/wp-includes/js/wp-embed.min.js </script> https://tbenews.com/tbe/wp-content/uploads/2017/09/Estonia.jpg1180250TBE in Estonia Kuulo Kutsar E-CDC risk status: endemic (last edited in June 2026, update for 2024: 138 reported cases; update for 2025: 143 reported cases) History and current situation The first cases of tick-borne encephalitis (TBE) in Estonia were identified in 1949. Today, Estonia is a  TBE- endemic country. A TBE-endemic area in Estonia is defined as an area with circulation of the TBEV between ticks and vertebrate hosts as determined by detection of the TBEV or the demonstration of autochthonous infections in humans or animals within the last 20 years. Euro-Asian genotypes of TBEV – the Western or European (TBEV-EU), Siberian (TBEV-Sib), and Far-Eastern (TBEV-FE) subtypes are co-circulating in Estonia. Vectors of TBEV, the tick species Ixodes ricinus and Ixodes persulcatus, are distributed throughout the country. The high-risk season for infection coincides with the period of biological activity of ticks and lasts for 7 months from April to November, peaking in June to August. Most TBE cases are diagnosed in persons ≥60 years of age and the incidence among the rural population is 1.8 times higher than among the urban population. Overview of TBE in Estonia Table 1: TBE in Estonia Viral subtypes, distribution Co-circulation of European (TBEV-EU), Far-Eastern (TBEV-FE), and Siberian (TBEV-Sib) subtypes Reservoir animals Rodents, ruminants, game Infected tick species (%) 2011: I. persulcatus 8%, I. ricinus on mainland 0.6% – 0.8% and Saaremaa 3.0%.2013: Estonia: I. persulcatus 4.23%, I. ricinus 0.42%.2018: Tallinn 0.44% – 2.7% 2023: Estonia 1.1% – 8.3%: Valga county 6.1% and Viljandi county 8.3%. Dairy product transmission Documented but rare Mandatory TBE reporting Reporting: neurologists, infectious disease specialist Case definitionClinical criteria: a person with symptoms of the central nervous system (meningitis, meningoencephalitis, encephalomyelitis, encephaloradiculitis) Laboratory criteria for case confirmation: At least 1 of the following:– TBE-specific IgM and IgG antibodies in blood– TBE-specific IgM antibodies in CSF– Seroconversion of 4-fold increase of TBE-specific antibodies in paired serum samples– Detection of TBE viral nucleic acid in a clinical specimen– Isolation of TBEV from clinical specimens. Probable case: detection of TBE-specific IgM antibodies in a unique serum sample Epidemiological criteriaExposure to a common source (unpasteurized dairy product). Case classification:– Possible case: not applicable– Probable case: a person meeting the clinical criteria and the laboratory criteria for a probable case OR a person meeting the clinical criteria and with an epidemiological link– Confirmed case: a person meeting the clinical and laboratory criteria for case confirmation Other TBE surveillance Laboratory and epidemiological surveillance Special clinical features Biphasic disease: meningitis, meningoencephalitis, or meningoencephalomyelitis. Risk groups: people who often spend time outdoors (in nature) Available vaccines ENCEPUR CHILDREN, ENCEPUR ADULTS, TICOVAC CHILDREN, TICOVAC ADULTS (Table 2) Vaccination recommendations and reimbursement Vaccination recommendations 1998. No reimbursement; self-paid Vaccine uptake by age group/risk group/general population Vaccine uptake by general population (vaccinated and revaccinated): 2018 – 3.1%; 2019 – 3.7%; 2020 – 3.4%; 2021 – 2.6%, 2022 – 4,1%, 2023 – 5,8%. (Table 2) Name, address/website of TBE National Reference Center Health Board, Tallinn Paldiski St 81; https://www.terviseamet.ee Table 2: TBE vaccination by age in Estonia, 2022 Source data Figure 1: Age and gender distribution of TBE cases in Estonia, 2023. Update for 2025: 143 reported cases. Source data TBE seasonality: case numbers, Estonia 2023 January – 1, February – 1, March – 0, April – 0 , May – 3 , June – 20 , July – 19, August – 49, September – 45, October – 56, November – 11, December – 4 cases TBE total cases 209 and incidence 15.6 per 100 000 population in Estonia 2023 Figure 2: Age distribution of TBE in Estonia, 2005–2023 Source data Figure 3: Sites of TBEV-infection in Estonia, 2023 Source data Contact Kuulo Kutsarkkutsar@hotmail.com Author Kuulo Kutsar Citation Kutsar K. TBE in Estonia. Chapter 13. In: Dobler G, Erber W, Bröker M, Chitimia-Dobler L, Schmitt HJ, eds. The TBE Book. 9th ed. Singapore: Global Health Press; 2026. doi:10.33442/26613980_13-10-9 References