{"id":21943,"date":"2026-06-24T11:17:00","date_gmt":"2026-06-24T03:17:00","guid":{"rendered":"https:\/\/tbenews.com\/tbe\/?p=21943"},"modified":"2026-06-24T15:36:25","modified_gmt":"2026-06-24T07:36:25","slug":"13-10-9","status":"publish","type":"post","link":"https:\/\/tbenews.com\/tbe\/13-10-9\/","title":{"rendered":"Estonia"},"content":{"rendered":"\n
<\/a><\/span>
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TBE in Estonia<\/strong><\/h1>\n<\/div>\n\n\n\n

Kuulo Kutsar<\/strong><\/p>\n\n\n\n

E-CDC risk status: endemic<\/strong><\/h3>\n\n\n\n

(last edited in June 2026, update for 2024: 138 reported cases; update for 2025: 143 reported cases)<\/em><\/em><\/p>\n\n\n\n

History and current situation<\/strong><\/h3>\n\n\n\n

The first cases of tick-borne encephalitis (TBE) in Estonia were identified in 1949. Today, Estonia is a  TBE- endemic country. A TBE-endemic area in Estonia is defined as an area with circulation of the TBEV between ticks and vertebrate hosts as determined by detection of the TBEV or the demonstration of autochthonous infections in humans or animals within the last 20 years.<\/p>\n\n\n\n

Euro-Asian genotypes of TBEV \u2013 the Western or European (TBEV-EU), Siberian (TBEV-Sib), and Far-Eastern (TBEV-FE) subtypes are co-circulating in Estonia. Vectors of TBEV, the tick species Ixodes ricinus <\/em>and Ixodes persulcatus<\/em>, are distributed throughout the country.<\/p>\n\n\n\n

The high-risk season for infection coincides with the period of biological activity of ticks and lasts for 7 months from April to November, peaking in June to August.<\/p>\n\n\n\n

Most TBE cases are diagnosed in persons \u226560 years of age and the incidence among the rural population is 1.8 times higher than among the urban population.<\/p>\n\n\n\n

Overview of TBE in Estonia<\/strong><\/h3>\n\n\n\n
Table 1: TBE in Estonia<\/th><\/tr>
Viral subtypes, distribution<\/td>Co-circulation of European (TBEV-EU), Far-Eastern (TBEV-FE), and Siberian (TBEV-Sib) subtypes<\/td><\/tr>
Reservoir animals<\/td>Rodents, ruminants, game<\/td><\/tr>
Infected tick species (%)<\/td>2011: I. persulcatus 8%, I. ricinus on mainland 0.6% \u2013 0.8% and Saaremaa 3.0%.
2013: Estonia: I. persulcatus 4.23%, I. ricinus 0.42%.
2018: Tallinn 0.44% – 2.7%
2023: Estonia 1.1% – 8.3%: Valga county 6.1% and Viljandi county 8.3%.<\/td><\/tr>
Dairy product transmission<\/td>Documented but rare<\/td><\/tr>
Mandatory TBE reporting<\/td>Reporting<\/strong>: neurologists, infectious disease specialist

Case definition<\/strong>
Clinical criteria: a person with symptoms of the central nervous system (meningitis, meningoencephalitis, encephalomyelitis, encephaloradiculitis)

Laboratory criteria for case confirmation<\/strong>:
At least 1 of the following:
– TBE-specific IgM and IgG antibodies in blood
– TBE-specific IgM antibodies in CSF
– Seroconversion of 4-fold increase of TBE-specific antibodies in paired serum samples
– Detection of TBE viral nucleic acid in a clinical specimen
– Isolation of TBEV from clinical specimens. Probable case: detection of TBE-specific IgM antibodies in a unique serum sample

