Tick Borne Encephalitis

Tick-borne encephalitis (TBE) is the medically most common tick-borne viral disease in Europe and Asia. The TBE virus (TBEV) is a member of the family Flaviviridae. Transmission mainly to humans occurs by ticks of the Family Ixodidae, mainly the castor bean tick (Ixodes ricinus) in Europe and the taiga tick (Ixodes persulcatus) in Asia. Rarely TBEV is also transmitted by contaminated milk of infected ungulates (goat, sheep, cow). The clinical course of TBE is variable and may range from subclinical to fatal encephalomyelitis. Probably host and viral factors are involved in the pathogenesis of disease. So far, no specific treatment of the disease is available. The only effective prevention of TBE is vaccination. A number of different vaccines are available worldwide. In Europe two vaccines are licensed which contain inactivated European subtype TBEV. Probably the European vaccines protect also against infections with other subtypes of TBEV.

European subtype of tick-borne encephalitis virus. Literature review

This review is devoted to the European subtype of tick-borne encephalitis virus (TBEV). It summarizes and analyzes the information available at the scientific literature on the genetic and biological properties of strains of this virus subtype. A comparative analysis of the complete coding sequences of all currently recognized tick-borne flaviviruses was carried out. It was noted that the differences in TBEV strains included in the European subtype are minimal, which indicates a higher degree of their genetic homogeneity than in strains of the Far Eastern and Siberian subtypes. The level of differences in the genome of strains of the European subtype, depending on the region and the source of isolation, was analyzed. No relationship was found between the level of homology of nucleotide sequences of TBEV strains of the European subtype and the source of isolation. The proposed models for the evolution of TBE are described. The area of TBE of the European subtype in Eurasia is analyzed. The maps of the geographical distribution of the European subtype are presented. It shows the European subtype TBE is found in 14 regions of Russia. TBE of this subtype, as a rule, causes a disease with a milder course in comparison with TBE caused by a virus of the Far Eastern or Siberian subtypes. An analysis of the main vectors and reservoir hosts of the European subtype TBEV in Europe and in Siberia has been carried out. It is emphasized that in Eurasia the European TBEV circulates in territories that differ significantly in climatic conditions, relief, landscape, and characteristics of biotopes. However, analysis of scientific literature data showed that, despite these differences, it has a high degree of genome stability.

Delimitation of the Tick-Borne Flaviviruses. Resolving the Tick-Borne Encephalitis and Louping-Ill Virus Paraphyletic Taxa

The tick-borne flavivirus (TBFV) group contains at least 12 members where five of them are important pathogens of humans inducing diseases with varying severity (from mild fever forms to acute encephalitis). The taxonomy structure of TBFV is not fully clarified at present. In particular, there is a number of paraphyletic issues of tick-borne encephalitis virus (TBEV) and louping-ill virus (LIV). In this study, we aimed to apply different bioinformatic approaches to analyze all available complete genome amino acid sequences to delineate TBFV members at the species level. Results showed that the European subtype of TBEV (TBEV-E) is a distinct species unit. LIV, in turn, should be separated into two species. Additional analysis of the diversity of TBEV and LIV antigenic determinants also demonstrate that TBEV-E and LIV are significantly different from other TBEV subtypes. The analysis of available literature provided data on other virus phenotypic particularities that supported our hypothesis. So, within the TBEV+LIV paraphyletic group, we offer to assign four species to get a more accurate understanding of the TBFV interspecies structure according to the modern monophyletic conception.

TBE in Romania

Based on an epidemiological survey,1 human TBEV neuroinfections may have an endemic emergent course, and natural foci are in full territorial expansion. Identified risk areas are Tulcea district, Transylvania, at the base of the Carpathian Mountains and the Transylvanian Alps.2,3 TBE has been a notifiable disease since 1996. Surveillance of TBE is not done at the country level, only regionally in some counties (northern/central/western part, close to Hungary). The passive surveillance system was implemented in 2008. However, there is no regular screening and the relative risk of contracting this disease is unknown. In 1999, an outbreak of TBE in humans was recorded with a total of at least 38 human cases.4 The probable cause of the outbreak was goat milk and raw goat milk products. Subsequent studies to detect TBEV in ticks in the affected regions resulted in a non -specified number of TBEV isolates, which were described as belonging to the European subtype of TBEV. A publication of the neighboring Republic of Moldova described the existence of the Far-eastern subtype of TBEV just at the border to Romania.5

TBE in Croatia

Even though tick-borne encephalitis (TBE) has been a notifiable disease in Croatia since 2007, there are no or only limited data available on the occurring tick species in the endemic areas, on the prevalence of TBE virus (TBEV) in ticks, its distribution in Croatia, and its genetic characteristics. Reporting of human cases also is very scarce. The Central European subtype of virus (TBEV-EU) appears to be present in Croatia.

TBE in Bulgaria

First cases of probable tick-borne encephalitis (TBE) were reported in 1961 by Andonov et al. in eastern regions of Bulgaria.1 Possible TBE cases with the typical two-wave fever, originating from consumption of raw goat milk, were described back in 1953 by Vaptzarov et al. in southern Bulgaria.2 Investigations in the 1960s were able to isolate 3 tick-borne encephalitis virus (TBEV) strains from Haemaphysalis punctata and 1 from Dermacentor marginatus ticks from goats and sheep in the district of Plovdiv.3 The antigenic properties of these 4 virus strains were identical to the highly virulent strain “Hypr” of the European subtype of TBEV (TBEV-EU).

TBE in Germany

The beginning of research on TBE in Germany was influenced and inspired by the results and developments of TBE research in the former Czechoslovakia. There, TBE virus was detected in the Czechoslovak Republic in 1948. In Germany, the first evidence of the presence of TBE virus was found by Sinnecker and his group in the former German Democratic Republic (GDR).1 The first virus strains were isolated also by Sinnecker’s group in the early 1960s.2 In the former Federal Republic of Germany (FRG) TBE research started with research on TBE virus in the region of Franconia by Scheid and Ackermann.3,4 In the region of Lower Franconia a virus was isolated which was called “Zimmern Virus” after the location of the isolation5. Unfortunately, all these virus strains were lost but it can be assumed that they all belonged to the Western (European) subtype of TBE virus.

Climate, ticks and tick-borne encephalitis in Central Europe.

Tick-borne encephalitis (TBE) is a serious human disease of the central nervous system (CNS) caused by the European subtype of tick-borne encephalitis virus (TBEV) - genus Flavivirus of the family Flaviviridae - in the European area of its distribution. Its major vector is the tick, Ixodes ricinus. This expert opinion discusses the ecology of I. ricinus and the epidemiology of TBE in relation to changing climate in Central Europe.