The TBE Book

Book excerpt: While the number of vector-borne diseases and their incidence in Europe is much less than in tropical and/or developing countries, there are nevertheless a substantial number of such infections in Europe. The most important one is the zoonotic arbovirus infection Tick-Borne Encephalitis (TBE), a virus transmitted to humans by ticks or by consumption of unpasteurized dairy products from infected cows, goats, or sheep. TBE is endemic in the non-tropical Eurasian forest belt with most cases occurring in Russia and in central and eastern parts of Europe. In endemic areas, TBE is one of the most important causes of viral meningitis/encephalitis and a major public health concern. Moreover, TBE is becoming more and more frequent in Europe due to the appearance of new endemic areas and increasing awareness. However, it might be difficult to diagnose TBE, because clinical manifestations tend to be relatively nonspecific. Although a standardized case definition across the European Union has existed now for a few years, national implementation of TBE programs, including regular screening and diagnosis, are done in only very few countries. Therefore, wide differences in the intensity and quality of national surveillance of TBE cases still exist, and the true burden of disease and the areas with circulation of the TBE viral subtypes in Europe and Asia are not fully known. Moreover, although safe and effective vaccines are available, vaccination uptake in most endemic countries is too low to reduce the TBE burden significantly. The authors of “The TBE Book’ therefore have tried to compile in this “working book” the most recent and relevant aspects of TBE.