Epidemiological criteria<\/strong>
Exposure to a common source (unpasteurized dairy product). Case classification:
– Possible case: not applicable
– Probable case: a person meeting the clinical criteria and the laboratory criteria for a probable case OR a person meeting the clinical criteria and with an epidemiological link
– Confirmed case: a person meeting the clinical and laboratory criteria for case confirmation<\/td><\/tr>
Other TBE surveillance<\/td>Laboratory and epidemiological surveillance<\/td><\/tr>
Special clinical features<\/td>Biphasic disease: meningitis, meningoencephalitis, or meningoencephalomyelitis. Risk groups: people who often spend time outdoors (in nature)<\/td><\/tr>
Available vaccines<\/td>ENCEPUR CHILDREN, ENCEPUR ADULTS, TICOVAC CHILDREN, TICOVAC ADULTS (Table 2)
<\/td><\/tr>
Vaccination recommendations and reimbursement<\/td>Vaccination recommendations 1998. No reimbursement; self-paid<\/td><\/tr>
Vaccine uptake by age group\/risk group\/general population<\/td>Vaccine uptake by general population (vaccinated and revaccinated): 2018 \u2013 3.1%; 2019 \u2013 3.7%; 2020 \u2013 3.4%; 2021 \u2013 2.6%, 2022 \u2013 4,1%, 2023 \u2013 5,8%. (Table 2)<\/td><\/tr>
Name, address\/website of TBE National Reference Center<\/td>Health Board, Tallinn Paldiski St 81; https:\/\/www.terviseamet.ee<\/td><\/tr><\/tbody><\/table>\n\n\n\n
\n
Table 2: TBE vaccination by age in Estonia, 2022<\/th><\/tr><\/table>\n
Source data \n\n\n\n\t\n\n\t\n\t\n\t
Age<\/th>Vaccination (3 doses)<\/th>Revaccination (dose 4 or more)<\/th>\n<\/tr>\n<\/thead>\n
1 - 14<\/td>6513<\/td>6544<\/td>\n<\/tr>\n
15 - 17<\/td>418<\/td>1261<\/td>\n<\/tr>\n
Adults<\/td>14475<\/td>25800<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/a><\/div><\/div>\n\n\n\n
\n
\n

Figure 1:<\/span> Age and gender distribution of TBE cases in Estonia, 2023. Update for 2025: 143 reported cases.<\/h3>\n

<\/a><\/p>\n<\/div>\n

\"\"<\/a><\/figure>
<\/div>\n
Source data \n\n\n\n\t\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t
Age (years)<\/th>Males<\/th>Females<\/th>All<\/th>\n<\/tr>\n<\/thead>\n
0 - 9<\/td>17<\/td>7<\/td>24<\/td>\n<\/tr>\n
10 - 19<\/td>15<\/td>5<\/td>20<\/td>\n<\/tr>\n
20 - 29<\/td>6<\/td>3<\/td>9<\/td>\n<\/tr>\n
30 - 39<\/td>14<\/td>12<\/td>26<\/td>\n<\/tr>\n
40 - 49<\/td>5<\/td>12<\/td>17<\/td>\n<\/tr>\n
50 - 59<\/td>14<\/td>23<\/td>37<\/td>\n<\/tr>\n
60 - 69<\/td>13<\/td>19<\/td>32<\/td>\n<\/tr>\n
70 - 79<\/td>16<\/td>21<\/td>37<\/td>\n<\/tr>\n
80 and older<\/td>2<\/td>5<\/td>7<\/td>\n<\/tr>\n
Total<\/td>102<\/td>107<\/td>209<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/a><\/div>\n

TBE seasonality: case numbers, Estonia 2023<\/strong>\nJanuary \u2013 1, February \u2013 1, March \u2013 0, April \u2013 0 , May \u2013 3 , June \u2013 20 , July \u2013 19, August \u2013 49, September \u2013 45, October \u2013 56, November \u2013 11, December \u2013 4 cases\nTBE total cases 209 and incidence 15.6 per 100 000 population in Estonia 2023<\/strong>\n<\/p>\n<\/div>
\n\n\n\n

