Recommendations to Improve Tick-Borne Encephalitis Surveillance and Vaccine Uptake in Europe.

There has been an increase in reported TBE cases in Europe since 2015, reaching a peak in some countries in 2020, highlighting the need for better management of TBE risk in Europe. TBE surveillance is currently limited, in part, due to varying diagnostic guidelines, access to testing, and awareness of TBE. Consequently, TBE prevalence is underestimated and vaccination recommendations inadequate. TBE vaccine uptake is unsatisfactory in many TBE-endemic European countries. This review summarizes the findings of a scientific workshop of experts to improve TBE surveillance and vaccine uptake in Europe. Strategies to improve TBE surveillance and vaccine uptake should focus on: aligning diagnostic criteria and testing across Europe; expanding current vaccine recommendations and reducing their complexity; and increasing public education of the potential risks posed by TBEV infection.

Phylogenetic analysis of tick-borne encephalitis virus strains found in an engorged tick and traveler returning from Russia.

Although travel-related tick-borne encephalitis (TBE) cases have been increasingly registered worldwide, very few published case studies are available to date. The present report describes a travel-related TBE case and provides genotypic characterization of two viral isolates. Laboratory diagnostics were based on complement fixation test and virus isolation. This report is unique because the TBE case was first confirmed by virus isolation from the engorged tick and only later from the patient's blood. Moreover, this case demonstrated a successful prophylaxis performed on day 8 post tick exposure although it is generally recommended that anti-TBEV immunoglobulins should be administered not later than on day 4 after tick bite. Sequences of E protein gene fragments were used to phylogenetically characterize the two isolates. The results demonstrated that both viral isolates belonged to clusteron 3A (Zausaev group) of the Asian lineage of the TBEV Siberian subtype. The synonymous nucleotide substitution, C351 T, was identified in E protein gene fragments of TBEV 88 and TBEV 89, which could have been induced by virus transmission. A few important take-home messages can be gleaned from the reported case. First, travelers should be aware of TBE endemic areas that they plan to visit and be proactive when exposed to Ixodes ticks. Second, medical practitioners should always consider travel history and potential tick exposure of patients. Lastly, engorged Ixodes spp. ticks removed from the patients, who have arrived from endemic areas, should be tested for TBEV even in the absence of TBE clinical signs.

Partial Characterization of Tick-Borne Encephalitis Virus Isolates from Ticks of Southern Ukraine.

Tick-borne encephalitis (TBE) is the most common tick-borne viral infection in Eurasia; thousands of human cases are annually reported from several European countries. Several tick species are vectors of the tick-borne encephalitis virus (TBEV), while TBE appears to be spreading from the Eurasian continent westward to Europe. Fifteen study sites were chosen from five territories of southern Ukraine, including Odessa, Mykolaiv, Kherson Oblast, the Autonomous Republic of Crimea, and Sevastopol. Tick collection was performed in spring season of three consecutive years (1988-1990) using either flagging technique or direct collection of specimens feeding on cattle. A total of 15,243 tick imagoes and nymphs were collected from nine species, including Dermacentor marginatus, D. reticulatus, Haemaphysalis parva, H. punctata, Hyalomma marginatum, Ixodes ricinus, Rhipicephalus bursa, R. rossicus, and R. sanguineus, pooled in 282 monospecific samples. Supernatant of grinded pool was used for inoculation to suckling mice for virus isolation. Eight TBEV isolates were identified from ticks among six study sites. Ticks showed a minimum infection rate from 0.11% to 0.81%. Phylogenetic analysis of the envelope (E) protein gene of seven isolates, assigned all to the European subtype (TBEV-Eu) showing a maximum identity of 97.17% to the "Pan" TBEV-Eu reference strain. Compared to 104 TBEV-Eu isolates they clustered within the same clade as the Pan reference strain and distinguished from other TBEV-Eu isolates. Amino acid sequence analysis of the South Ukrainian TBEV-Eu isolates revealed the presence of four amino acid substitutions 67 (N), 266 (R), 306 (V), and 407 (R), in the ectodomains II and III and in the stem-anchor region of the E protein gene. This study confirmed TBEV-Eu subtype distribution in the southern region of Ukraine, which eventually overlaps with TBEV-FE (Far Eastern subtype) and TBEV-Sib (Siberian subtype) domains, showing the heterogeneity of TBEV circulating in Ukraine.

Natural foci diseases as a stable biological threat.

The key aspects of the natural foci of especially dangerous diseases as a type of biological threats are presented. Approaches to epidemiological surveillance and control to the spread of the agents of especially dangerous diseases on endemic areas are described for zoonosis that has a medical value. The knowledge of specific design of tools for the implementation of epidemiological surveillance, monitoring and evaluation of natural foci diseases in developing countries is low; accordingly, little is known on the ecology and transmission dynamics for the agents of especially dangerous diseases. Important is to know the effectiveness of serological monitoring of the indigenous population to determine the activity of natural foci of hemorrhagic fever with renal syndrome, tick-borne encephalitis, tularemia, Q-fever, Lyme disease and West Nile disease. The main species of reservoirs and vectors for these agents have been determined in different regions of Ukraine. New tick-borne agents that were unknown for certain regions have been detected. These data indicate the spreading of different pathogens in combination with natural foci.