{"version":"1.0","provider_name":"TBE Book","provider_url":"https:\/\/tbenews.com\/tbe","author_name":"IT","author_url":"https:\/\/tbenews.com\/tbe\/author\/brianong\/","title":"Switzerland - TBE Book","type":"rich","width":600,"height":338,"html":"<blockquote class=\"wp-embedded-content\" data-secret=\"o2eS7WD2pP\"><a href=\"https:\/\/tbenews.com\/tbe\/13-33-9\/\">Switzerland<\/a><\/blockquote><iframe sandbox=\"allow-scripts\" security=\"restricted\" src=\"https:\/\/tbenews.com\/tbe\/13-33-9\/embed\/#?secret=o2eS7WD2pP\" width=\"600\" height=\"338\" title=\"&#8220;Switzerland&#8221; &#8212; TBE Book\" data-secret=\"o2eS7WD2pP\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\" class=\"wp-embedded-content\"><\/iframe><script>\n\/*! This file is auto-generated *\/\n!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);\n\/\/# sourceURL=https:\/\/tbenews.com\/tbe\/wp-includes\/js\/wp-embed.min.js\n<\/script>\n","thumbnail_url":"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/01\/Switzerland.jpg","thumbnail_width":1180,"thumbnail_height":250,"description":"TBE in Switzerland and Liechtenstein Kyra Zens E-CDC risk status: endemic (last edited in June 2026, update for 2024: 435 reported cases; update for 2025: 503 reported cases) History and current situation Tickborne Encephalitis (TBE) was first reported in Switzerland in 1969.1 From the 1970s through the 1990s the causative agent, the tickborne encephalitis virus (TBEV), was found to be endemic in geographically localized areas within the northeastern part of the country.2-4 A formal case definition and surveillance activities were introduced in 1984 and TBE was made a mandatory notifiable disease in 1988.5 Currently, all suspected TBE cases are reported to the Swiss Federal Office of Public Health (FOPH) using a two-tiered system. First, all laboratory tests indicative of acute TBEV infection are reported to the FOPH. Then, attending physicians are requested to complete a notification form providing specific clinical information, which is forwarded to the cantonal physician for review and then returned to the FOPH (Table 1). Both laboratory and completed clinical reporting forms are registered and maintained by the FOPH.5 The TBE case definition used in Switzerland is based on a combination of clinical and laboratory criteria and is similar to, but differs slightly from, that used by the ECDC in that \u201cpossible\u201d cases, in addition to \u201cprobable\u201d and \u201cconfirmed\u201d cases, are included (Table 1).6-9 The majority of TBE cases in Switzerland are reported between April and October (Figure 1).10 Cases are more commonly reported in men, compared to women, and individuals aged 50-69 are most affected, though a bimodal trend with a smaller peak in cases among children aged 5-9 is also observed (Figure 2).10 Recent work has demonstrated that approximately 5% of unvaccinated individuals throughout the country are seropositive, suggesting that exposures far outnumber clinically confirmed cases of disease.11 Among clinical TBE cases, approximately 75% recalled a tick bite within the 4 weeks prior to disease onset.6,8 Approximately 75% result in hospitalization. Meningitis is observed in 19-49% of cases,6,12,13 meningoencephalitis in 43-59% of cases,6,12,13 and meningoencephalomyelitis and\/or radiculitis in 5-7%.6,12,13 Just under 1% of cases are fatal (Table 1).6,8,13 Over the last two decades, both the geographic range and total incidence of TBE cases have increased dramatically throughout Switzerland.10,14,15 From an initial localization to the northeastern part of the country, TBE cases have increasingly been reported further west- and southward. This has been paralleled by increases in the range of TBEV-infected ticks16-23 and small and large mammal populations with positive anti-TBEV serology (Table 1).24-28 Currently, TBEV has been identified in ticks from most regions of Switzerland and in Liechtenstein, and, accordingly, human cases are now found in most areas of the country.29 In 2020, the nationwide average disease incidence exceeded the WHO\u2019s definition of \u201chighly endemic\u201d, with greater than 5.0 cases\/100,000 individuals reported.10 Official recommendations for vaccination against TBE have been in place in Switzerland and Liechtenstein since 2006; initially for all individuals aged 6 and older living or spending significant time in 71 \u201chigh risk\u201d areas throughout both countries (Table 1).30 These risk areas, based on reported cases and viral surveillance in the environment, were updated and expanded annually to reflect the changing epidemiology of the disease.29,31 The resulting risk area map (Figure 3) was used until 2018 to define TBE vaccination recommendations throughout the country.29,31 However, in 2019, in view of the continuing increases in incidence and geographic range of disease, health authorities in Switzerland and Liechtenstein expanded the risk area and simplified the vaccination recommendation to cover the entirety of both countries \u2013 with the exceptions of the Swiss cantons of Geneva and Ticino14,29 (Figure 3a \u2013 3c). In 2024 the recommendation was further revised to include the canton of Geneva (from summer 2024) as well as to recommend vaccination beginning at 3 years of age.32 Vaccination is reimbursed by compulsory health insurance for individuals to which the recommendation applies; namely those 3 years of age and older living or spending significant time in risk area.14,32 In children 1\u20132 years of age, vaccination is considered and reimbursed on a case-by-case basis.14,32 Considerations are also made for those with \u201chigh risk\u201d occupations, though the cost of vaccination is to be reimbursed by the employer (Table 1).14,32 Nationwide, between 2020 and 2022, just 2% of 2-year-olds were vaccinated, increasing to 50% coverage among 8- and 16-year-olds. Among adults, from the most recent data in 2018, 42% had received at least one TBE vaccine dose while 33% had completed at least the three dose primary series (Table 1).33 Following completion of primary immunization, Switzerland has a unique recommendation for administration of booster vaccine doses every 10 years,30,34 unlike most other European countries and in contrast to the label. However, recent epidemiologic studies in the country have demonstrated that vaccine effectiveness (VE) remains high in both children35 and adults36 over this interval, with sustained protection for at least 10 years after the last vaccine dose was received. Overview of TBE in Switzerland Table 1: TBE in Switzerland Viral subtypes, distribution Only the European subtype has been described17,20,22,23 Reservoir animals Small mammals, generally rodents (Apodemus flavicollis, A. sylvaticus, Myodes glareolus), are the primary reservoir hosts for TBEV observed in Switzerland24TBEV-infected ticks have also been found on migrating birds21 Infected tick species (%) Only Ixodes ricinus ticks described; Prevalence in ticks is focal and ranges widely, generally less than 1% of questing ticks but as high as 14.3%16-23,25,26,37 Dairy product transmission Not documented, risk estimated to be low38 Case definition used by authorities Possible Case: positive IgM serology with influenza-like illness (ILI) or non-specific neurological signs &amp; symptoms, OR, positive IgM + positive IgG serology without specific clinical symptomsProbable Case: positive IgM serology with meningitis, meningoencephalitis, encephalomyelitis or radiculitis, OR, positive IgM + positive IgG serology with influenza-like illness (ILI) or non-specific neurological signs &amp; symptomsConfirmed Case: positive IgM + positive IgG serology with meningitis, meningoencephalitis, encephalomyelitis or radiculitis, OR, TBE-RNA detection by PCR with meningitis, meningoencephalitis, encephalomyelitis or radiculitis Completeness of case detection and reporting Case reporting assumed to be complete or near complete due to two-tiered"}