PubMed · 12628808
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C Kunz, F X Heinz. 2003-04-01. Tick-borne encephalitis.. https://doi.org/10.1016/s0264-410x(02)00810-1
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The prospective studies available today confirm the experience gained from several retrospective studies that TBE is a disease with a severe acute clinical course and considerable long-term morbidity. A defined post-encephalitic TBE syndrome exists, causing long-lasting morbidity that often affects the quality of life and sometimes also forces the individual to a change in life-style. The sequelae render high costs for individual patients and the society. Three clinical courses may be identified: one with complete recovery within 2 months, occurring in approximately one fourth of patients, one with protracted, mainly cognitive dysfunction, and one with persisting spinal nerve paralysis with or without other post-encephalitic symptoms. Up to 46% of patients are left with permanent sequelae at long-time follow-up, the most commonly reported residuals being various cognitive or neuropsychiatric complaints, balance disorders, headache, dysphasia, hearing defects, and spinal paralysis. This knowledge enhances the need for continued local epidemiological surveillance of TBE to form a basis for vaccination policies. Even though knowledge of the clinical course of TBE has improved in recent years, there are still several aspects of this disease that warrant further studies. These comprise the clinical picture and prognosis in children, an evaluation of different rehabilitation strategies, and an improved understanding of pathogenic mechanisms to permit the development of antiviral or, maybe more probable, immune modulatory treatment strategies.
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BACKGROUND: Central European encephalitis, caused by the tick-borne encephalitis virus (TBEV), is exceptional in France. Most cases have been described in Alsace. As 2 cases of tick-borne encephalitis were diagnosed in the Nancy region, a seroepidemiological survey was conducted in the Lorraine region (Meurthe & Moselle, Moselle, Vosges, Meuse) in 1996. METHODS: The survey was proposed to approximately 1,000 persons attending preventive medicine clinics. The subjects were asked to fill out a self-administered questionnaire on factors related to tick bite exposure and underwent TBEV serology tests. RESULTS: 1,777 subjects participated in the survey. Half of them lived in rural areas, 91% had occasional or regular contact with the forest environment and 21% had experienced tick bites. TBEV serology (IgG) was positive in 19 subjects (1.6%; 95% CI: 0.9%-2.3%); 9 sera were positive on Western blot (0.76). No IgM positive serum was found. Seroprevalence was higher in subjects with a past history of tick bites compared with the others (2.9% vs 1.3%, p = 0.074). CONCLUSION: The low seroprevalence of TBEV in this survey is not in favor of widespread tick-bite encephalitis virus in the Lorraine general population.