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Volume 23, Number 1—January 2017

Travel-Related Tick-Borne Encephalitis, Israel, 2006–2014

Eyal Meltzer1Comments to Author , Yael Paran1, Yaniv Lustig, Shmuel Stienlauf, Miriam Weinberger, and Eli Schwartz
Author affiliations: Chaim Sheba Medical Center, Tel Hashomer, Israel (E. Meltzer‚ Y. Lustig, S. Stienlauf, E. Schwartz); Tel Aviv University, Tel Aviv, Israel (E. Meltzer‚ S. Stienlauf, M. Weinberger, E. Schwartz); Tel Aviv Sourasky Medical Center, Tel Aviv (Y. Paran); Assaf Harofeh Medical Center, Zerifin, Israel (M. Weinberger)

Main Article

Table 1

Clinical, epidemiologic, and laboratory data for TBE cases, Israel*

Variable Case-patient 1 Case-patient 2 Case-patient 3 Case-patient 4
Destination Austria Germany, Switzerland Sweden Russia
Probable area of exposure Salzburgland Baden-Wurttemberg Northwest of Stockholm Southwestern Siberia
Month of travel 2014 Jun 2012 Sep 2011 May–Aug 2010 Aug
Duration of travel, d 3 14 107 17
Duration of probable exposure to tick habitat 1 h 4 d Undetermined 17
Recorded tick bite
Neurologic manifestations during acute phase Diplopia → stupor, aphasia, quadriparesis Dysphagia, dysgeusia, bilateral facial nerve paralysis Meningismus, mild confusion, dysarthria → Lt facial nerve. paralysis Acute confusion, stupor
Neurologic outcome at 6 mo
Complete motor recovery, difficulty in complex tasks, depression.
Complete recovery
Complete recovery
Complete recovery
TBE serology results†
First serum sample IgM positive, IgG positive IgM positive, IgG negative IgM positive, IgG positive IgM positive, IgG positive
Convalescent-phase serum sample IgM positive, IgG 10-fold increase IgM positive, IgG seroconversion IgM positive‡, IgG positive‡ ND

*ND, not done; TBE, tickborne encephalitis.
†West Nile virus was ruled out serologically in all cases.
‡Direct comparison between serum samples was not possible because initial sample was taken abroad.

Main Article

1These authors contributed equally to this article.

Page created: December 14, 2016
Page updated: December 14, 2016
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