American Journal of Infectious Diseases and Microbiology
ISSN (Print): 2328-4056 ISSN (Online): 2328-4064 Website: https://www.sciepub.com/journal/ajidm Editor-in-chief: Maysaa El Sayed Zaki
Open Access
Journal Browser
Go
American Journal of Infectious Diseases and Microbiology. 2021, 9(1), 1-3
DOI: 10.12691/ajidm-9-1-1
Open AccessCase Report

Tick-borne Encephalitis in a 29-Year-Old Returning Traveller

Abolaji Atomode1, , Hassan Haruna1, Odega Emmanuel2, Mayode Ajiboye1, Sarah Mohammed1 and Joseph Ogwuche Onah3

1Department of Medicine, James Paget University Hospital NHS Foundation Trust, Norfolk, UK

2Department of Medicine, Morriston Hospital, Swansea, UK

3Department of Medicine, Royal Gwent Hospital, Newport, South Wales, UK

Pub. Date: January 18, 2021

Cite this paper:
Abolaji Atomode, Hassan Haruna, Odega Emmanuel, Mayode Ajiboye, Sarah Mohammed and Joseph Ogwuche Onah. Tick-borne Encephalitis in a 29-Year-Old Returning Traveller. American Journal of Infectious Diseases and Microbiology. 2021; 9(1):1-3. doi: 10.12691/ajidm-9-1-1

Abstract

Tick-borne encephalitis (TBE) is a central nervous system (CNS) disease with high morbidity and mortality caused by a flavivirus and usually transmitted to humans via the bite of an infected Ixodes ricinus tick. It is endemic to central Europe, Germany inclusive. Until 2019, the causative agent, TBE virus, was not considered to occur in the UK. However, with the increase in tourism TBE is becoming a problem also outside endemic regions. It has a varied clinical manifestation ranging from mild symptoms to potentially life-threatening meningoencephalitis or meningoencephalomyelitis. Its diagnosis relies on high index of clinical suspicion and supported by the demonstration of specific IgM- and IgG-serum antibodies by ELISA. Management is largely supportive. We present a unique case of tick-borne encephalitis in a young traveller returning from an endemic region to the UK, managed appropriately with no residual complications.

Keywords:
Tick-borne encephalitis (TBE) Borrelia spp. Ixodes spp Cerebrospinal fluid (CSF)

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  European Centre for Disease Prevention and Control. (2021), Fact-sheet about Tick-borne Encephalitis, Available from: https://www.ecdc.europa.eu/en/tick-borne- encephalitis/facts/factsheet (Accessed 10 January 2021).
 
[2]  Kreusch, T.M., Holding, M., Roger Hewson, R., Harder, T., Medlock, M, J., Hansford, M., K., et’al. (2019), A probable case of tick-borne encephalitis (TBE) acquired in England, July 2019., Euro Surveillance, 24(47): 1900679. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885749/ /(Accessed 10 January 2021).
 
[3]  World Health Organization (2020), Immunization is the best Protection against Tick-borne Encephalitis, Available from: https://www.who.int/news/item/19-02-2020-immunization-is-the- best-protection-against-tick-borne-encephalitis (Accessed 10 January 2021).
 
[4]  Steffen, R. (2016), Epidemiology of tick-borne encephalitis (TBE) in international travellers to Western/Central Europe and conclusions on vaccination recommendations, Journal of Travel Medicine, 23(4), PP. 1-10.
 
[5]  Monath TP, Heinz FX. Fields BN, Knipe DM, Howley PM, et al. Flaviviruses, Fields' virology, 1996, vol. Vol. 1 3rd ed. Philadelphia Lippincott-Raven (pg. 961-1034).
 
[6]  Dumpis U, Crook D, Oksi J. Tick-borne encephalitis, Clin Infect Dis, 1999, vol. 28 (pg. 882-90).
 
[7]  Vasilenko FI, Grigorjeva IGH. Early and late recurrences of tick-borne encephalitis [in Russian], 1987, vol. 87 (pg. 178-81). Available from: europepmc.org/article/med/3577500.
 
