1.0TBE Bookhttps://tbenews.com/tbeIThttps://tbenews.com/tbe/author/brianong/rich600338<blockquote class="wp-embedded-content" data-secret="ymVXgsRE1e"><a href="https://tbenews.com/tbe/13-36-9/">United Kingdom</a></blockquote><iframe sandbox="allow-scripts" security="restricted" src="https://tbenews.com/tbe/13-36-9/embed/#?secret=ymVXgsRE1e" width="600" height="338" title="“United Kingdom” — TBE Book" data-secret="ymVXgsRE1e" 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/2017/11/United-Kingdom.jpg1180250TBE in United Kingdom Maya Holding, Gillian Ellsbury, Claire Gordon ECDC risk status: affected (unknown if endemic) (last edited in June 2026, update for 2024: no data; update for 2025: 0 reported cases) History and current situation Until 2019, TBE was considered only to be an imported disease to the United Kingdom. In that year, evidence became available that the TBEV is likely circulating in the country1,2 and a first “probable case” of TBE originating in the UK was reported.3 In addition to TBEV, louping ill virus (LIV), a member of the TBEV-serocomplex, is also endemic in parts of the UK. Reports of clinical disease in livestock, caused by LIV are mainly from Scotland, parts of North and South West England and Wales.4 National deer sentinel surveillance was conducted between 2018 and 2021, initially to establish whether TBEV might be present in Great Britain, but undetected. Following confirmation of presence this was continued, to then detect the geographic extent of TBEV and any spread. In the initial samples collected between February 2018 and January 2019,1 four percent of sera from 1,309 deer culled across England and Scotland were ELISA-positive for TBEV serocomplex. Due to the close homology between LIV and TBEV, it was not possible to differentiate between the two viruses serologically, with 73.1% of ELISA positive samples also tested by LIV hemagglutination inhibition (HAI) test being positive by both methods. Many of the seropositive samples were in areas where LIV has been reported in livestock; however, a focus of the highest seropositivity rate (47.7% by ELISA) was identified in the Thetford Forest area (South East England), which has no previously published reports of LIV in livestock. Additionally, seropositivity of 14.3% was detected in Hampshire (Southern England), also a county with no previous LIV reports. Five from 2,041 I. ricinus ticks from culled deer in ELISA-positive regions tested positive by LIV/TBE PCR5, all five were from the Thetford Forest area. Of the ticks removed from deer in the Thetford Forest area, 2.6% were positive by RT-PCR. A full-length genome sequence was obtained from one positive tick (figure 2). TBEV-UK Thetford was identified to be a TBEV-Eu strain, sharing 99% sequence identity with the Norwegian Mandal strain isolated from ticks in 2009.6 Annual tick surveys have been conducted since 2018 in areas where seropositivity in deer have been detected, additionally surveys have been conducted in localities identified through follow up of probable or confirmed TBE cases. TBEV has been confirmed over multiple years in questing ticks in parts of Thetford Forest, the New Forest/Hampshire Dorset boarder and the North York Moors. The minimum infection rate detected tends to be below 1%, to illustrate, follow-up questing tick surveys were conducted in Hampshire during July and August 2018 and June 2019. Of 915 Ixodes ricinus ticks collected and tested in 2018 and 2,155 in 2019, one RT-PCR positive pool was identified from five adult female ticks collected from a site on the Hampshire/Dorset border2. Minimum infection rate (MIR) of ticks collected from this site was estimated to be 0.17%. Sequence analysis indicates that TBEV-UK Hampshire was most closely related to TBEV-NL (LC171402.1) detected in ticks in 2017.7 The diversity of the Thetford and Hampshire TBEV-EU strains (Figure 2) indicates that these were a result of at least two separate importation events into the UK.1,2 The first “probable TBE case” originating in the UK was in a 3-month old German infant returning from a family summer vacation in South East England in July 2019.3 Based on the timing of travel and incubation period, it is not possible that the child was infected in Germany and probable exposure was thought to be in the New Forest National Park, England, following a tick bite there. A second probable case was reported in July 2020 with exposure thought to be in in the Test Valley District of Hampshire, England, less than 20km from the first probable case.15 In September 2022, a third case tested positive for TBEV by PCR was reported in England, who was likely to have acquired infection in Scotland in June 2022. In October 2022 an additional case, also confirmed by TBEV PCR, was reported in England with probable exposure in the North York Moors.8 There were two probable TBE serocomplex cases reported in 2025, one with likely acquisition in Dartmoor and the second either from the Peak District or the Outer Hebrides. To summarize, overall serological evidence in deer supported by PCR detection in ticks and follow up sequence analysis of TBEV-EU RNA indicates that TBEV circulates within the Thetford Forest and the Hampshire/Dorset border and the North York Moors areas. There have been two confirmed and four probable autochthonous serocomplex cases, since TBE was first identified within the UK in 2019. Overview of TBE in the United Kingdom Table 1: TBE in the United Kingdom Viral subtypes, distribution TBEV-EU Reservoir animals Confirmed in ticks, but likely rodents Infected tick species (%) I. ricinus Diary product transmission Not reported Case definition used here Compatible clinical signs plus serological or PCR confirmation Completeness of case detection and reporting Unknown Type of reporting Acute encephalitis is a notifiable disease.9 TBEV is now a notifiable organism (from August 2019)10 Other TBE-surveillance Ongoing surveillance for possible TBE cases. Ecological studies, in addition to both sentinel and human serosurveillance studies Special clinical features None Licensed vaccines TicoVac® and TicoVac Junior®11 Vaccination recommendations The UK Joint Committee on Vaccination and Immunisation last reviewed the situation in October 2023. It was agreed that the Green Book wording could be adjusted to highlight accessibility to vaccination for those at risk in the UK context12 Vaccine uptake Uptake of vaccine not known Name, address/website of TBE National Reference Center Rare and Imported Pathogens Laboratory (RIPL)UK Health Security AgencyManor Farm RoadPorton DownWiltshireSP4 0JGwww.gov.uk/guidance/tick-borne-encephalitis-epidemiology-diagnosis-and-prevention Figure 1: Seropositive sentinel deer serum samples tested by both TBEV ELISA and LIV HAI and geographical distribution with density of samples (figure and accompanying legend are adapted and reprinted from reference)1. Update for 2024: No data; 1 possible case