\n
\n

Figure 2:<\/span> Age distribution of TBE in Estonia, 2005\u20132023<\/h3>\n

<\/a><\/p>\n<\/div>\n

\"\"<\/a><\/figure>
<\/div>\n
Source data \n\n\n\n\t\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t
Year<\/th>0-9<\/th>10-19<\/th>20-29<\/th>30-39<\/th>40-49<\/th>50-59<\/th>60\u2265<\/th>\n<\/tr>\n<\/thead>\n
2005<\/td>17<\/td>22<\/td>20<\/td>26<\/td>23<\/td>21<\/td>35<\/td>\n<\/tr>\n
2006<\/td>14<\/td>22<\/td>22<\/td>15<\/td>25<\/td>31<\/td>42<\/td>\n<\/tr>\n
2007<\/td>10<\/td>15<\/td>14<\/td>25<\/td>21<\/td>18<\/td>37<\/td>\n<\/tr>\n
2008<\/td>6<\/td>10<\/td>11<\/td>14<\/td>13<\/td>14<\/td>22<\/td>\n<\/tr>\n
2009<\/td>17<\/td>23<\/td>20<\/td>22<\/td>32<\/td>24<\/td>41<\/td>\n<\/tr>\n
2010<\/td>18<\/td>24<\/td>22<\/td>19<\/td>33<\/td>34<\/td>51<\/td>\n<\/tr>\n
2011<\/td>12<\/td>20<\/td>28<\/td>28<\/td>31<\/td>47<\/td>84<\/td>\n<\/tr>\n
2012<\/td>12<\/td>28<\/td>12<\/td>27<\/td>24<\/td>21<\/td>54<\/td>\n<\/tr>\n
2013<\/td>8<\/td>11<\/td>12<\/td>12<\/td>14<\/td>19<\/td>37<\/td>\n<\/tr>\n
2014<\/td>7<\/td>11<\/td>7<\/td>10<\/td>16<\/td>11<\/td>22<\/td>\n<\/tr>\n
2015<\/td>10<\/td>11<\/td>7<\/td>19<\/td>17<\/td>15<\/td>37<\/td>\n<\/tr>\n
2016<\/td>8<\/td>8<\/td>5<\/td>8<\/td>18<\/td>11<\/td>23<\/td>\n<\/tr>\n
2017<\/td>16<\/td>6<\/td>10<\/td>13<\/td>10<\/td>11<\/td>21<\/td>\n<\/tr>\n
2018<\/td>6<\/td>12<\/td>3<\/td>13<\/td>15<\/td>7<\/td>29<\/td>\n<\/tr>\n
2019<\/td>7<\/td>11<\/td>5<\/td>12<\/td>12<\/td>10<\/td>26<\/td>\n<\/tr>\n
2020<\/td>2<\/td>8<\/td>7<\/td>9<\/td>10<\/td>10<\/td>24<\/td>\n<\/tr>\n
2021<\/td>9<\/td>9<\/td>7<\/td>5<\/td>13<\/td>14<\/td>23<\/td>\n<\/tr>\n
2022<\/td>15<\/td>8<\/td>6<\/td>15<\/td>24<\/td>23<\/td>47<\/td>\n<\/tr>\n
2023<\/td>24<\/td>20<\/td>9<\/td>26<\/td>17<\/td>37<\/td>76<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>
\n\n\n\n
\n
\n

