{"version":"1.0","provider_name":"TBE Book","provider_url":"https:\/\/tbenews.com\/tbe","author_name":"Administrator admin","author_url":"https:\/\/tbenews.com\/tbe\/author\/administrator-admin\/","title":"Kazakhstan - TBE Book","type":"rich","width":600,"height":338,"html":"<blockquote class=\"wp-embedded-content\" data-secret=\"9KRsaxNdbX\"><a href=\"https:\/\/tbenews.com\/tbe\/tbe12b17\/\">Kazakhstan<\/a><\/blockquote><iframe sandbox=\"allow-scripts\" security=\"restricted\" src=\"https:\/\/tbenews.com\/tbe\/tbe12b17\/embed\/#?secret=9KRsaxNdbX\" width=\"600\" height=\"338\" title=\"&#8220;Kazakhstan&#8221; &#8212; TBE Book\" data-secret=\"9KRsaxNdbX\" 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\/04\/Kazakhstan.jpg","thumbnail_width":1180,"thumbnail_height":250,"description":"TBE in Kazakhstan Andrey Dmitrovskiy E-CDC risk status: Endemic (data as of end 2022) History and current situation The first isolation of the TBEV in Kazakhstan was achieved in the Almaty region by M.P. Chumakov in 1941 (only one strain from one patient) during the expedition organized by the Central Institute of Epidemiology and Microbiology (Moscow). This is proof that the clinically well-described \u201cspring-summer encephalitis\u201d in the Almaty region was in fact TBE. Later, in 1943, 1944 and 1945 the TBEV was also isolated from additional patients by local scientists from the Institute of Epidemiology and Microbiology, Laboratory of Virology in Alma-Ata by Prof. E. I. Demikhovsky. Isolation had been accomplished from CSF samples up to 8 days of illness and also from brain tissue on day 12.1 In Kazakhstan, the clinical manifestations of TBE were first described by Steblov E.M, again in the Alamty region, and the disease had been named \u201cAlmaty encephalitis\u201d. More over, Steblow described a chronic variant of TBE as \u201cKojevnikov\u2019s Epilepsy\u201d.2 In 1954 the TBEV was isolated from Ixodes persulcatus ticks.3 The endemic zone in Eastern Kazakhstan was first characterized by Zhumatov in 1957.4 In 1959, a total of 5 TBEV strains were isolated from 315 Dermacentor pictus ticks (45% in 11 pools) in Zailiysky Alatau and 12 additional strains in Jungarsky Alatau (720 ticks \u2013 12 pools \u2013 100%).5 In the 1960s the Arbovirus Infections Laboratory of the Institute of Epidemiology, Microbiology and Hygiene (Alma-Ata) under the direction of Prof. Zhumatov conducted extensive work to study the natural foci of TBE in Kazakhstan. In particular, for several years, they examined birds for TBEV antibodies in Eastern Kazakhstan using a Hemagglutination Inhibition Assay. In 1961, during the examination of the sera of 46 birds, anti-TBEV antibodies were found in 4 local (non-migratory) species of birds (including jackdaw and starling). In 1962, 2 starlings out of 260 were also found with antibodies to the TBEV, whereas testing of 174 farm animal sera turned out to be negative. At the same time, studies of humans in Eastern Kazakhstan demonstrated seropositivity rates from 1.9% to 19.4%.6 The study of human sera in different endemic regions showed that in mountain foci where I. persulcatus is common, antibodies were detected in 12.0% of patients whereas in steppe foci it was 4.7%.&nbsp; Of persons between the ages of 11\u201315 years, antibodies were detected in 0.7%, between 16\u201325 years in 7.8%, between 26\u201335 years in 9.9% and over 35 years in 8.3%.8 When studying human TBEV infection by different genera of ticks in different endemic territories of Kazakhstan, researchers concluded that in those places with no I. persulcatus ticks patients were infected by D. pictus or D. marginatus and such infections did not result in any symptoms of TBE.7 All this work resulted in the creation of an epidemiological surveillance network for TBE, including the annual collection and study of ticks for infection rate, tick treatment of farm and domestic animals, as well as in areas where humans are in areas with a high population density, and in addition vaccination of the population in endemic areas. Local medical organizations are officially advised to conduct timely identification, recording and reporting of cases, including all individuals affected by tick bites, and this documentation includes diagnostic measures taken, hospitalization, medical examination and treatment of patients with TBE. Clinical supervision for patients who recovered from TBE must be conducted by a neurologist for a two-year period or longer, depending on the patient&#8217;s health status. Routine immunization against tick-borne encephalitis must be carried out by medical organizations and must be provided for individuals whose activities are connected with being in a natural focus of TBE.13 The Kazakh Institute of Epidemiology, Microbiology and Hygiene Research defines TBE-endemic areas in the 27 districts and 6 regions of Kazakhstan (Almaty, Eastern Kazakhstan, Akmola, Kostanai, Karaganda and Northern Kazakhstan).13 With no typical TBE cases in steppe foci in recent years, only 15 districts in 2 regions (Almaty and Eastern Kazakhstan)13 are still on the list of TBE-endemic areas. However, in 2016 new cases appeared in \u201cold\u201d endemic zones in the Akmola region.17,18 In 2020, 32 cases were registered, including 6 cases in Akmola and 4 cases in Northern Kazakhstan regions that are not officially endemic. Only one case was registered in the Almaty region and no cases were registered in such major cities as Almaty and Nur Sultan. We explain this by the development of the COVID-19 pandemic and the implementation of restrictive anti-epidemic measures during the tick activity season (April\u2013May), when people could not move freely and travel to endemic zones. In 2021, the incidence of tick-borne encephalitis continued to decrease (by more than 20% compared to 2020), including a decrease in the number of cases in children (4 and 3 cases, respectively). At the same time, 2021 was characterized by an increase in the number of cases in the &#8220;new&#8221; endemic territory \u2013 the North Kazakhstan region (9 cases compared to 4 in 2020) and the appearance of cases in &#8220;non-endemic&#8221; territories \u2013 Zhambyl region (1 case). In 2022, the number of confirmed TBE cases has increased to 32 (25% more compared to 2021). The highest number of cases was noted in the Almaty region (together with Almaty city) (13 cases), followed by the East Kazakhstan region (9 cases). The incidence was still registered in the &#8220;new&#8221; endemic regions \u2013 Akmola region (together with Astana, former Nur Sultan, city) with 6 cases, North Kazakhstan region with 3 cases and Zhambyl region with 1 case. Thus, the data of the former Kazakh Institute of Epidemiology on the wider endemicity of TBE, in addition to the Almaty and East Kazakhstan regions, are confirmed. We can also talk about the spread of endemicity in the Zhambyl region. Overview of TBE in Kazakhstan Table 1: Virus, vector, transmission of TBE in Kazakhstan Viral subtypes, distribution Siberian subtype, Almaty region12 Siberian subtype, Eastern Kazakhstan region13 Reservoir animals No information available Infected tick species (%) By virology studies (1970):14 74% of natural foci are"}