Abstract:
Tick-borne encephalitis (TBE) is one of the most important infectious diseases of the central nervous system in dogs from endemic areas. While in humans survival rate and long-term outcomes are well described, these data are lacking in veterinary literature. The aim of the present paper is to characterize the clinical aspects of TBE and to investigate fatality rate, long-term outcome and the long-term neurological sequelae in a population of dogs infected with TBE. We performed a retrospective analysis of 54 dogs diagnosed with TBE at the veterinary hospital of the University of Zurich between 1999 and 2016. Medical data such as signalment, clinical presentation, results of diagnostic procedures, treatment and outcome were collected and analyzed. Statistical analysis including a cox proportional hazard model using a backward stepwise regression approach was performed. In 62% of the TBE cases unspecific signs were described before the onset of neurological signs, resembling a biphasic appearance that is well known in human TBE. Case fatality rate was 33% and all dogs died within the first 4 months after diagnosis. Long-term neurological sequalae were detected in 17% of the TBE cases. For each day of clinical signs before hospital entry the odds of sequalae increased by a factor of 1.88 (CI 1.04-3.15). Older dogs and dogs presented with seizure activity had an increased hazard risk of death (Hazard ration = 1.2, p = 0.03; and 9.38, p = 0.001, respectively). In conclusion, despite TBE being a life-threatening disease with severe clinical signs, the survival rate in our study was 67%. However, long-term sequalae can be of concern especially in dogs with longer clinical course.
摘要:
tick传脑炎(TBE)是流行地区犬中枢神经系统最重要的传染病之一。虽然在人类中,生存率和长期结果得到了很好的描述,这些数据在兽医文献中是缺乏的。本文的目的是表征TBE的临床方面并调查死亡率,感染TBE的犬群的长期结果和长期神经系统后遗症。我们对1999年至2016年期间在苏黎世的兽医医院诊断为TBE的54只狗进行了回顾性分析。医疗数据,如信号,临床表现,诊断程序的结果,收集并分析治疗和结果。使用后向逐步回归方法进行包括cox比例风险模型的统计分析。在62%的TBE病例中,在出现神经系统体征之前就描述了非特异性体征。类似于在人类TBE中众所周知的双相外观。病死率为33%,所有狗在诊断后的前4个月内死亡。在17%的TBE病例中检测到长期神经后遗症。入院前每天出现临床体征,后遗症的几率增加1.88倍(CI1.04-3.15)。年龄较大的狗和出现癫痫发作活动的狗具有增加的死亡危险风险(分别为危险比=1.2,p=0.03;和9.38,p=0.001)。总之,尽管TBE是一种具有严重临床症状的危及生命的疾病,我们研究的生存率为67%.然而,长期后遗症可能会引起关注,尤其是在临床病程较长的狗中。