-Tick-borne encephalitis (TBE) is a flaviviral infection caused by TBE virus with three subtypes: European, Siberian, and Far Eastern.
-Flaviviruses are positive-sense, single-stranded RNA, icosahedral capsid, enveloped viruses
-The principal reservoirs and vectors for TBE virus are ticks
-The virus is transmitted to humans by ticks.
-Outbreaks happened after ingestion of unpasteurized milk from infected sheep and goat
Symptoms & Signs
-The incubation period is 7–14 days for tick-borne exposures and only 3–4 days for milk ingestion.
-Most cases are subclinical
-The disease is characterized by a biphasic illness.
Fever-myalgia phase: Fever, arthralgia, headaches, nausea
CNS phase: headaches, meningitis, encephalitis, paralysis
-Post-encephalitic syndrome: headaches, balance disorders, fatigue, hearing defects, attention deficits, depression, learning impairment
Labs: leukocytosis, neutrophilia, hyponatremia
PCR: Virus detection by RT-PCR in ticks from TBE patients
ELISA: TBE virus IgM and IgG are detected by ELISA
Treatment is supportive.
Complete recovery in most cases
-There is no available TBE vaccine in the United States
-Effective vaccines are available in Europe, Canada and China