Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 28, Number 2—February 2022
CME ACTIVITY - Synopsis

Clinical and Laboratory Characteristics and Outcome of Illness Caused by Tick-Borne Encephalitis Virus without Central Nervous System Involvement

Petra BogovičComments to Author , Andrej Kastrin, Stanka Lotrič-Furlan, Katarina Ogrinc, Tatjana Avšič Županc, Miša Korva, Nataša Knap, and Franc Strle
Author affiliations: University Medical Center Ljubljana, Ljubljana, Slovenia (P. Bogovič, S. Lotrič-Furlan, K. Ogrinc, F. Strle); University of Ljubljana, Faculty of Medicine, Ljubljana (A. Kastrin, T. Avšič Županc, M. Korva, N. Knap)

Main Article

Figure 3

TBEV RNA load according to demographic and clinical characteristics in cases of febrile illness without central nervous system involvement at the time of evaluations, Slovenia. A) Age, B) sex, C) duration of illness until evaluation, D) total duration of illness, E) hospitalization, F) presence of IgM to TBEV, and G) later CNS involvement. Blue lines indicate loess regression lines; shaded areas indicate 95% CIs. Relationships between variables in panels A, B, and D are modeled by using restricted cubic splines with 3 knots (25). Comparisons between groups in panels B, E, F, and G are based on a Wilcoxon rank-sum test. CNS, central nervous system; TBEV, tick-borne encephalitis virus.

Figure 3. TBEV RNA load according to demographic and clinical characteristics in cases of febrile illness without central nervous system involvement at the time of evaluations, Slovenia. A) Age, B) sex, C) duration of illness until evaluation, D) total duration of illness, E) hospitalization, F) presence of IgM to TBEV, and G) later CNS involvement. Blue lines indicate loess regression lines; shaded areas indicate 95% CIs. Relationships between variables in panels A, B, and D are modeled by using restricted cubic splines with 3 knots (25). Comparisons between groups in panels B, E, F, and G are based on a Wilcoxon rank-sum test. CNS, central nervous system; TBEV, tick-borne encephalitis virus.

