1.0TBE Bookhttps://tbenews.com/tbeIThttps://tbenews.com/tbe/author/brianong/rich600338<blockquote class="wp-embedded-content" data-secret="i7EYtQAwET"><a href="https://tbenews.com/tbe/13-29-9/">Slovakia</a></blockquote><iframe sandbox="allow-scripts" security="restricted" src="https://tbenews.com/tbe/13-29-9/embed/#?secret=i7EYtQAwET" width="600" height="338" title="“Slovakia” — TBE Book" data-secret="i7EYtQAwET" 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/2017/07/Slovakia.jpg1180250TBE in Slovakia Jana Kerlik ECDC risk status: endemic (last edited in June 2026, update for 2024: 176 reported cases; update for 2025: 193 reported cases) History and current situation The former Czechoslovak Republic was one of the first countries in Europe where the tick-borne encephalitis (TBE) virus was identified. This discovery was made in 1947, when Rampas and Gallia observed a high incidence of disease identified as “Czechoslovakia encephalitis”, and TBE virus was isolated from Ixodes ricinus.1 In 1951, for the first time ever, and again in Czechoslovakia, the alimentary transmission of TBE virus from infected animals to humans was confirmed during a large outbreak in Rožňava. There were 271 hospitalized and serologically confirmed TBE patients. Blaškovič et al. found that most patients had drunk milk from the local dairy, which did not comply with basic sanitary requirements. The milk had not been pasteurized, but only stirred, equalized, and distributed. In addition, the goat milk that had been supplied to the dairy was also possibly infected.2 During the examination of the TBE focus in Rožňava, the goats were found with high anti-TBE virus titers.3 A list of natural foci of TBE in Slovakia was developed by the Public Health Authority of Slovakia in 2002 directly on the basis of virus isolation data from ticks and reservoir animals in the years 1964–1997 from the Institute of Virology, Slovak Academy of Sciences in Bratislava as well as indirectly according to the site of infection in patients with TBE as reported during 1972–2002.8 In recent years there has been a shift of natural TBE foci from the southern to the northern and central areas of the country.9  The reason is attributed to several factors including climate change.4 There is a long-term increasing trend of TBE cases in Slovakia. In 2022 we observed the highest number of TBE cases over the last 60 years.31 Slovakia is well known in Europe for TBE alimentary outbreaks that are reported almost every year.10 Over the last few years, there has been a growing trend in the number of food-borne TBE outbreaks. The percentage of TBE virus infections through consumption of unpasteurized milk and its products is quite high compared with other countries, e. g. in 2023, 34% of alimentary TBE cases were reported.31 Slovaks like to consume traditional products made from raw goat and sheep milk, especially sheep cheese. Moreover, raw goat milk has been recently promoted as a product to improve health and immunity in humans. In 2020 we reported a case of probable transmission of TBE virus from an unvaccinated mother to an infant through breast-feeding.5 Overview of TBE in Slovakia Table 1: TBE in Slovakia Viral subtypes isolated European subtype1 Reservoir animals Tribeč region (Jarok pri Nitre, Jelenec, Topoľčianky), 1965: Out of 46 blood and brain samples taken from moles (Talpa europaea), 7 positive isolations of TBE VIRUS were obtained. Therefore, moles can represent not only an important host animal, but may also be considered a reservoir of TBE VIRUS in elementary foci11 Tribeč region, 1967: Isolation of virus from the blood of Apodemus flavicollis, Clethrionomys glareolus, and Erinaceus roumanicus12 Tribeč region, 1967: 2 TBE VIRUS strains were isolated from Ixodes ricinus collected on 2 Turdus merula13 Lúky pod Makytou, 1981: 5 strains of TBE VIRUS isolated from ticks and organs of Apodemus flavicollis (in 15% infected)14 Western Slovakia (6 localities), 1981–1986: 6 TBE VIRUS strains isolated from organs of C. glareolus (4), Apodemus flavicollis (1), Sorex araneus (1)15 Záhorská Ves, 1990–1992: 8 TBE virus isolates from organs of C. glareolus (6), Apodemus flavicollis (1), Apodemus sylvaticus (1)16 Košická Belá, 2013: TBE virus from the brain sample of Buteo buteo17 The Drienovská wetland, 2019-2020: 9.8% seropositivity in the birds (n = 37) of 376 tested sera28 Percentage infected ticks The number of infected ticks in endemic areas varies widely from 0.1% to 5% depending on the season and habitat18    Tribeč, 1964: On average, 0.2% of ticks were infected by TBE virus in the entire Tribeč region. When only elementary foci were taken into account, this proportion increased to 0.4% (Topoľčianky) and 0.8% (Jelenec)18 Záhorská Bystrica, 1965: 1.7% of female ticks infected by TBE virus19 Devín, 1973: 0.1% of nymphs and 1.1% of female ticks infected by TBE virus20 Slovakia, 1981: In Slovakia there are 2 types of TBE VIRUS natural foci – Carpathian and Pannonian. In Carpathian natural TBE virus foci, there were 2.6% of ticks infected by TBE virus. In the Pannonian natural TBE virus foci, there were 0.1% of ticks infected by TBE virus21 Kurínec, 1982: 0.8% of nymphs and 6% of male ticks (I. ricinus) in south-central Slovakia22 Carpathian and Pannonian types of TBE natural foci, 1972–1982: The proportion of infected ticks in both types of natural foci was 1.7% in total. In Carpathian elementary foci (ranging from 0.4% to 4.1%; average of 2.5% of ticks were infected). In Pannonian elementary foci (ranging from 0.07% to 6.0%; average of 0.9% of ticks were infected)23 Western and Central Slovakia, 1980–1984: Western Slovakia, April–July 1980 (0.7%), May 1984 (0.1%), Central Slovakia April–May 1982 (0.2%)24 Western Slovakia, 1985–1990: In Slovakia surveillance of TBE virus in ticks, carried out during 1985–1990 by the Virology Institute of the Slovak Academy of Sciences in Bratislava, showed that the TBE virus distribution rates among ticks ranged from 0.30% (Jarok, Bardoňovo in 1987) to 0.38% (Malacky in 1990) in the 25 sites in the western region (data not published) Žiar nad Hronom, Banská Štiavnica a Žarnovica, 2002–2007: In the small sample of 142 ticks tested, there were 4.98% infected with TBE virus25 Dairy product transmission Slovakia is well known in Europe for TBE alimentary outbreaks that are reported almost every year.10 Over the few last years, there has been a growing trend in the number of food-borne TBE outbreaks. The percentage of TBE virus infection through consumption of unpasteurized milk and its products is quite high compared with other countries, e. g. in 2023, 34% of alimentary TBE cases were reported.31  During 2007–2016 a total of 26 TBE alimentary outbreaks (2 or more cases/outbreak) with 142 TBE cases have been observed (13.9% of all TBE cases). Larger outbreaks