PDF(Pubmed)
Abstract：
In Germany, tick-borne encephalitis (TBE) infections mainly occur in southern regions. Despite recent increases in incidence, TBE vaccination coverage remains low, necessitating additional preventive strategies against TBE. Our case-control study in Southern Germany from 2018 to 2020 mapped knowledge/application of tick-protective strategies and identified TBE risk factors. We calculated odds ratios (OR), with 95% confidence intervals (CI). We interviewed 581 cases and 975 matched controls. Most participants recalled lifetime tick bites, mainly while walking, gardening, or hiking. However, only 45% of cases noticed ticks during exposure time; another 12% reported unpasteurized milk intake. While tick-protection knowledge was satisfactory, application lagged behind. Risk factors included dog ownership (OR = 2.45, 95% CI: 1.85−3.24), walks ≥ 4×/week (OR = 2.11, 95% CI: 1.42−3.12), gardening ≥ 4×/week (OR = 1.83, 95% CI: 1.11−3.02), and garden proximity < 250 m of forests (OR = 2.54, 95% CI: 1.82−3.56). Applying ≥2 tick-protective strategies (OR = 0.52, 95% CI: 0.40−0.68) and keeping lawns mowed (OR = 0.63, 95% CI: 0.43−0.91) were inversely associated with TBE. In 2020 (likely pandemic-related), cases reported significantly more walks than previously, potentially explaining the record high case numbers. Our findings provide guidance on targets for TBE prevention. Persons with gardens near forests, frequent outdoor activities, or dogs could particularly benefit from targeted information, including on vaccination and preventing tick bites.
摘要：
在德国,蜱传脑炎（TBE）感染主要发生在南部地区。尽管最近发病率有所增加，TBE疫苗接种覆盖率仍然很低，需要针对TBE的额外预防策略。我们于2018年至2020年在德国南部进行的病例对照研究绘制了滴答保护策略的知识/应用，并确定了TBE风险因素。我们计算了赔率比(OR)，95%置信区间(CI)。我们采访了581例病例和975例匹配的对照。大多数参与者回忆起一生的蜱叮咬，主要是在走路的时候，园艺,或者徒步旅行.然而,只有45％的病例在暴露时间内发现了蜱虫;另有12％的病例报告了未经巴氏消毒的牛奶摄入量。虽然壁虱保护知识令人满意，应用程序落后。风险因素包括养狗(OR=2.45，95%CI：1.85−3.24)，步行≥4×/周(OR=2.11，95%CI：1.42−3.12)，园艺≥4×/周(OR=1.83，95%CI：1.11−3.02)，和花园接近<250米的森林(OR=2.54，95%CI：1.82−3.56)。应用≥2种蜱保护策略(OR=0.52，95%CI：0.40−0.68)和保持草坪修剪(OR=0.63，95%CI：0.43−0.91)与TBE呈负相关。2020年（可能与大流行有关），报告的病例比以前有更多的步行，可能解释了创纪录的高病例数。我们的研究结果为TBE预防目标提供了指导。森林附近有花园的人，频繁的户外活动,或者狗可以特别受益于有针对性的信息，包括疫苗接种和预防蜱叮咬。