Figure 3:<\/span> Sites of TBEV-infection in Estonia, 2023<\/h3>\n

<\/a><\/p>\n<\/div>\n

\"\"<\/a><\/figure>
<\/div>\n
Source data \n\n\n\n\t\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t
Counties<\/th>Cases<\/th>\n<\/tr>\n<\/thead>\n
Tallinn (capital)<\/td>31<\/td>\n<\/tr>\n
Harjumaa<\/td>25<\/td>\n<\/tr>\n
Hiiumaa<\/td>2<\/td>\n<\/tr>\n
Ida-Virumaa<\/td>3<\/td>\n<\/tr>\n
J\u00e4rvamaa<\/td>5<\/td>\n<\/tr>\n
J\u00f5gevamaa<\/td>4<\/td>\n<\/tr>\n
L\u00e4\u00e4nemaa<\/td>3<\/td>\n<\/tr>\n
L\u00e4\u00e4ne-Virumaa<\/td>8<\/td>\n<\/tr>\n
P\u00e4rnumaa<\/td>45<\/td>\n<\/tr>\n
P\u00f5lvamaa<\/td>5<\/td>\n<\/tr>\n
Raplamaa<\/td>4<\/td>\n<\/tr>\n
Saaremaa<\/td>15<\/td>\n<\/tr>\n
Tartumaa<\/td>30<\/td>\n<\/tr>\n
Valgamaa<\/td>4<\/td>\n<\/tr>\n
Viljandimaa<\/td>13<\/td>\n<\/tr>\n
V\u00f5rumaa<\/td>12<\/td>\n<\/tr>\n
Total<\/td>209<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>
\n\n\n\n

Contact<\/h3>\n\n\n\n

Kuulo Kutsar<\/a>
kkutsar@hotmail.com<\/a><\/p>\n\n\n\n

Author<\/h3>\n\n\n\n

Kuulo Kutsar<\/a><\/p>\n\n\n\n

Citation<\/h3>\n\n\n\n

Kutsar K. TBE in Estonia. Chapter 13. In: Dobler G, Erber W, Br\u00f6ker M, Chitimia-Dobler L, Schmitt HJ, eds. The TBE Book<\/em>. 9th ed. Singapore: Global Health Press; 2026. doi:10.33442\/26613980_13-10-9<\/p>\n\n\n\n

References<\/h3>\n\n\n\n
    \n
  1. Health Board of Estonia. [Nakkushaiguste esinemine ja immunoprof\u00fclaktika]. 2022. Accessed 9 April, 2024. <\/li>\n\n\n\n
  2. https:\/\/www.terviseamet.ee\/sites\/default\/files\/Nakkushaigused\/Haigestumine\/epid_ulevaade_2022_0.pdf<\/a>Katargina O, Russakova S, Geller J et al. Detection and characterization of tick-borne encephalitis virus in Baltic countries and Eastern Poland. PLoS One<\/em>. 2013;8(5):e61375<\/li>\n\n\n\n
  3. Geller J, Vikentjeva M. [Ticks as disease carriers in the green areas of Tallinn and the surrounding area]. 2020. Accessed 30 March, 2024. https:\/\/www.tai.ee\/sites\/default\/files\/2021-03\/159852954118_Pealinna%20rohealade%20puugid%20ja%20puugihaigused.pdf<\/a><\/li>\n\n\n\n
  4. Vikentjeva M, Geller J. Linnapuugid 2023 \u2013 puukide levimus ja puugihaiguste oht Eesti linnade avalikel haljasaladel. Tervise Arengu Instituut. 2023. Accessed 30 March 2024. https:\/\/tai.ee\/sites\/default\/files\/2023-09\/Linnapuugid_2023.pdf<\/a><\/li>\n<\/ol>\n<\/span>","protected":false},"excerpt":{"rendered":"