[8]  Rendi-Wagner P. Risk and prevention of tick-borne encephalitis in travellers. J Travel Med. 2004; 11(5): 307-12.
 
[9]  Kunze U; ISW TBE. Conference report of the 9th meeting of the International Scientific Working Group of TickBorne Encephalitis (ISW TBE). Tick Borne Encephalitis: from epidemiology to current vaccination recommendations. Vaccine. 2007; 25(50): 8350-1
 
[10]  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;90:1781-1794
 
[11]  Kaiser R. Tick-borne encephalitis. Infect Dis Clin North Am. 2008; 22: 561-575, x.
 
[12]  Spagnolo, E., V., Mondello, C., Roccuzzo,S., Cardia, L., and Raffino, C. (2018), A lethal Tick-Borne Encephalitis (TBE) due to TBE Virus in Sicily (Italy): a case of IgG+/IgM- response? La Clinica Terapeutica, 169(4):e145-e148.
 
[13]  Shapoval AN. Primary progredient forms of tick-borne encephalitis, Zh Nevrol Psikhiatr Im S S Korsakova, 1976, vol. 76 (pg. 182-8).
 
[14]  Sigal LH. Laboratory confirmation of the diagnosis of Lyme disease. Uptodate. 2002; 11: 1.
 
[15]  Tugwell P, Dennis DT, Weinstein A, Wells G, Shea B, Nichol G, et al. Laboratory evaluation in the diagnosis of Lyme disease. Ann Intern Med. 1997; 127: 1109-23.
 
[16]  Bunikis J, Barbour AG. Laboratory testing for suspected Lyme disease. Med Clin North Am. 2002; 86: 311-40.
 
[17]  Taba, P., Schmutzhard, E., Forsber,P., Lutsar, I., Ljøstad U., Mygland, A. et’al (2017), EAN consensus review on prevention, diagnosis and management of tick-borne encephalitis, European Journal of Neurology, 24(10): 1214-e61.
 
[18]  Human Animal Infections and Risk Surveillance group. HAIRS risk assessment: tick-borne encephalitis. Qualitative assessment of the risk that tick-borne encephalitis presents to the UK population. London: Public Health England; 2019. Available from: https://www.gov.uk/government/publications/hairs-risk- assessment-tick-borne-encephalitis (Accessed 10 January 2021).
 
[19]  Lotric-Furlan S, Avsic-Zupanc T, Strle F. An abortive form of tick-borne encephalitis (TBE)--a rare clinical manifestation of infection with TBE virus. Wien Klin Wochenschr. 2002; 114: 627-629.
 
[20]  Hellenbrand W, Kreusch T, Böhmer MM, Wagner-Wiening C, Dobler G, Wichmann O, et al. (2019) Epidemiology of Tick-Borne Encephalitis (TBE) in Germany, 2001-2018, Pathogen, 8(2): E42. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630332/(Accessed 10 January 2021).
 
[21]  Wormser GP, Dattwyler RJ, Shapiro ED , et al. “The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis”. Clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006; 43: 1089-134. [PMID: 17029130]
 
[22]  Linden T. Hu, “Lyme Disease”, Annals of Internal Medicine; American College of Physicians, 2016, 10.
 
[23]  Donoso Mantke O, Escadafal C, Niedrig M, Pfeffer M, On Behalf Of The Working Group For Tick-Borne Encephalitis Virus C. Tick-borne encephalitis in Europe, 2007 to 2009. Euro Surveill. 2011; 16(39): pii=19976.
 
[24]  Lindquist L, Vapalahti O. Tick-borne encephalitis. Lancet. 2008; 371(9627): 1861-71.
 
[25]  Walder G, Falkensammer B, Hein FX, Holzmann H, Dierich MP, Würzner R. Tick-borne encephalitis in the Tyrol (Austria): changes in incidence and endemicity 2000-2006. Int J Med Microbiol. 2008; 298 Suppl 1:88-93.
 
[26]  Anna J. Henningsson, A., J., Lindqvist, R., Norberg, P., Lindblom, P., Roth, A., Forsberg, P., et ‘al. (2016), Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick, Emerging Infecious Disease, 22(8): 1485-1487.