Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2015; 3(5): 430-441
Published online May 16, 2015. doi: 10.12998/wjcc.v3.i5.430
Tick-borne encephalitis: A review of epidemiology, clinical characteristics, and management
Petra Bogovic, Franc Strle
Petra Bogovic, Franc Strle, Department of Infectious Diseases, University Medical Center Ljubljana, 1525 Ljubljana, Slovenia
Author contributions: Both authors approved the final version of the manuscript before submission.
Conflict-of-interest: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Petra Bogovic, MD, Department of Infectious Diseases, University Medical Center Ljubljana, Japljeva 2, 1525 Ljubljana, Slovenia.
Telephone: +386-1-5222110 Fax: +386-1-5222456
Received: July 23, 2014
Peer-review started: July 25, 2014
First decision: August 28, 2014
Revised: September 18, 2014
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: May 16, 2015

Tick-borne encephalitis is an infection of central nervous system caused by tick-borne encephalitis virus transmitted to humans predominantly by tick bites. During the last few decades the incidence of the disease has been increasing and poses a growing health problem in almost all endemic European and Asian countries. Most cases occur during the highest period of tick activity, in Central Europe mainly from April to November. Tick-borne encephalitis is more common in adults than in children. Clinical spectrum of the disease ranges from mild meningitis to severe meningoencephalitis with or without paralysis. Rare clinical manifestations are an abortive form of the disease and a chronic progressive form. A post-encephalitic syndrome, causing long-lasting morbidity that often affects the quality of life develops in up to 50% of patients after acute tick-borne encephalitis. Clinical course and outcome vary by subtype of tick-borne encephalitis virus (the disease caused by the European subtype has milder course and better outcome than the disease caused by Siberian and Far-Easter subtypes), age of patients (increasing age is associated with less favorable outcome), and host genetic factors. Since clinical features and laboratory results of blood and cerebrospinal fluid are nonspecific, the diagnosis must be confirmed by microbiologic findings. The routine laboratory confirmation of the tick-borne encephalitis virus infection is based mainly on the detection of specific IgM and IgG antibodies in serum (and cerebrospinal fluid), usually by enzyme-linked immunosorbent assay. There is no specific antiviral treatment for tick-borne encephalitis. Vaccination can effectively prevent the disease and is indicated for persons living in or visiting tick-borne encephalitis endemic areas.

Keywords: Tick-borne encephalitis, Diagnosis, Epidemiology, Clinical manifestations, Treatment, Prevention/vaccination

Core tip: Tick-borne encephalitis (TBE) is the most common tick-borne central nervous system infection in Europe and Asia. It is caused by three subtypes of TBE virus: European, Siberian and Far-Eastern. Because of relatively severe clinical course, the absence of etiologic treatment, considerable proportion of patients with incomplete recovery after acute illness, as well as due to increasing incidence it represents a growing public health problem that could be substantially reduced with vaccination.