    TBE in Estonia Kuulo Kutsar E-CDC risk status: endemic (last edited in June 2026, update for 2024: 138 reported cases; update for 2025: 143 reported cases) History and current situation The first cases of tick-borne encephalitis (TBE) in Estonia were identified in 1949. Today, Estonia is a  TBE- endemic country. A TBE-endemic area in Estonia is defined as an area with circulation of the TBEV between ticks and vertebrate hosts as determined by detection of the TBEV or the demonstration of autochthonous infections in humans or animals within the last 20 years. Euro-Asian genotypes of TBEV \u2013 the Western or European (TBEV-EU), Siberian (TBEV-Sib), and Far-Eastern (TBEV-FE) subtypes are co-circulating in Estonia. Vectors of TBEV, the tick species Ixodes ricinus and Ixodes persulcatus, are distributed throughout the country. The high-risk season for infection coincides with the period of biological activity of ticks and lasts for 7 months from April to November, peaking in June to August. Most TBE cases are diagnosed in persons \u226560 years of age and the incidence among the rural population is 1.8 times higher than among the urban population. Overview of TBE in Estonia Table 1: TBE in Estonia Viral subtypes, distribution Co-circulation of European (TBEV-EU), Far-Eastern (TBEV-FE), and Siberian (TBEV-Sib) subtypes Reservoir animals Rodents, ruminants, game Infected tick species (%) 2011: I. persulcatus 8%, I. ricinus on mainland 0.6% \u2013 0.8% and Saaremaa 3.0%.2013: Estonia: I. persulcatus 4.23%, I. ricinus 0.42%.2018: Tallinn 0.44% – 2.7% 2023: Estonia 1.1% – 8.3%: Valga county 6.1% and Viljandi county 8.3%. Dairy product transmission Documented but rare Mandatory TBE reporting Reporting: neurologists, infectious disease specialist Case definitionClinical criteria: a person with symptoms of the central nervous system (meningitis, meningoencephalitis, encephalomyelitis, encephaloradiculitis) Laboratory criteria for case confirmation: At least 1 of the following:– TBE-specific IgM and IgG antibodies in blood– TBE-specific IgM antibodies in CSF– Seroconversion of 4-fold increase of TBE-specific antibodies in paired serum samples– Detection of TBE viral nucleic acid in a clinical specimen– Isolation of TBEV from clinical specimens. Probable case: detection of TBE-specific IgM antibodies in a unique serum sample Epidemiological criteriaExposure to a common source (unpasteurized dairy product). Case classification:– Possible case: not applicable– Probable case: a person meeting the clinical criteria and the laboratory criteria for a probable case OR a person meeting the clinical criteria and with an epidemiological link– Confirmed case: a person meeting the clinical and laboratory criteria for case confirmation Other TBE surveillance Laboratory and epidemiological surveillance Special clinical features Biphasic disease: meningitis, meningoencephalitis, or meningoencephalomyelitis. Risk groups: people who often spend time outdoors (in nature) Available vaccines ENCEPUR CHILDREN, ENCEPUR ADULTS, TICOVAC CHILDREN, TICOVAC ADULTS (Table 2) Vaccination recommendations and reimbursement Vaccination recommendations 1998. No reimbursement; self-paid Vaccine uptake by age group\/risk group\/general population Vaccine uptake by general population (vaccinated and revaccinated): 2018 \u2013 3.1%; 2019 \u2013 3.7%; 2020 \u2013 3.4%; 2021 \u2013 2.6%, 2022 \u2013 4,1%, 2023 \u2013 5,8%. (Table 2) Name, address\/website of TBE National Reference Center Health Board, Tallinn Paldiski St 81; https:\/\/www.terviseamet.ee Table 2: TBE vaccination by age in Estonia, 2022 Source data Figure 1: Age and gender distribution of TBE cases in Estonia, 2023. Update for 2025: 143 reported cases. Source data TBE seasonality: case numbers, Estonia 2023 January \u2013 1, February \u2013 1, March \u2013 0, April \u2013 0 , May \u2013 3 , June \u2013 20 , July \u2013 19, August \u2013 49, September \u2013 45, October \u2013 56, November \u2013 11, December \u2013 4 cases TBE total cases 209 and incidence 15.6 per 100 000 population in Estonia 2023 Figure 2: Age distribution of TBE in Estonia, 2005\u20132023 Source data Figure 3: Sites of TBEV-infection in Estonia, 2023 Source data Contact Kuulo Kutsarkkutsar@hotmail.com Author Kuulo Kutsar Citation Kutsar K. TBE in Estonia. Chapter 13. In: Dobler G, Erber W, Br\u00f6ker M, Chitimia-Dobler L, Schmitt HJ, eds. The TBE Book. 9th ed. Singapore: Global Health Press; 2026. doi:10.33442\/26613980_13-10-9 References<\/p>\n","protected":false},"author":1409,"featured_media":12828,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[45],"tags":[],"coauthors":[652],"class_list":["post-21943","post","type-post","status-publish","format-standard","has-post-thumbnail","category-tbe-countries-estonia"],"yoast_head":"\nEstonia - TBE Book<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/tbenews.com\/tbe\/13-10-9\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Estonia - TBE Book\" \/>\n<meta property=\"og:description\" content=\"TBE in Estonia Kuulo Kutsar E-CDC risk status: endemic (last edited in June 2026, update for 2024: 138 reported cases; update for 2025: 143 reported cases) History and current situation The first cases of tick-borne encephalitis (TBE) in Estonia were identified in 1949. Today, Estonia is a  TBE- endemic country. A TBE-endemic area in Estonia is defined as an area with circulation of the TBEV between ticks and vertebrate hosts as determined by detection of the TBEV or the demonstration of autochthonous infections in humans or animals within the last 20 years. Euro-Asian genotypes of TBEV \u2013 the Western or European (TBEV-EU), Siberian (TBEV-Sib), and Far-Eastern (TBEV-FE) subtypes are co-circulating in Estonia. Vectors of TBEV, the tick species Ixodes ricinus and Ixodes persulcatus, are distributed throughout the country. The high-risk season for infection coincides with the period of biological activity of ticks and lasts for 7 months from April to November, peaking in June to August. Most TBE cases are diagnosed in persons \u226560 years of age and the incidence among the rural population is 1.8 times higher than among the urban population. Overview of TBE in Estonia Table 1: TBE in Estonia Viral subtypes, distribution Co-circulation of European (TBEV-EU), Far-Eastern (TBEV-FE), and Siberian (TBEV-Sib) subtypes Reservoir animals Rodents, ruminants, game Infected tick species (%) 2011: I. persulcatus 8%, I. ricinus on mainland 0.6% \u2013 0.8% and Saaremaa 3.0%.2013: Estonia: I. persulcatus 4.23%, I. ricinus 0.42%.2018: Tallinn 0.44% – 2.7% 2023: Estonia 1.1% – 8.3%: Valga county 6.1% and Viljandi county 8.3%. Dairy product transmission Documented but rare Mandatory TBE reporting Reporting: neurologists, infectious disease specialist Case definitionClinical criteria: a person with symptoms of the central nervous system (meningitis, meningoencephalitis, encephalomyelitis, encephaloradiculitis) Laboratory criteria for case confirmation: At least 1 of the following:– TBE-specific IgM and IgG antibodies in blood– TBE-specific IgM antibodies in CSF– Seroconversion of 4-fold increase of TBE-specific antibodies in paired serum samples– Detection of TBE viral nucleic acid in a clinical specimen– Isolation of TBEV from clinical specimens. Probable case: detection of TBE-specific IgM antibodies in a unique serum sample Epidemiological criteriaExposure to a common source (unpasteurized dairy product). Case classification:– Possible case: not applicable– Probable case: a person meeting the clinical criteria and the laboratory criteria for a probable case OR a person meeting the clinical criteria and with an epidemiological link– Confirmed case: a person meeting the clinical and laboratory criteria for case confirmation Other TBE surveillance Laboratory and epidemiological