1.0TBE Bookhttps://tbenews.com/tbeIThttps://tbenews.com/tbe/author/brianong/rich600338<blockquote class="wp-embedded-content" data-secret="ydClbiwISd"><a href="https://tbenews.com/tbe/13-25-9/">Poland</a></blockquote><iframe sandbox="allow-scripts" security="restricted" src="https://tbenews.com/tbe/13-25-9/embed/#?secret=ydClbiwISd" width="600" height="338" title="“Poland” — TBE Book" data-secret="ydClbiwISd" 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/2017/06/Poland.jpg1180250TBE in Poland Katarzyna Pancer E-CDC risk status: endemic (last edited in June 2026, update for 2024: 803 reported cases; update for 2025: no data)  History and current situation The history of tick-borne encephalitis (TBE) in Poland started in 1948, when clinical symptoms of TBE were described by Demiaszkiewicz.7 Disease reporting has been mandatory since 1970. In the years between 1970-1992, a total of 576 TBE cases were reported; the annual number varied from 4 (1991) to 60 (1970), and the incidence in that period ranged from 0.01/100,000 population to 0.2/100,000 inhabitants, respectively. In 1993, however, the number of reported TBE cases increased rapidly, probably because of the first introduction of commercial tests serologically to confirm the diagnosis of TBE by ELISA, which rapidly replaced the older HI assay (Fig.1).2,3,15  As in other European countries, TBE cases occur mainly in men aged 30-60 y. (Fig.2). This trend continued through the 1990s into the beginning of the 21st century. The number of reported TBE cases ranged from 149 in 2015 to 315 cases in 2009. In total, 4,690 cases of TBE were reported in Poland between 2000 and 2019. The respective incidence varied from 0.33 to 0.92/100,000. Possibly, a 3–4-year cycle was identified based on the reported numbers of TBE cases, with peaks observed in 2003, 2006, and 2009, but in the next years the cycle varied and peaks were observed in 2016, 2017 and 2019 (Fig.1).2,15 During the early 2020s strong effects of the COVID-19 pandemic were observed. In contrast to neighboring Germany and Sweden15 there was a decrease in reported case numbers in Poland. However, data from another independent surveillance system, the Nationwide General Hospital Morbidity Study (NGHMS), which collects data about hospitalizations for TBEV and other viral neuro-infections, indicated a large increase of clinical TBE detections at the same time. An analysis of data collected from different databases indicated that the sensitivity of the Polish epidemiological surveillance system for TBE still needs to improve and that the suboptimal use of laboratory diagnostics for identification of the etiological agent in patients with presumed viral CNS-infection is probably the main reason for the underestimation of TBE in Poland.16 The same conclusion was drawn based on the results of a project that retrospectively verified diagnoses in cases of viral neuro-infections.21 It is necessary to expand the scope of diagnostics of neuro-infections to include tests for TBEV, particularly outside known endemic areas. Over the last 4 years (2020-2023), a constant and significant increase in the number of TBE cases has been observed in Poland, reaching up to 663 cases with an incidence of 1.76/100,000 population in 2023.2 Moreover changes in the geographic distribution of TBE cases were observed in this period: while in previous decades each year more than 60% of TBE cases were detected in just 2 provinces in northeastern Poland (Podlaskie, >45% reported TBE cases; Warmińsko-Mazurskie, 15%-25% of reported cases), in the last 4 years, the predominance of reported cases in the Podlasie Province was reduced to 32%, whereas the proportion of TBE cases in Mazowieckie voivodeship increased from 10% to 15.8%. The ratio of TBE cases in Warmińsko-Mazurskie was stable (15%). The lowest incidence was observed in Lubuskie voivodeship: usually there were no reported TBE cases, with exception of 2023 (3 cases) (Fig.3).2 Moreover, more cases were diagnosed in autumn and early winter in the recent years and the percentage of TBE cases reported between October and December increased in comparison to other seasons (2018: 50%; 2022: 42%). One possible explanation for this phenomenon is climate change, with higher temperatures than in previous periods, longer heat waves, periods of drought and violent atmospheric phenomena occurring with varying intensity in Poland. Vaccination against TBE in Poland started in the 1970s. Vaccines using the TBEV-European strain have been available since 1993 and are recommended for persons staying in endemic TBE areas, specifically forest workers, soldiers, hunters, border guards, firefighters, farmers, tourists and campers of any age as of one year of age. There is no reimbursement.3 Vaccine uptake was low before 2019 (0.05-0.12%). Since 2019, the number of vaccinations has increased twice, especially among children and young adults <19 years of age. Today, the total number of adults and children vaccinated each year are similar – in 2022 – 41,728 vs 41,292.1  Overview of TBE in Poland Table 1: TBE in Poland1,3-6,8-21 Viral subtypes isolated European subtype (TBEV-EU)9,11,14 Reservoir animals Mainly small mammals like:  Apodemus sylvaticus, Apodemus flavicollis, Rinaceus roumanicus, Myodes glareolus, Microtus agrestis, Sciurus vulgaris, Sorex araneus, Talpa europaea8 Infected tick species (%) Varied depending on regions and vector:4,13,17,19,20· from 0 to 1.6% in I.ricinus, mainly found in North-Eastern and Eastern Poland.· from 0.99 to 12.5% in D.reticulatus (Central Poland -7.6%; Eastern  – up to 10.8%; North-Eastern – 0.99-12.5%). Diary product transmission Sporadic cases and limited outbreaks5,6,10,18 Case definition used by authorities Based on ECDC15 Completeness of case detection and reporting Comparison of surveillance data and other data from hospitalization and National Health Fund databases indicated strong underreporting of TBE in 202016Retrospective verification of clinical recognition – undetected cases of TBE were found in 13.9% of examined patients21 Type of reporting Mandatory reporting of all cases with neuroinfection. Passive surveillance; obligatory reporting of TBE detection by clinicians as well as positive results of laboratory diagnostics by labs15 Other TBE-surveillance No available data Special clinical features 70-80% BiphasicClinical manifestation: fever 95.3%; headache 95%, muscle pain 43%, dizziness 6.3%, vomiting 42%, neurological disorders 11%, meningeal symptoms 70%15,21 Licensed vaccines Commercially available products are: FSME-IMMUN (FSME-IMMUN 0,25-ml Junior, FSME-IMMUN 0,5-ml) and Encepur (Encepur K for children >1 year old; Encepur Adults >12. year old) Vaccination recommendations Risk groups related to occupation or habits; no reimbursement3Vaccination for TBE is recommended for persons employed in forest exploitation; military; firefighters and border guards; farmers; people engaging in particularly frequent physical activity outdoors. Vaccine uptake Vaccine uptake differs by region; highest usually in the highly affected regions with an incidence >5/100,000; in 2021, 0.5% of the general population in Podlaskie voivodeship was vaccinated in comparison to 0.18% in the