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Angulo FJ, Zhang P, Halsby K, Kelly P, Pilz A, Madhava H, Moïsi JC, Jodar L. A systematic literature review of the effectiveness of tick-borne encephalitis vaccines in Europe. Vaccine 2023; 41:6914-6921. [PMID: 37858450 DOI: 10.1016/j.vaccine.2023.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Tick-borne encephalitis (TBE) is an infectious disease caused by the tick-borne encephalitis virus (TBEV) in patients with symptoms of central nervous system (CNS) inflammation. More than 25 European countries have one or more TBE-endemic areas. Although two TBE vaccines, FSME-IMMUN® and Encepur®, are commonly used in Europe, there are no published reviews of the real-world effectiveness of TBE vaccines in Europe or elsewhere. METHODS We searched PubMed for TBE vaccine effectiveness (VE) articles and extracted information on country, study design, study period, study population, number of TBEV-infected cases, number of participants, and VE against TBEV infection and outcomes. RESULTS We identified 13 studies, conducted in Austria, the Czech Republic, Latvia, Germany, and Switzerland, published in 2003-2023. One study was a cohort investigation of a milk-borne outbreak. In the other studies, 11 (91.7%) used the screening method and two (16.7%) used a case-control design (one study used both). TBE vaccines were highly effective (VE estimates >92%) against TBEV infection in all age groups. Vaccines were also highly protective against mild infections (i.e., infections in patients without symptoms of CNS inflammation), and against infections resulting in TBE and hospitalization. Vaccines were also highly protective against the most serious outcomes such as hospitalization greater than 12 days. Product-specific VE estimates were also high, though limited data were available. Studies in Austria, the Czech Republic, Latvia, and Switzerland estimated that TBE vaccines prevented >1,000 TBE cases a year, avoiding many hospitalizations and deaths, in these countries combined. CONCLUSIONS Published VE studies demonstrate a high real-world effectiveness of the commercially available TBE vaccines in Europe. Although cases averted have been estimated in only four countries, TBE vaccination prevents thousands of cases in Europe each year. To prevent life-threatening TBE, TBE vaccine uptake and compliance with the vaccination schedule should be increased in residents of, and travelers to, TBE-endemic countries in Europe.
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Affiliation(s)
- Frederick J Angulo
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Collegeville, PA, United States.
| | - Pingping Zhang
- Medical Affairs Evidence Generation Statistics, Pfizer Research and Development, Collegeville, PA, United States.
| | - Kate Halsby
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, London, England.
| | - Patrick Kelly
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Collegeville, PA, United States.
| | - Andreas Pilz
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Vienna, Austria.
| | - Harish Madhava
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, London, England.
| | - Jennifer C Moïsi
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Paris, France.
| | - Luis Jodar
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, Collegeville, PA, United States.
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Hills SL, Poehling KA, Chen WH, Staples JE. Tick-Borne Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023. MMWR Recomm Rep 2023; 72:1-29. [PMID: 37943707 PMCID: PMC10651317 DOI: 10.15585/mmwr.rr7205a1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Tick-borne encephalitis (TBE) virus is focally endemic in parts of Europe and Asia. The virus is primarily transmitted to humans by the bites of infected Ixodes species ticks but can also be acquired less frequently by alimentary transmission. Other rare modes of transmission include through breastfeeding, blood transfusion, solid organ transplantation, and slaughtering of viremic animals. TBE virus can cause acute neurologic disease, which usually results in hospitalization, often permanent neurologic or cognitive sequelae, and sometimes death. TBE virus infection is a risk for certain travelers and for laboratory workers who work with the virus. In August 2021, the Food and Drug Administration approved Ticovac TBE vaccine for use among persons aged ≥1 year. This report summarizes the epidemiology of and risks for infection with TBE virus, provides information on the immunogenicity and safety of TBE vaccine, and summarizes the recommendations of the Advisory Committee on Immunization Practices (ACIP) for