surveillance Special clinical features Biphasic disease: meningitis, meningoencephalitis, or meningoencephalomyelitis. Risk groups: people who often spend time outdoors (in nature) Available vaccines ENCEPUR CHILDREN, ENCEPUR ADULTS, TICOVAC CHILDREN, TICOVAC ADULTS (Table 2) Vaccination recommendations and reimbursement Vaccination recommendations 1998. No reimbursement; self-paid Vaccine uptake by age group\/risk group\/general population Vaccine uptake by general population (vaccinated and revaccinated): 2018 \u2013 3.1%; 2019 \u2013 3.7%; 2020 \u2013 3.4%; 2021 \u2013 2.6%, 2022 \u2013 4,1%, 2023 \u2013 5,8%. (Table 2) Name, address\/website of TBE National Reference Center Health Board, Tallinn Paldiski St 81; https:\/\/www.terviseamet.ee Table 2: TBE vaccination by age in Estonia, 2022 Source data Figure 1: Age and gender distribution of TBE cases in Estonia, 2023. Update for 2025: 143 reported cases. Source data TBE seasonality: case numbers, Estonia 2023 January \u2013 1, February \u2013 1, March \u2013 0, April \u2013 0 , May \u2013 3 , June \u2013 20 , July \u2013 19, August \u2013 49, September \u2013 45, October \u2013 56, November \u2013 11, December \u2013 4 cases TBE total cases 209 and incidence 15.6 per 100 000 population in Estonia 2023 Figure 2: Age distribution of TBE in Estonia, 2005\u20132023 Source data Figure 3: Sites of TBEV-infection in Estonia, 2023 Source data Contact Kuulo Kutsarkkutsar@hotmail.com Author Kuulo Kutsar Citation Kutsar K. TBE in Estonia. Chapter 13. In: Dobler G, Erber W, Br\u00f6ker M, Chitimia-Dobler L, Schmitt HJ, eds. The TBE Book. 9th ed. Singapore: Global Health Press; 2026. doi:10.33442\/26613980_13-10-9 References\" \/>\n<meta property=\"og:url\" content=\"https:\/\/tbenews.com\/tbe\/13-10-9\/\" \/>\n<meta property=\"og:site_name\" content=\"TBE Book\" \/>\n<meta property=\"article:published_time\" content=\"2026-06-24T03:17:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-06-24T07:36:25+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/09\/Estonia.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1180\" \/>\n\t<meta property=\"og:image:height\" content=\"250\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"IT\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"IT\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/13-10-9\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/13-10-9\\\/\"},\"author\":{\"name\":\"IT\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/#\\\/schema\\\/person\\\/6dd4b733e0a9724f047e3b700d0995f6\"},\"headline\":\"Estonia\",\"datePublished\":\"2026-06-24T03:17:00+00:00\",\"dateModified\":\"2026-06-24T07:36:25+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/13-10-9\\\/\"},\"wordCount\":686,\"publisher\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/13-10-9\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/wp-content\\\/uploads\\\/2017\\\/09\\\/Estonia.jpg\",\"articleSection\":[\"Estonia\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/13-10-9\\\/\",\"url\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/13-10-9\\\/\",\"name\":\"Estonia - 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TBE Book","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/tbenews.com\/tbe\/13-10-9\/","og_locale":"en_US","og_type":"article","og_title":"Estonia - TBE Book","og_description":"TBE in Estonia Kuulo Kutsar E-CDC risk status: endemic (last edited in June 2026, update for 2024: 138 reported cases; update for 2025: 143 reported cases) History and current situation The first cases of tick-borne encephalitis (TBE) in Estonia were identified in 1949. Today, Estonia is a  TBE- endemic country. A TBE-endemic area in Estonia is defined as an area with circulation of the TBEV between ticks and vertebrate hosts as determined by detection of the TBEV or the demonstration of autochthonous infections in humans or animals within the last 20 