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Long-term sequelae after tick-borne encephalitis in Germany: a nationwide claims-based matched cohort study
Guy Levy1, Daniel Gensorowsky2, Jana Diekmannshemke2
1Pfizer Pharma GmbH, Friedrichstraße 110, 10117 Berlin, Germany.
Ticks and Tick-Borne Diseases
|June 17, 2026
Summary
Tick-borne encephalitis (TBE) often leads to neurological issues and increased sick leave, resulting in higher societal costs. This highlights the need for TBE follow-up care and vaccination in Germany.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Tick-borne encephalitis (TBE) is a significant public health concern in Europe.
- Effective vaccines exist, yet real-world data on long-term TBE sequelae are limited.
Purpose of the Study:
- To investigate the frequency, timing, and economic impact of long-term sequelae following TBE.
- To assess neurological, mental, and general sequelae post-TBE in Germany.
Main Methods:
- Retrospective cohort study using German health insurance claims (2013-2023).
- 187 TBE patients matched 1:5 to TBE-free controls.
- Sequelae assessed up to 18 months post-diagnosis/discharge; healthcare utilization and costs compared.
Main Results:
- Neurological sequelae were significantly more common after TBE (IRR 1.56), especially in adults ≥40 and men.
- No significant differences in general or mental sequelae.
- TBE patients incurred higher costs due to excess sick leave and sickness benefits.
Conclusions:
- TBE is linked to excess neurological sequelae, increased sick leave, and higher sickness benefit costs.
- Findings suggest a substantial post-acute clinical and societal burden in Germany.
- Supports the importance of TBE follow-up care and preventive vaccination.
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