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Albinsson B, Hoffman T, Kolstad L, Bergström T, Bogdanovic G, Heydecke A, Hägg M, Kjerstadius T, Lindroth Y, Petersson A, Stenberg M, Vene S, Ellström P, Rönnberg B, Lundkvist Å. Seroprevalence of tick-borne encephalitis virus and vaccination coverage of tick-borne encephalitis, Sweden, 2018 to 2019. Euro Surveill 2024; 29:2300221. [PMID: 38214080 PMCID: PMC10785208 DOI: 10.2807/1560-7917.es.2024.29.2.2300221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/07/2023] [Indexed: 01/13/2024] Open
Abstract
BackgroundIn Sweden, information on seroprevalence of tick-borne encephalitis virus (TBEV) in the population, including vaccination coverage and infection, is scattered. This is largely due to the absence of a national tick-borne encephalitis (TBE) vaccination registry, scarcity of previous serological studies and use of serological methods not distinguishing between antibodies induced by vaccination and infection. Furthermore, the number of notified TBE cases in Sweden has continued to increase in recent years despite increased vaccination.AimThe aim was to estimate the TBEV seroprevalence in Sweden.MethodsIn 2018 and 2019, 2,700 serum samples from blood donors in nine Swedish regions were analysed using a serological method that can distinguish antibodies induced by vaccination from antibodies elicited by infection. The regions were chosen to reflect differences in notified TBE incidence.ResultsThe overall seroprevalence varied from 9.7% (95% confidence interval (CI): 6.6-13.6%) to 64.0% (95% CI: 58.3-69.4%) between regions. The proportion of vaccinated individuals ranged from 8.7% (95% CI: 5.8-12.6) to 57.0% (95% CI: 51.2-62.6) and of infected from 1.0% (95% CI: 0.2-3.0) to 7.0% (95% CI: 4.5-10.7). Thus, more than 160,000 and 1,600,000 individuals could have been infected by TBEV and vaccinated against TBE, respectively. The mean manifestation index was 3.1%.ConclusionA difference was observed between low- and high-incidence TBE regions, on the overall TBEV seroprevalence and when separated into vaccinated and infected individuals. The estimated incidence and manifestation index argue that a large proportion of TBEV infections are not diagnosed.
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Affiliation(s)
- Bo Albinsson
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- These authors contributed equally to the work and share the first authorship
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
| | - Tove Hoffman
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- These authors contributed equally to the work and share the first authorship
| | - Linda Kolstad
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tomas Bergström
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Gordana Bogdanovic
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Heydecke
- Centre for Research and Development, Uppsala University, Region Gävleborg, Gävle, Sweden
| | - Mirja Hägg
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Ylva Lindroth
- Department of Laboratory Medicine, Medical Microbiology, Lund University, Skåne Laboratory Medicine, Lund, Sweden
| | - Annika Petersson
- Department of Clinical Chemistry and Transfusion Medicine, Växjö Central Hospital, Växjö, Sweden
| | - Marie Stenberg
- Laboratory Medical Center Gotland, Visby hospital, Visby, Sweden
| | - Sirkka Vene
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Patrik Ellström
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
- Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Bengt Rönnberg
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
| | - Åke Lundkvist
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
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Lamsal A, Edgar KS, Jenkins A, Renssen H, Kjaer LJ, Alfsnes K, Bastakoti S, Dieseth M, Klitgaard K, Lindstedt HEH, Paulsen KM, Vikse R, Korslund L, Kjelland V, Stuen S, Kjellander P, Christensson M, Teräväinen M, Jensen LM, Regmi M, Giri D, Marsteen L, Bødker R, Soleng A, Andreassen ÅK. Prevalence of tick-borne encephalitis virus in questing Ixodes ricinus nymphs in southern Scandinavia and the possible influence of meteorological factors. Zoonoses Public Health 2023; 70:473-484. [PMID: 37248739 DOI: 10.1111/zph.13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/25/2023] [Accepted: 05/06/2023] [Indexed: 05/31/2023]
Abstract