Main Article

References
  1. Demina  TV, Dzhioev  YP, Verkhozina  MM, Kozlova  IV, Tkachev  SE, Plyusnin  A, et al. Genotyping and characterization of the geographical distribution of tick-borne encephalitis virus variants with a set of molecular probes. J Med Virol. 2010;82:965–76. DOIPubMedGoogle Scholar
  2. Kozlova  IV, Demina  TV, Tkachev  SE, Doroschenko  EK, Lisak  OV, Verkhozina  MM, et al. Characteristics of the Baikal subtype of tick-borne encephalitis virus circulating in Eastern Siberia. Acta Biomedicia Scientifica. 2018;3:53–60. DOIGoogle Scholar
  3. Marvik  Å, Tveten  Y, Pedersen  AB, Stiasny  K, Andreassen  ÅK, Grude  N. Low prevalence of tick-borne encephalitis virus antibodies in Norwegian blood donors. Infect Dis (Lond). 2021;53:44–51. DOIPubMedGoogle Scholar
  4. Tomažič  J, Pikelj  F, Schwartz  B, Kunze  M, Kraigher  A, Matjašič  M, et al.; Slovenian TBE study group. The clinical features of tick-borne encephalitis in Slovenia. A study of 492 cases in 1994. Antibiot Monitor. 1996;12:115–20.
  5. Günther  G, Haglund  M, Lindquist  L, Forsgren  M, Sköldenberg  B. Tick-bone encephalitis in Sweden in relation to aseptic meningo-encephalitis of other etiology: a prospective study of clinical course and outcome. J Neurol. 1997;244:230–8. DOIPubMedGoogle Scholar
  6. Kaiser  R. The clinical and epidemiological profile of tick-borne encephalitis in southern Germany 1994-98: a prospective study of 656 patients. Brain. 1999;122:2067–78. DOIPubMedGoogle Scholar
  7. Kaiser  R, Holzmann  H. Laboratory findings in tick-borne encephalitis—correlation with clinical outcome. Infection. 2000;28:78–84. DOIPubMedGoogle Scholar
  8. Mickiene  A, Laiskonis  A, Günther  G, Vene  S, Lundkvist  A, Lindquist  L. Tickborne encephalitis in an area of high endemicity in lithuania: disease severity and long-term prognosis. Clin Infect Dis. 2002;35:650–8. DOIPubMedGoogle Scholar
  9. Kaiser  R. Tick-borne encephalitis (TBE) in Germany and clinical course of the disease. Int J Med Microbiol. 2002;291(Suppl 33):58–61. DOIPubMedGoogle Scholar
  10. Logar  M, Bogovic  P, Cerar  D, Avsic-Zupanc  T, Strle  F. Tick-borne encephalitis in Slovenia from 2000 to 2004: comparison of the course in adult and elderly patients. Wien Klin Wochenschr. 2006;118:702–7. DOIPubMedGoogle Scholar
  11. Misić Majerus  L, Daković Rode  O, Ruzić Sabljić  E. [Post-encephalitic syndrome in patients with tick-borne encephalitis] [in Croatian]. Acta Med Croatica. 2009;63:269–78.PubMedGoogle Scholar
  12. Radzišauskienė  D, Urbonienė  J, Kaubrys  G, Andruškevičius  S, Jatužis  D, Matulytė  E, et al. The epidemiology, clinical presentation, and predictors of severe Tick-borne encephalitis in Lithuania, a highly endemic country: A retrospective study of 1040 patients. PLoS One. 2020;15:e0241587. DOIPubMedGoogle Scholar
  13. Barp  N, Trentini  A, Di Nuzzo  M, Mondardini  V, Francavilla  E, Contini  C. Clinical and laboratory findings in tick-borne encephalitis virus infection. Parasite Epidemiol Control. 2020;10:e00160. DOIPubMedGoogle Scholar
  14. Bogovič  P, Lotrič-Furlan  S, Avšič-Županc  T, Korva  M, Kastrin  A, Lusa  L, et al. Comparison of clinical, laboratory and immune characteristics of the monophasic and biphasic course of tick-borne encephalitis. Microorganisms. 2021;9:796. DOIPubMedGoogle Scholar
  15. Kohlmaier  B, Schweintzger  NA, Sagmeister  MG, Švendová  V, Kohlfürst  DS, Sonnleitner  A, et al.; The Eu-Tick-Bo Study Group. Clinical characteristics of patients with tick-borne encephalitis (TBE): a European multicentre study from 2010 to 2017. Microorganisms. 2021;9:1420. DOIPubMedGoogle Scholar
  16. Mansfield  KL, Johnson  N, Phipps  LP, Stephenson  JR, Fooks  AR, Solomon  T. Tick-borne encephalitis virus - a review of an emerging zoonosis. J Gen Virol. 2009;90:1781–94. DOIPubMedGoogle Scholar
  17. Bogovic  P, Strle  F. Tick-borne encephalitis: A review of epidemiology, clinical characteristics, and management. World J Clin Cases. 2015;3:430–41. DOIPubMedGoogle Scholar