use of TBE vaccine among U.S. travelers and laboratory workers. The risk for TBE for most U.S. travelers to areas where the disease is endemic is very low. The risk for exposure to infected ticks is highest for persons who are in areas where TBE is endemic during the main TBE virus transmission season of April–November and who are planning to engage in recreational activities in woodland habitats or who might be occupationally exposed. All persons who travel to areas where TBE is endemic should be advised to take precautions to avoid tick bites and to avoid the consumption of unpasteurized dairy products because alimentary transmission of TBE virus can occur. TBE vaccine can further reduce infection risk and might be indicated for certain persons who are at higher risk for TBE. The key factors in the risk-benefit assessment for vaccination are likelihood of exposure to ticks based on activities and itinerary (e.g., location, rurality, season, and duration of travel or residence). Other risk-benefit considerations should include 1) the rare occurrence of TBE but its potentially high morbidity and mortality, 2) the higher risk for severe disease among certain persons (e.g., older persons aged ≥60 years), 3) the availability of an effective vaccine, 4) the possibility but low probability of serious adverse events after vaccination, 5) the likelihood of future travel to areas where TBE is endemic, and 6) personal perception and tolerance of risk ACIP recommends TBE vaccine for U.S. persons who are moving or traveling to an area where the disease is endemic and will have extensive exposure to ticks based on their planned outdoor activities and itinerary. Extensive exposure can be considered based on the duration of travel and frequency of exposure and might include shorter-term (e.g., <1 month) travelers with daily or frequent exposure or longer-term travelers with regular (e.g., a few times a month) exposure to environments that might harbor infected ticks. In addition, TBE vaccine may be considered for persons who might engage in outdoor activities in areas where ticks are likely to be found, with a decision to vaccinate made on the basis of an assessment of their planned activities and itinerary, risk factors for a poor medical outcome, and personal perception and tolerance of risk. In the laboratory setting, ACIP recommends TBE vaccine for laboratory workers with a potential for exposure to TBE virus
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Ulrich RG, Drewes S, Haring V, Panajotov J, Pfeffer M, Rubbenstroth D, Dreesman J, Beer M, Dobler G, Knauf S, Johne R, Böhmer MM. [Viral zoonoses in Germany: a One Health perspective]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:599-616. [PMID: 37261460 PMCID: PMC10233563 DOI: 10.1007/s00103-023-03709-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023]
Abstract
The COVID-19 pandemic and the increasing occurrence of monkeypox (mpox) diseases outside Africa have illustrated the vulnerability of populations to zoonotic pathogens. In addition, other viral zoonotic pathogens have gained importance in recent years.This review article addresses six notifiable viral zoonotic pathogens as examples to highlight the need for the One Health approach in order to understand the epidemiology of the diseases and to derive recommendations for action by the public health service. The importance of environmental factors, reservoirs, and vectors is emphasized, the diseases in livestock and wildlife are analyzed, and the occurrence and frequency of diseases in the population are described. The pathogens selected here differ in their reservoirs and the role of vectors for transmission, the impact of infections on farm animals, and the disease patterns observed in humans. In addition to zoonotic pathogens that have been known in Germany for a long time or were introduced recently, pathogens whose zoonotic potential has only lately been shown are also considered.For the pathogens discussed here, there are still large knowledge gaps regarding the transmission routes. Future One Health-based studies must contribute to the further elucidation of their transmission routes and the development of prevention measures. The holistic approach does not necessarily include a focus on viral pathogens/diseases, but also includes the question of the interaction of viral, bacterial, and other pathogens, including antibiotic resistance and host microbiomes.
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Affiliation(s)
- Rainer G Ulrich
- Institut für neue und neuartige Tierseuchenerreger, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Südufer 10, 17493, Greifswald-Insel Riems, Deutschland.