Ixodes ricinus ticks are Scandinavia's main vector for tick-borne encephalitis virus (TBEV), which infects many people annually. The aims of the present study were (i) to obtain information on the TBEV prevalence in host-seeking I. ricinus collected within the Øresund-Kattegat-Skagerrak (ØKS) region, which lies in southern Norway, southern Sweden and Denmark; (ii) to analyse whether there are potential spatial patterns in the TBEV prevalence; and (iii) to understand the relationship between TBEV prevalence and meteorological factors in southern Scandinavia. Tick nymphs were collected in 2016, in southern Scandinavia, and screened for TBEV, using pools of 10 nymphs, with RT real-time PCR, and positive samples were confirmed with pyrosequencing. Spatial autocorrelation and cluster analysis was performed with Global Moran's I and SatScan to test for spatial patterns and potential local clusters of the TBEV pool prevalence at each of the 50 sites. A climatic analysis was made to correlate parameters such as minimum, mean and maximum temperature, relative humidity and saturation deficit with TBEV pool prevalence. The climatic data were acquired from the nearest meteorological stations for 2015 and 2016. This study confirms the presence of TBEV in 12 out of 30 locations in Denmark, where six were from Jutland, three from Zealand and two from Bornholm and Falster counties. In total, five out of nine sites were positive from southern Sweden. TBEV prevalence of 0.7%, 0.5% and 0.5%, in nymphs, was found at three sites along the Oslofjord (two sites) and northern Skåne region (one site), indicating a potential concern for public health. We report an overall estimated TBEV prevalence of 0.1% in questing I. ricinus nymphs in southern Scandinavia with a region-specific prevalence of 0.1% in Denmark, 0.2% in southern Sweden and 0.1% in southeastern Norway. No evidence of a spatial pattern or local clusters was found in the study region. We found a strong correlation between TBEV prevalence in ticks and relative humidity in Sweden and Norway, which might suggest that humidity has a role in maintaining TBEV prevalence in ticks. TBEV is an emerging tick-borne pathogen in southern Scandinavia, and we recommend further studies to understand the TBEV transmission potential with changing climate in Scandinavia.
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Affiliation(s)
- Alaka Lamsal
- Department of Natural Science and Environmental Health, The University of South-Eastern Norway, Bø, Norway
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristin Skarsfjord Edgar
- Department of Pest Control, Norwegian Institute of Public Health, Oslo, Norway
- Department of Microbiology, Norwegian Veterinary Institute, Ås, Norway
| | - Andrew Jenkins
- Department of Natural Science and Environmental Health, The University of South-Eastern Norway, Bø, Norway
| | - Hans Renssen
- Department of Natural Science and Environmental Health, The University of South-Eastern Norway, Bø, Norway
| | - Lene Jung Kjaer
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Kristian Alfsnes
- Department of Bacteriology, Norwegian Institute of Public Health, Oslo, Norway
| | - Srijana Bastakoti
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Malene Dieseth
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Kirstine Klitgaard
- Department for Diagnostics and Scientific Advice, National Veterinary Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - Katrine M Paulsen
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Rose Vikse
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars Korslund
- Department of Natural Sciences, University of Agder, Kristiansand, Norway
| | - Vivian Kjelland
- Department of Natural Sciences, University of Agder, Kristiansand, Norway
- Research Unit, Sørlandet Hospital Health Enterprise, Kristiansand, Norway
| | - Snorre Stuen
- Department of Production Animal Clinical Sciences, Section of Small Ruminant Research, Norwegian University of Life Sciences, Sandnes, Norway
| | - Petter Kjellander
- Department of Ecology, Grimsö Wildlife Research Station, Swedish University of Agricultural Sciences, Riddarhyttan, Sweden
| | - Madeleine Christensson
- Department of Ecology, Grimsö Wildlife Research Station, Swedish University of Agricultural Sciences, Riddarhyttan, Sweden
| | - Malin Teräväinen
- Department of Ecology, Grimsö Wildlife Research Station, Swedish University of Agricultural Sciences, Riddarhyttan, Sweden
| | - Laura Mark Jensen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Manoj Regmi
- Department of Data Science, Kristiania University College, Oslo, Norway
| | - Dhiraj Giri
- School of Arts, Kathmandu University, Dhulikhel, Nepal
| | | | - René Bødker
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Arnulf Soleng
- Department of Pest Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Åshild Kristine Andreassen
- Department of Natural Science and Environmental Health, The University of South-Eastern Norway, Bø, Norway
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
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Abstract
Powassan virus is an increasingly recognized cause of severe encephalitis that is transmitted by Ixodes ticks. Given the nonspecific clinical, laboratory, and imaging features of Powassan virus disease, providers should consider it in patients with compatible exposures and request appropriate testing.