  18. Taba  P, Schmutzhard  E, Forsberg  P, Lutsar  I, Ljøstad  U, Mygland  Å, et al. EAN consensus review on prevention, diagnosis and management of tick-borne encephalitis. Eur J Neurol. 2017;24:1214–e61. DOIPubMedGoogle Scholar
  19. Bogovič  P, Stupica  D, Rojko  T, Lotrič-Furlan  S, Avšič-Županc  T, Kastrin  A, et al. The long-term outcome of tick-borne encephalitis in Central Europe. Ticks Tick Borne Dis. 2018;9:369–78. DOIPubMedGoogle Scholar
  20. Kunz  C. Tick-borne encephalitis in Europe. Acta Leiden. 1992;60:1–14.PubMedGoogle Scholar
  21. Granström  M. Tick-borne zoonoses in Europe. Clin Microbiol Infect. 1997;3:156–69. DOIPubMedGoogle Scholar
  22. Dumpis  U, Crook  D, Oksi  J. Tick-borne encephalitis. Clin Infect Dis. 1999;28:882–90. DOIPubMedGoogle Scholar
  23. Borde  JP, Zajkowska  J. TBE in adults. In: Dobler G, Erber W, Bröker M, Schmitt HJ, editors. The TBE Book, 2nd ed. Singapore: Global Health Press; 2019. p. 105–24.
  24. Schultze  D, Dollenmaier  G, Rohner  A, Guidi  T, Cassinotti  P. Benefit of detecting tick-borne encephalitis viremia in the first phase of illness. J Clin Virol. 2007;38:172–5. DOIPubMedGoogle Scholar
  25. Lotrič-Furlan  S, Avsic-Zupanc  T, Strle  F. Is an isolated initial phase of a tick-borne encephalitis a common event? Clin Infect Dis. 2000;30:987–8. DOIPubMedGoogle Scholar
  26. Saksida  A, Jakopin  N, Jelovšek  M, Knap  N, Fajs  L, Lusa  L, et al. Virus RNA load in patients with tick-borne encephalitis, Slovenia. Emerg Infect Dis. 2018;24:1315–23. DOIPubMedGoogle Scholar
  27. van Buuren  S. Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res. 2007;16:219–42. DOIPubMedGoogle Scholar
  28. Perperoglou  A, Sauerbrei  W, Abrahamowicz  M, Schmid  M. A review of spline function procedures in R. BMC Med Res Methodol. 2019;19:46. DOIPubMedGoogle Scholar
  29. R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing [cited 2021 May 18]. http://www.r-project.org
  30. Lotrič-Furlan  S, Bogovič  P, Avšič-Županc  T, Jelovšek  M, Lusa  L, Strle  F. Tick-borne encephalitis in patients vaccinated against this disease. J Intern Med. 2017;282:142–55. DOIPubMedGoogle Scholar
  31. Bogovič  P, Lotrič-Furlan  S, Avšič-Županc  T, Lusa  L, Strle  F. Factors associated with severity of tick-borne encephalitis: A prospective observational study. Travel Med Infect Dis. 2018;26:25–31. DOIPubMedGoogle Scholar
  32. Anić  K, Soldo  I, Perić  L, Karner  I, Barac  B. Tick-borne encephalitis in eastern Croatia. Scand J Infect Dis. 1998;30:509–12. DOIPubMedGoogle Scholar
  33. Lotric-Furlan  S, Petrovec  M, Avsic-Zupanc  T, Strle  F. Clinical distinction between human granulocytic ehrlichiosis and the initial phase of tick-borne encephalitis. J Infect. 2000;40:55–8. DOIPubMedGoogle Scholar
  34. Lotric-Furlan  S, Petrovec  M, Avsic-Zupanc  T, Logar  M, Strle  F. Epidemiological, clinical and laboratory distinction between human granulocytic ehrlichiosis and the initial phase of tick-borne encephalitis. Wien Klin Wochenschr. 2002;114:636–40.PubMedGoogle Scholar
  35. Lotric-Furlan  S, Strle  F. Thrombocytopenia, leukopenia and abnormal liver function tests in the initial phase of tick-borne encephalitis. Zentralbl Bakteriol. 1995;282:275–8. DOIPubMedGoogle Scholar
  36. Lotric-Furlan  S, Strle  F. Thrombocytopenia—a common finding in the initial phase of tick-borne encephalitis. Infection. 1995;23:203–6. DOIPubMedGoogle Scholar
  37. Saksida  A, Duh  D, Lotric-Furlan  S, Strle  F, Petrovec  M, Avsic-Zupanc  T. The importance of tick-borne encephalitis virus RNA detection for early differential diagnosis of tick-borne encephalitis. J Clin Virol. 2005;33:331–5. DOIPubMedGoogle Scholar
  38. Ackermann  R, Krüger  K, Roggendorf  M, Rehse-Küpper  B, Mörtter  M, Schneider  M, et al. [Spread of early-summer meningoencephalitis in the Federal Republic of Germany] [in German]. Dtsch Med Wochenschr. 1986;111:927–33. DOIPubMedGoogle Scholar

Main Article

Page created: December 02, 2021
Page updated: January 21, 2022
Page reviewed: January 21, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external