| | - Stephan Drewes
- Institut für neue und neuartige Tierseuchenerreger, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Südufer 10, 17493, Greifswald-Insel Riems, Deutschland
| | - Viola Haring
- Institut für neue und neuartige Tierseuchenerreger, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Südufer 10, 17493, Greifswald-Insel Riems, Deutschland
| | - Jessica Panajotov
- Fachgruppe Viren in Lebensmitteln, Bundesinstitut für Risikobewertung, Berlin, Deutschland
| | - Martin Pfeffer
- Institut für Tierhygiene und Öffentliches Veterinärwesen, Universität Leipzig, Leipzig, Deutschland
| | - Dennis Rubbenstroth
- Institut für Virusdiagnostik, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Greifswald-Insel Riems, Deutschland
| | | | - Martin Beer
- Institut für Virusdiagnostik, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Greifswald-Insel Riems, Deutschland
| | - Gerhard Dobler
- Abteilung Virologie und Rickettsiologie, Institut für Mikrobiologie der Bundeswehr, München, Deutschland
| | - Sascha Knauf
- Institut für Internationale Tiergesundheit/One Health, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Greifswald-Insel Riems, Deutschland
| | - Reimar Johne
- Fachgruppe Viren in Lebensmitteln, Bundesinstitut für Risikobewertung, Berlin, Deutschland
| | - Merle M Böhmer
- Landesinstitut Gesundheit II - Task Force Infektiologie, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), München, Deutschland
- Institut für Sozialmedizin und Gesundheitssystemforschung, Otto-von-Guericke Universität, Magdeburg, Deutschland
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4
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Ruzek D. Editorial for the Special Issue: “Tick-Borne Encephalitis”. Microorganisms 2023; 11:microorganisms11040934. [PMID: 37110357 PMCID: PMC10144950 DOI: 10.3390/microorganisms11040934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
Tick-borne encephalitis (TBE) is a disease caused by the tick-borne encephalitis virus (TBEV) [...]
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Affiliation(s)
- Daniel Ruzek
- Faculty of Science, Masaryk University, CZ-62500 Brno, Czech Republic
- Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, CZ-37005 Ceske Budejovice, Czech Republic
- Laboratory of Emerging Viral Infections, Veterinary Research Institute, CZ-62100 Brno, Czech Republic
- Research Center for Thermotolerant Microbial Resources, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-0841, Japan
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Müller I, Althof N, Hoffmann B, Klaus C, Schilling-Loeffler K, Falkenhagen A, Johne R. Comparison of Extraction Methods for the Detection of Tick-Borne Encephalitis Virus RNA in Goat Raw Milk and Cream Cheese. FOOD AND ENVIRONMENTAL VIROLOGY 2023; 15:32-42. [PMID: 36127560 PMCID: PMC9488872 DOI: 10.1007/s12560-022-09535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
Infection with the tick-borne encephalitis virus (TBEV) can cause meningitis, meningoencephalitis and myelitis in humans. TBEV is an enveloped RNA virus of the family Flaviviridae, which is mostly transmitted via tick bites. However, transmission by consumption of virus-contaminated goat raw milk and goat raw milk products has also been described. Only a few methods have been reported for the detection of TBEV in food so far. Here, we compare different virus extraction methods for goat raw milk and goat raw milk cream cheese and subsequent detection of TBEV-RNA by RT-qPCR. Langat virus (LGTV), a naturally attenuated TBEV strain, was used for artificial contamination experiments. Mengovirus and the human coronavirus 229E were compared to assess their suitability to serve as internal process controls. Out of three tested extraction protocols for raw milk, sample centrifugation followed by direct RNA extraction from the aqueous interphase yielded the best results, with a recovery rate (RR) of 31.8 ± 4.9% for LGTV and a detection limit of 6.7 × 103 LGTV genome copies/ml. Out of two methods for cream cheese, treatment of the samples with TRI Reagent® and chloroform prior to RNA extraction showed the best RR of 4.7 ± 1.6% for LGTV and a detection limit of 9.4 × 104 LGTV genome copies/g. RRs of Mengovirus and LGTV were similar for both methods; therefore, Mengovirus is suggested as internal process control virus. The developed methods may be useful for screening or surveillance studies, as well as in outbreak investigations.
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Affiliation(s)
- Irene Müller
- German Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
| | - Nadine Althof
- German Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
| | - Bernd Hoffmann
- Institute for Diagnostic Virology, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Christine Klaus
- Institute for Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Str. 96a, 07743, Jena, Germany
| | | | - Alexander Falkenhagen
- German Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
| | - Reimar Johne
- German Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589, Berlin, Germany.
