Epidemiological situation of tick-borne encephalitis in the European Union and European Free Trade Association countries
The report summarises existing information on the occurrence of TBE to obtain a better understanding of the current magnitude of TBE in the European Union (EU) and European Free Trade Association (EFTA) countries. The specific objectives are to characterise the different reporting systems for TBE in EU/EFTA countries; to identify and assess the current epidemiological situation for TBE; identify key risk areas for the disease and provide ECDC with data into its study on burden of disease. The report is a first effort to collect existing data on TBE in EU/EFTA countries. The data, covering the period 2000–2010, were collected from different sources.
Executive Summary
ECDC publishes today a report on the epidemiological situation of tick-borne encephalitis (TBE) and TBE surveillance systems in EU and EFTA. It has epidemiological data for the period 2000 – 2010, for 20 out of 30 EU/EFTA countries, including ‘country profiles’ for each of the countries that implemented TBE surveillance.
The report identifies key risk areas for the disease and contains recommendations for improving the TBE surveillance and prevention in Europe.
The main risk areas and groups for TBE are:
- Baltic and Nordic countries and central and eastern Europe - extending west as far as Switzerland and Alsace, France, and southern Europe up to northern Italy and the Balkans
- Males aged 40-–60 years, indicating those working outdoors may be at greater risk
- June to October, a seasonal peak over the summer.
Surveillance systems for TBE are implemented in the majority of EU/EFTA countries (20 out of 30). However, significant differences exist among them, making it difficult to compare national data at EU level. The ECDC’s report suggests that national and regional public health authorities improve and harmonise the TBE surveillance systems. It also recommends particular measures, such as the implementation of a standard EU case definition and routine collection of surveillance data from EU countries.
TBE has been recently added to the list of notifiable diseases within the EU and a standard EU case definition for TBE has been agreed and approved and will be published soon.
To foster TBE prevention in Europe, the report proposes developing vaccination recommendations for residents and travellers to affected areas. More precise information about areas at potential risk and the best way to avoid tick bites, as well as vaccination availability for residents and travellers to affected areas are also needed.
The report is the first attempt to systematically collect and compile existing surveillance data on TBE in EU/EFTA countries. Tick-borne encephalitis (TBE) is a viral tick-borne infectious disease that occurs in endemic areas across large regions of Europe. Over the last decades, the number of TBE cases in Europe increased and affected areas spread.
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Publication data
Map
TBE Key risk areas: TBE average annual incidence rate per 100 000 inhabitants in the EU/EFTA at country level
The key risk areas for TBE are located in central and eastern Europe and the Baltic and Nordic countries.
Map
TBE Key risk areas: TBE average annual incidence rate per 100 000 inhabitants in the EU/EFTA at lower administrative level NUTS 2 (Italy) or NUTS 3
The key risk areas for TBE are located in central and eastern Europe and the Baltic and Nordic countries.
Data set
TBE Key risk groups: Number of TBE cases, regardless of the applied case definition, by age group and gender reported in 16 EU/EFTA countries, 2000–2010 (n= 22 378)
In Europe, TBE cases occurred more commonly among men than women and the number of reported cases increased with age.
Data set
TBE Cases by year: Number of TBE cases, regardless of the applied case definition, by year reported in 16 EU/EFTA countries, 2000–2010 (n= 29 381)
During the 2000–2010 period, the overall number of reported TBE cases (all case definitions combined) stayed relatively stable, with notable increases in 2003, 2006 and 2009–2010. The Czech Republic reported 25% of all reported cases, Lithuania 15%, Latvia and Germany 11% each and Slovenia 10%.
Data set
TBE Seasonality: Number of TBE cases, regardless of the applied case definition, by month of onset reported in nine EU/EFTA countries, 2000–2010 (n= 7 083)
The majority of cases reported during 2000–2010 showed disease onset between July and October.
Country profile
TBE surveillance implemented in EU/EFTA countries
Among the 30 EU/EFTA, 20 (67%) had developed surveillance systems for TBE. Comprehensive surveillance exists in 18 countries (60%).
Country profile
Country profile: Austria. Tick-borne encephalitis (TBE)
TBE is endemic in all of Austria’s federal states.
Country profile
Country profile: Belgium. Tick-borne encephalitis (TBE)
During 2000–2010, there were no TBE cases reported. TBE is not known to be endemic in Belgium.
Country profile
Country profile: Czech republic. Tick-borne encephalitis (TBE)
TBE is endemic in the Czech Republic and 500–1 000 cases are reported annually.
Country profile
Country profile: Denmark. Tick-borne encephalitis (TBE)
In Denmark, TBE occurs sporadically, with 5–10 cases reported annually.
Country profile
Country profile: Estonia. Tick-borne encephalitis (TBE)
TBE incidence, Estonia. TBE cases and incidence by year/TBE cases by gender and age, Estonia.
Country profile
Country profile: Finland. Tick-borne encephalitis (TBE)
TBE cases and incidence/TBE cases by gender and age, Finland
Country profile
Country profile: France. Tick-borne encephalitis (TBE)
A few cases of TBE are reported in France annually.
Country profile
Country profile: Germany. Tick-borne encephalitis (TBE)
TBE is known to be endemic in Germany and high-risk areas are located in Bavaria and Baden-Württemberg.
Country profile
Country profile: Greece. Tick-borne encephalitis (TBE)
During the period 2000–2010, there were no TBE cases reported. Information on the epidemiology of TBE in Greece is limited.
Country profile
Country profile: Hungary. Tick-borne encephalitis (TBE)
TBE is endemic in Hungary.
Country profile
Country profile: Italy. Tick-borne encephalitis (TBE)
TBE incidence in Italy is very low and is restricted to the central and north eastern part of the country.
Country profile
Country profile: Latvia. Tick-borne encephalitis (TBE)
TBE is endemic in Latvia.
Country profile
Country profile: Lithuania. Tick-borne encephalitis (TBE)
Lithuania is one of the countries with the highest number of reported TBE cases in Europe.
Country profile
Country profile: Norway. Tick-borne encephalitis (TBE)
TBE occurs sporadically in Norway although parts of the southern coast have been established as endemic.
Country profile
Country profile: Poland. Tick-borne encephalitis (TBE)
In Poland, TBE is endemic and 200–300 cases are reported annually, 90% from two provinces neighbouring the Baltic States.
Country profile
Country profile: Romania. Tick-borne encephalitis (TBE)
In Romania TBE occurs sporadically and information on its epidemiology is limited.
Country profile
Country profile: Slovakia. Tick-borne encephalitis (TBE)
In Slovakia TBE is endemic. Around 60–80 cases are reported annually.
Country profile
Country profile: Slovenia. Tick-borne encephalitis (TBE)
Slovenia is one of the countries with the highest reported number of TBE cases.
Country profile
Country profile: Sweden. Tick-borne encephalitis (TBE)
In Sweden 100–200 cases are reported annually.
Country profile
Country profile: Switzerland. Tick-borne encephalitis (TBE)
TBE is endemic in areas of northern Switzerland. A surveillance case definition has been in use since 1988 and was revised in 2007.