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Affiliation(s)
- Anne Piantadosi
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA; Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
| | - Isaac H Solomon
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, AL360U.2, Boston, MA 02115, USA
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Wang H, Zhao S, Wang S, Zheng Y, Wang S, Chen H, Pang J, Ma J, Yang X, Chen Y. Global magnitude of encephalitis burden and its evolving pattern over the past 30 years. J Infect 2022; 84:777-787. [PMID: 35452715 DOI: 10.1016/j.jinf.2022.04.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/01/2022] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We aimed to estimate the spatiotemporal patterns of the encephalitis burden along with its attributable risk factors at the national, regional, and global levels, which may be helpful in guiding targeted prevention and treatment programs. METHODS Based on available data sources, the incidence, mortality, and disability-adjusted life years (DALYs) of encephalitis in 204 countries and regions from 1990 to 2019 were reconstructed by the Global Burden of Disease Study 2019 using the Cause of Death Ensemble model, spatiotemporal Gaussian process regression, and DisMod-MR 2.1. We conducted a systematic analysis on the epidemiological characteristics of encephalitis in detail by gender, region, and age over the past three decades. RESULTS Globally, 1,444,720 incident cases, 89,900 deaths, and 4.80 million DALYs related to encephalitis were estimated in 2019. The age-standardized incidence rate and age-standardized mortality rate (ASMR) decreased from 23.17 and 2.18 to 19.33 and 1.19 per 100,000 person-years over the past 30 years, respectively. However, beginning in 2011-2013, the burden of encephalitis has shown an inflection point, with a further decline of the ASRs ceasing. Lower socio-demographic index (SDI) regions in South Asia, Western and Eastern Sub-Saharan Africa had the highest burden of encephalitis in 2019. During the past three decades, most countries of South Asia achieved significant control of the burden. In contrast, developed countries with a higher SDI have shown a notable increase in ASMR and age-standardized DALYs rate. Children and older adults have always been high-risk groups for encephalitis. CONCLUSION Although the global burden of encephalitis has decreased in the past 30 years, a further decline stopped from 2011-2013. The diverse burden in different regions calls for differentiated management, and the persistent high burden in some low-SDI regions and the increased burden in developed countries with higher SDIs deserve more attention. ABBREVIATIONS ASDR: age-standardized DALY rate, ASIR: age-standardized incidence rate, ASMR: age-standardized mortality rate, ASR: age-standardized rate, CI: confidence interval, DALY: disability-adjusted life-year, EAPC: estimated annual percentage change, GBD: Global Burden of Disease Study, HAP: household air pollution from solid fuels, HSE: herpes simplex encephalitis, HSV: herpes simplex virus, ICD: International Classification of Diseases, JE: Japanese encephalitis, PCR: polymerase chain reaction, SDI: socio-demographic index, TBE: tick-borne encephalitis, UI: uncertainty interval.
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Affiliation(s)
- Hao Wang
- Department of Critical Care Medicine, Qilu Hospital, Shandong University, Jinan, China; Department of Pharmacology, School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Shaohua Zhao
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, Jinan, China; Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Shandong University, Jinan, China
| | - Shengjun Wang
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yue Zheng
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China; Qilu Hospital, Cheeloo College of Medicine, Clinical Research Center of Shandong University, Shandong University, Jinan, China
| | - Shaohua Wang
- Department of Internal Medicine, Jinan Hospital, Jinan, China
| | - Hui Chen
- Qilu Hospital, Cheeloo College of Medicine, Clinical Research Center of Shandong University, Shandong University, Jinan, China; Clinical Epidemiology Unit, Qilu Hospital, Shandong University, Jinan, China
| | - Jiaojiao Pang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Juan Ma
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, Jinan, China
| | - Xiaorong Yang
- Qilu Hospital, Cheeloo College of Medicine, Clinical Research Center of Shandong University, Shandong University, Jinan, China; Clinical Epidemiology Unit, Qilu Hospital, Shandong University, Jinan, China.
| | - Yuguo Chen
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China; Qilu Hospital, Cheeloo College of Medicine, Clinical Research Center of Shandong University, Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China.
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