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Egyed L, Nagy A, Lakos A, Zöldi V, Lang Z. Tick-borne encephalitis epidemic in Hungary 1951-2021: The story and lessons learned. Zoonoses Public Health 2023; 70:81-92. [PMID: 36205381 DOI: 10.1111/zph.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 01/07/2023]
Abstract
The authors analysed epidemiological data of the Hungarian tick-borne encephalitis epidemic from the past seven decades. A total of 911 meningitis serosa cases were described from 1930-1950 s by local hospital physicians, indicating that the virus had been present in the country decades before its official identification in 1952. The virus spread freely in the 1950s-1960s, occupying almost all habitats where ticks occurred in large numbers. The increasing number of cases drove authorities to classify this illness as a notifiable disease in 1977 and to organize the first measures to stop the epidemic. Statistical analysis revealed that the large-scale vaccination launched from the 1990s was responsible for the sharp decrease in the number of human cases from 1997. A significant negative correlation was found between the number of vaccine doses sold and human cases 6 years later. The TBEV endemic area covers 16.57% of the territory and 16.65% of the population of the country. In the last 10 years, 186,000 vaccine doses/year in average were enough to keep the incidence of human TBEV infections between 0.45 and 0.06/100,000 persons. A 20-year-long study found evidence for easing clinical signs in TBEV-infected hospitalized patients. Statistics found a sharp decrease in the number of samples sent for TBEV diagnosis after 1989. Male dominance of patients was characteristic of the epidemics since the 1940s, but now analysis of detailed data from the 1981-2021 period (60.5%-87.5%) proved the statistical significance of this dominance. Obviously, the voluntary vaccination programme was the tool which broke the spread of the epidemic. Widespread public awareness of the disease and the tick vector, probable evolutionary spread of less pathogenic virus strains supplemented with the vaccination campaign led to a negligible level of human TBE cases in Hungary in the last years.
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Affiliation(s)
- László Egyed
- Veterinary Medical Research Institute, Budapest, Hungary
| | - Anna Nagy
- National Reference Laboratory for Viral Zoonoses, National Public Health Centre, Budapest, Hungary
| | - András Lakos
- Centre for Tick-borne Diseases, Budapest, Hungary
| | - Viktor Zöldi
- Department of Pest Control, National Centre for Epidemiology, Budapest, Hungary
| | - Zsolt Lang
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
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Martello E, Gillingham EL, Phalkey R, Vardavas C, Nikitara K, Bakonyi T, Gossner CM, Leonardi-Bee J. Systematic review on the non-vectorial transmission of Tick-borne encephalitis virus (TBEv). Ticks Tick Borne Dis 2022; 13:102028. [PMID: 36030646 DOI: 10.1016/j.ttbdis.2022.102028] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/15/2022] [Accepted: 08/10/2022] [Indexed: 12/30/2022]
Abstract
Tick-borne encephalitis (TBE) is an infection caused by the Tick-borne encephalitis virus (TBEv) and it is common in Europe. The virus is predominantly transmitted by ticks, but other non-vectorial modes of transmission are possible. This systematic review synthesises the epidemiological impact of non-vectorial modes of TBEv transmission in Europe. 41 studies were included comprising of 1308 TBE cases. Alimentary (36 studies), handling infected material (3 studies), blood-borne (1 study), solid organ transplant (1 study) were identified as potential routes of TBEv transmission; however, no evidence of vertical transmission from mother to offspring was reported (2 studies). Consumption of unpasteurised milk/milk products was the most common vehicle of transmission and significantly increased the risk of TBE by three-fold (pooled RR 3.05, 95% CI 1.53 to 6.11; 4 studies). This review also confirms handling infected material, blood-borne and solid organ transplant as potential routes of TBEv transmission. It is important to tracing back to find the vehicle of the viral infection and to promote vaccination as it remains a mainstay for the prevention of TBE.
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Affiliation(s)
- Elisa Martello
- Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK.
| | | | - Revati Phalkey
- Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK; Climate Change and Health Group, UK Health Security Agency, UK
| | - Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Crete, Greece; Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | | | - Tamas Bakonyi
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Céline M Gossner
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
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Elbaz M, Gadoth A, Shepshelovich D, Shasha D, Rudoler N, Paran Y. Systematic Review and Meta-analysis of Foodborne Tick-Borne Encephalitis, Europe, 1980-2021. Emerg Infect Dis 2022; 28. [PMID: 36149234 PMCID: PMC9514354 DOI: 10.3201/eid2810.220498] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Most cases were associated with ingesting unpasteurized dairy products from goats; the clinical attack rate was 14%. Tick-borne encephalitis (TBE) is a viral infection of the central nervous system that occurs in many parts of Europe and Asia. Humans mainly acquire TBE through tick bites, but TBE occasionally is contracted through consuming unpasteurized milk products from viremic livestock. We describe cases of TBE acquired through alimentary transmission in Europe during the past 4 decades. We conducted a systematic review and meta-analysis of 410 foodborne TBE cases, mostly from a region in central and eastern Europe. Most cases were reported during the warmer months (April–August) and were associated with ingesting unpasteurized dairy products from goats. The median incubation period was short, 3.5 days, and neuroinvasive disease was common (38.9%). The clinical attack rate was 14% (95% CI 12%–16%), and we noted major heterogeneity. Vaccination programs and public awareness campaigns could reduce the number of persons affected by this potentially severe disease.