years. Euro-Asian genotypes of TBEV \u2013 the Western or European (TBEV-EU), Siberian (TBEV-Sib), and Far-Eastern (TBEV-FE) subtypes are co-circulating in Estonia. Vectors of TBEV, the tick species Ixodes ricinus and Ixodes persulcatus, are distributed throughout the country. The high-risk season for infection coincides with the period of biological activity of ticks and lasts for 7 months from April to November, peaking in June to August. Most TBE cases are diagnosed in persons \u226560 years of age and the incidence among the rural population is 1.8 times higher than among the urban population. Overview of TBE in Estonia Table 1: TBE in Estonia Viral subtypes, distribution Co-circulation of European (TBEV-EU), Far-Eastern (TBEV-FE), and Siberian (TBEV-Sib) subtypes Reservoir animals Rodents, ruminants, game Infected tick species (%) 2011: I. persulcatus 8%, I. ricinus on mainland 0.6% \u2013 0.8% and Saaremaa 3.0%.2013: Estonia: I. persulcatus 4.23%, I. ricinus 0.42%.2018: Tallinn 0.44% – 2.7% 2023: Estonia 1.1% – 8.3%: Valga county 6.1% and Viljandi county 8.3%. Dairy product transmission Documented but rare Mandatory TBE reporting Reporting: neurologists, infectious disease specialist Case definitionClinical criteria: a person with symptoms of the central nervous system (meningitis, meningoencephalitis, encephalomyelitis, encephaloradiculitis) Laboratory criteria for case confirmation: At least 1 of the following:– TBE-specific IgM and IgG antibodies in blood– TBE-specific IgM antibodies in CSF– Seroconversion of 4-fold increase of TBE-specific antibodies in paired serum samples– Detection of TBE viral nucleic acid in a clinical specimen– Isolation of TBEV from clinical specimens. Probable case: detection of TBE-specific IgM antibodies in a unique serum sample Epidemiological criteriaExposure to a common source (unpasteurized dairy product). Case classification:– Possible case: not applicable– Probable case: a person meeting the clinical criteria and the laboratory criteria for a probable case OR a person meeting the clinical criteria and with an epidemiological link– Confirmed case: a person meeting the clinical and laboratory criteria for case confirmation Other TBE surveillance Laboratory and epidemiological surveillance Special clinical features Biphasic disease: meningitis, meningoencephalitis, or meningoencephalomyelitis. Risk groups: people who often spend time outdoors (in nature) Available vaccines ENCEPUR CHILDREN, ENCEPUR ADULTS, TICOVAC CHILDREN, TICOVAC ADULTS (Table 2) Vaccination recommendations and reimbursement Vaccination recommendations 1998. No reimbursement; self-paid Vaccine uptake by age group\/risk group\/general population Vaccine uptake by general population (vaccinated and revaccinated): 2018 \u2013 3.1%; 2019 \u2013 3.7%; 2020 \u2013 3.4%; 2021 \u2013 2.6%, 2022 \u2013 4,1%, 2023 \u2013 5,8%. (Table 2) Name, address\/website of TBE National Reference Center Health Board, Tallinn Paldiski St 81; https:\/\/www.terviseamet.ee Table 2: TBE vaccination by age in Estonia, 2022 Source data Figure 1: Age and gender distribution of TBE cases in Estonia, 2023. Update for 2025: 143 reported cases. Source data TBE seasonality: case numbers, Estonia 2023 January \u2013 1, February \u2013 1, March \u2013 0, April \u2013 0 , May \u2013 3 , June \u2013 20 , July \u2013 19, August \u2013 49, September \u2013 45, October \u2013 56, November \u2013 11, December \u2013 4 cases TBE total cases 209 and incidence 15.6 per 100 000 population in Estonia 2023 Figure 2: Age distribution of TBE in Estonia, 2005\u20132023 Source data Figure 3: Sites of TBEV-infection in Estonia, 2023 Source data Contact Kuulo Kutsarkkutsar@hotmail.com Author Kuulo Kutsar Citation Kutsar K. TBE in Estonia. Chapter 13. In: Dobler G, Erber W, Br\u00f6ker M, Chitimia-Dobler L, Schmitt HJ, eds. The TBE Book. 9th ed. 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