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Tick-borne encephalitis-clinical course and outcome. Review of the literature
Lindquist, Lars | Huddinge University Hospital, Stockholm |
Tick-borne encephalitis (TBE) virus is one of the major human pathogenic flaviviruses, which causes infection of the central nervous system. The clinical spectrum of TBE ranges from symptoms of mild meningitis to severe meningoencephalitis with or without myelitis. The mortality rate in Europe is 0-3.9% and paresis in the acute stage is seen in up to 23% of cases. The convalescence after TBE lasts about one year and the frequency of permanent sequelae is 26-46%. In as much as 9% of patients severe disability that required adjustment of daily activities are observed. The incidence of clinical TBE cases increases with age and the severity of the disease as well as the risk of contracting permanent sequelae are agedependent. Despite the fact that areas where TBE is endemic are widely spread over many countries of Europe and Asia, there is only limited reference to this disease in the English-speaking literature. This review will focus on the clinical presentation of the acute disease caused by TBE virus both in adults and children, the risk of contracting permanent sequelae, and a description of the different manifestations at long-term follow up. A summary of retrospective and prospective studies on acute stage of TBE as well as follow-up studies describing the complete spectrum of post-encephalitic symptoms will be presented.