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Sero-epidemiology of tick-borne encephalitis in small ruminants in the Czech Republic. Ticks Tick Borne Dis 2022; 13:101996. [DOI: 10.1016/j.ttbdis.2022.101996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/30/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022]
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Gonzalez G, Bournez L, Moraes RA, Marine D, Galon C, Vorimore F, Cochin M, Nougairède A, Hennechart-Collette C, Perelle S, Leparc-Goffart I, Durand GA, Grard G, Bénet T, Danjou N, Blanchin M, Lacour SA, Franck B, Chenut G, Mainguet C, Simon C, Brémont L, Zientara S, Moutailler S, Martin-Latil S, Dheilly NM, Beck C, Lecollinet S. A One-Health Approach to Investigating an Outbreak of Alimentary Tick-Borne Encephalitis in a Non-endemic Area in France (Ain, Eastern France): A Longitudinal Serological Study in Livestock, Detection in Ticks, and the First Tick-Borne Encephalitis Virus Isolation and Molecular Characterisation. Front Microbiol 2022; 13:863725. [PMID: 35479640 PMCID: PMC9037541 DOI: 10.3389/fmicb.2022.863725] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/04/2022] [Indexed: 12/30/2022] Open
Abstract
Tick-borne encephalitis virus’ (TBEV) geographic range and the human incidence are increasing throughout Europe, putting a number of non-endemic regions and countries at risk of outbreaks. In spring 2020, there was an outbreak of tick-born encephalitis (TBE) in Ain, Eastern France, where the virus had never been detected before. All patients but one had consumed traditional unpasteurised raw goat cheese from a local producer. We conducted an investigation in the suspected farm using an integrative One Health approach. Our methodology included (i) the detection of virus in cheese and milk products, (ii) serological testing of all animals in the suspected farm and surrounding farms, (iii) an analysis of the landscape and localisation of wooded area, (iv) the capture of questing ticks and small mammals for virus detection and estimating enzootic hazard, and (v) virus isolation and genome sequencing. This approach allowed us to confirm the alimentary origin of the TBE outbreak and witness in real-time the seroconversion of recently exposed individuals and excretion of virus in goat milk. In addition, we identified a wooded focus area where and around which there is a risk of TBEV exposure. We provide the first TBEV isolate responsible for the first alimentary-transmitted TBE in France, obtained its full-length genome sequence, and found that it belongs to the European subtype of TBEV. TBEV is now a notifiable human disease in France, which should facilitate surveillance of its incidence and distribution throughout France.
