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[Tick-borne meningoencephalitis in Thurgau Canton: a clinical and epidiomological analysis]
M Schwanda1, S Oertli, B Frauchiger
1Medizinische Klinik, Kantonsspital Münsterlingen.
Background:
Tick-borne meningo-encephalitis (TBE) is caused by a flavivirus species that is transmitted from rodents to humans by Ixodes ticks. The clinical picture of central nervous system involvement varies from febrile headache to lethal encephalitis. To date no specific treatment exists, although protective active immunisation is available.
Methods:
We present the clinical and epidemiological data from 73 patients with TBE who acquired the infection in Canton Thurgau in the years 1996-1999.
Results:
Canton Thurgau is a state in eastern Switzerland with a population of 230,000. Within the last five years the reported cases of TBE have increased more than threefold. The area where infectious tick bites were registered has expanded from the western to the eastern part and now encompasses the entire state. The risk of infection is clearly related to frequent activities in wooded areas, though outdoor activities not in forests also carry a considerable risk. In > 80% of the cases a postviral neurasthenic syndrome develops involving absence from work for two months on average. In the elderly and patients who present with encephalitic symptoms, a worse outcome with persistent neurological symptoms or even death has been observed.
Conclusion:
The increasing incidence of TBE, the expansion of infectious ticks to the east and high morbidity justify active immunisation against TBE on a broad scale in Canton Thurgau.
Insights
Tick-borne meningoencephalitis (TBE) cases have significantly increased in Canton Thurgau, Switzerland. Broad-scale active immunization is recommended due to expanding tick ranges and high disease morbidity.
Area of Science:
- Epidemiology
- Virology
- Public Health
Context:
- Tick-borne meningoencephalitis (TBE) is a significant public health concern in Europe.
- The flavivirus is transmitted by Ixodes ticks, with varied clinical presentations from mild headache to severe encephalitis.
- No specific antiviral treatment is currently available, highlighting the importance of preventative measures.
Purpose:
- To analyze the clinical and epidemiological data of TBE cases in Canton Thurgau, Switzerland, between 1996 and 1999.
- To assess the changing incidence and geographical spread of TBE within the region.
- To evaluate the morbidity associated with TBE and inform public health strategies.
Summary:
- TBE incidence in Canton Thurgau has more than tripled in five years, with infectious tick ranges expanding eastward.
- Risk is associated with outdoor activities, particularly in wooded areas, but also in non-forest environments.
- Over 80% of patients develop a post-viral neurasthenic syndrome, leading to an average of two months of work absence. Severe outcomes, including persistent neurological deficits and death, are observed in the elderly and those with encephalitic symptoms.
Impact:
- The findings underscore the urgent need for widespread active immunization against TBE in Canton Thurgau.
- Increased awareness and preventative measures are crucial given the expanding risk areas and high disease burden.
- This study provides critical data for public health policy regarding TBE prevention and control in endemic regions.