ArticleInfection2023
Recovery and sequelae in 523 adults and children with tick-borne encephalitis in Germany.
Article in Infection, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 24 citations in OpenAlex.
- Tick-borne encephalitis in the Åland Islands, Finland: incidence and disease course since the implementation of a general TBE vaccination programme.Emerging microbes & infections · 2026Article
- Long-term patient-reported neurocognitive and functional outcomes after tick-borne encephalitis: a prospective controlled multicenter cohort study.Journal of neurology · 2026Article
- Long-Term Outcomes in Adult Patients with Tick-Borne Encephalitis in Latvia.Pathogens (Basel, Switzerland) · 2026Article
- Omsk Hemorrhagic Fever Virus and Powassan Virus Infections at Different Times After Immunization with the TBE Vaccine in In Vivo Experiments.International journal of molecular sciences · 2026Article
- Tick-borne encephalitis in Norway: A cohort study of clinical course and health-related quality of life at three- and twelve-month follow-up.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Sequelae of viral CNS infections including outcomes, mechanisms, and knowledge gaps.Npj viruses · 2025Review
- Clinical Spectrum and Dynamics of Sequelae Following Tick-Borne Encephalitis Virus Infection: A Systematic Literature Review.Open forum infectious diseases · 2025Article
- Tick-borne encephalitis in adults in Denmark: a nationwide prospective cohort study from 2015 to 2023.Journal of neurology · 2025Article
- Clinical Characteristics of Tick-Borne Encephalitis in Adult Patients: A 10-year Retrospective Study in Stockholm, Sweden.The Journal of infectious diseases · 2025Article
- Low frequency of N-methyl-D-aspartate receptor autoimmunity in tick-borne encephalitis.PloS one · 2025Article
- Flaviviruses-Induced Neurological Sequelae.Pathogens (Basel, Switzerland) · 2024Review
- Article
- Clinical characteristics and factors affecting disease severity in hospitalized tick-borne encephalitis patients in Norway from 2018 to 2022.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Observational
- Suspected tick-borne flavivirus meningoencephalomyelitis in dogs from the UK: six cases (2021).The Journal of small animal practice · 2024Article
- Results of Tick-Borne Encephalitis Virus (TBEV) Diagnostics in an Endemic Area in Southern Germany, 2007 to 2022.Viruses · 2023Article
- Tick-Borne Encephalitis (TBE): From Tick to Pathology.Journal of clinical medicine · 2023Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
purposeDespite being vaccine-preventable, tick-borne encephalitis (TBE) continues to cause considerable morbidity in Germany. Limited insight into potentially debilitating consequences of TBE may partially underly low (~ 20%) TBE vaccine uptake. We aimed to systematically assess TBE sequelae and other consequences.
methodsRoutinely notified TBE patients from 2018 to 2020 from Southern Germany were invited to telephone interviews acutely and again after 18 months. Duration of acute symptoms was prospectively assessed. Recovery was defined as score 0 on the modified RANKIN scale. Determinants of time to recovery were analysed with cox regression, adjusted for covariates identified using directed acyclic graphs, yielding hazard ratios (HR) and 95% confidence intervals (CI).
resultsOf 558 cases, 523 (93.7%) completed follow-up. Full recovery was reported by 67.3% (children: 94.9%, adults: 63.8%). Sequelae included fatigue (17.0%), weakness (13.4%), concentration deficit (13.0%), and impaired balance (12.0%). Compared with 18-39-year-olds, recovery rates were 44% lower in ≥ 50-year-olds (HR: 0.56, 95%CI 0.42-0.75) and 79% higher in children (HR: 1.79, 95%CI 1.25-2.56). The recovery rate was 64% lower after severe TBE (compared to mild; HR: 0.36, 95%CI 0.25-0.52) and 22% lower with comorbidities (HR: 0.78, 95%CI 0.62-0.99). Substantial health-care use was reported (90.1% hospitalisation, 39.8% rehabilitation). Of employed cases, 88.4% required sick leave; 10.3% planned/reported premature retirement due to sequelae.
conclusionHalf the adult and 5% of paediatric patients reported persisting sequelae after 18 months. Improved prevention could alleviate both individual (morbidity) and societal TBE burden (health-care costs, productivity losses). Insights into sequelae can help guide at-risk populations towards tick-avoidant strategies and encourage TBE vaccination.
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