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Affiliation(s)
- Gaëlle Gonzalez
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Laure Bournez
- ANSES, Nancy Laboratory for Rabies and Wildlife, Malzéville, France
| | - Rayane Amaral Moraes
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Dumarest Marine
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Clémence Galon
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Fabien Vorimore
- Bacterial Zoonosis Unit, Laboratory for Animal Health, ANSES Maisons-Alfort, Paris-Est University, Paris, France
| | - Maxime Cochin
- Unité des Virus Émergents (UVE), Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection, Marseille, France
| | - Antoine Nougairède
- Unité des Virus Émergents (UVE), Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection, Marseille, France
| | | | - Sylvie Perelle
- ANSES Laboratory for Food Safety, Université Paris-Est, Maisons-Alfort, France
| | - Isabelle Leparc-Goffart
- Unité des Virus Émergents (UVE), Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection, Marseille, France.,French National Reference Centre for Arbovirus, Armed Forces Biomedical Research Institute, Marseille, France
| | - Guillaume André Durand
- Unité des Virus Émergents (UVE), Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection, Marseille, France.,French National Reference Centre for Arbovirus, Armed Forces Biomedical Research Institute, Marseille, France
| | - Gilda Grard
- Unité des Virus Émergents (UVE), Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection, Marseille, France.,French National Reference Centre for Arbovirus, Armed Forces Biomedical Research Institute, Marseille, France
| | - Thomas Bénet
- Santé Publique France, French Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Nathalie Danjou
- Regional Health Agency (Agence Régionale de Santé), Auvergne-Rhône-Alpes, Lyon, France
| | - Martine Blanchin
- Regional Health Agency (Agence Régionale de Santé), Auvergne-Rhône-Alpes, Lyon, France
| | - Sandrine A Lacour
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Boué Franck
- ANSES, Nancy Laboratory for Rabies and Wildlife, Malzéville, France
| | - Guillaume Chenut
- Local Health Authority, Direction Départementale de la Protection de la Population de l'Ain, Bourg-en-Bresse, France
| | - Catherine Mainguet
- Local Health Authority, Direction Départementale de la Protection de la Population de l'Ain, Bourg-en-Bresse, France
| | - Catherine Simon
- Local Health Authority, Direction Départementale de la Protection de la Population de l'Ain, Bourg-en-Bresse, France
| | - Laurence Brémont
- Local Health Authority, Direction Départementale de la Protection de la Population de l'Ain, Bourg-en-Bresse, France
| | - Stephan Zientara
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Sara Moutailler
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Sandra Martin-Latil
- ANSES Laboratory for Food Safety, Université Paris-Est, Maisons-Alfort, France
| | - Nolwenn M Dheilly
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Cécile Beck
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Sylvie Lecollinet
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, Maisons-Alfort, France
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11
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Food-Borne Transmission of Tick-Borne Encephalitis Virus—Spread, Consequences, and Prophylaxis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031812. [PMID: 35162837 PMCID: PMC8835261 DOI: 10.3390/ijerph19031812] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022]
Abstract
Tick-borne encephalitis (TBE) is the most common viral neurological disease in Eurasia. It is usually transmitted via tick bites but can also occur through ingestion of TBEV-infected milk and dairy products. The present paper summarises the knowledge of the food-borne TBEV transmission and presents methods for the prevention of its spread. The incidence of milk-borne TBE outbreaks is recorded in central, eastern, and north-eastern Europe, where Ixodes ricinus, Ixodes persulcatus, and/or Dermacentor reticulatus ticks, i.e., the main vectors of TBEV, occur abundantly. The growing occurrence range and population size of these ticks increases the risk of infection of dairy animals, i.e., goats, sheep, and cows, with viruses transmitted by these ticks. Consumers of unpasteurised milk and dairy products purchased from local farms located in TBE endemic areas are the most vulnerable to alimentary TBEV infections. Familial infections with these viruses are frequently recorded, mainly in children. Food-transmitted TBE can be monophasic or biphasic, and some of its neurological and psychiatric symptoms may persist in patients for a long time. Alimentary TBEV infections can be effectively prevented by consumption of pasteurised milk and the use of TBEV vaccines. It is recommended that milk and dairy products should be checked for the presence of TBE viruses prior to distribution. Protection of dairy animals against tick attacks and education of humans regarding the epidemiology and prophylaxis of TBE are equally important.
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12
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Ličková M, Fumačová Havlíková S, Sláviková M, Klempa B. Alimentary Infections by Tick-Borne Encephalitis Virus. Viruses 2021; 14:56. [PMID: 35062261 PMCID: PMC8779402 DOI: 10.3390/v14010056] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/30/2022] Open
Abstract
Tick-borne encephalitis virus (TBEV) causes serious the neurological disease, tick-borne encephalitis (TBE). TBEV can be transmitted to humans by ticks as well as by the alimentary route, which is mediated through the consumption of raw milk products from infected ruminants such as sheep, goats, and cows. The alimentary route of TBEV was recognized in the early 1950s and many important experimental studies were performed shortly thereafter. Nowadays, alimentary TBEV infections are recognized as a relevant factor contributing to the overall increase in TBE incidences in Europe. This review aims to summarize the history and current extent of alimentary TBEV infections across Europe, to analyze experimental data on virus secretion in milk, and to review possible alimentary infection preventive measures.
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Affiliation(s)
| | | | | | - Boris Klempa
- Biomedical Research Center, Institute of Virology, Slovak Academy of Sciences, 84505 Bratislava, Slovakia; (M.L.); (S.F.H.); (M.S.)
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