Abstract:
Tick-borne encephalitis (TBE) is a viral arthropod infection, endemic to large parts of Europe and Asia, and is characterised by neurological involvement, which can range from mild to severe, and in 33-60% of cases, it leads to a post-encephalitis syndrome and long-term morbidity. While TBE virus, now identified as Orthoflavivirus encephalitidis, was originally isolated in 1937, the pathogenesis of TBE is not fully appreciated with the mode of transmission (blood, tick, alimentary), viral strain, host immune response, and age, likely helping to shape the disease phenotype that we explore in this review. Importantly, the incidence of TBE is increasing, and due to global warming, its epidemiology is evolving, with new foci of transmission reported across Europe and in the UK. As such, a better understanding of the symptomatology, diagnostics, treatment, and prevention of TBE is required to inform healthcare professionals going forward, which this review addresses in detail. To this end, the need for robust national surveillance data and randomised control trial data regarding the use of various antivirals (e.g., Galidesivir and 7-deaza-2\'-CMA), monoclonal antibodies, and glucocorticoids is required to improve the management and outcomes of TBE.
摘要:
蜱传脑炎(TBE)是一种病毒性节肢动物感染,欧洲和亚洲大部分地区特有,以神经系统受累为特征,从轻度到重度,在33-60%的病例中,它会导致脑炎后综合征和长期发病。而TBE病毒,现在被确定为正黄病毒脑炎,最初分离于1937年,TBE的发病机理并没有完全理解其传播方式(血液,tick,消化道),病毒株,宿主免疫反应,和年龄,可能有助于塑造我们在这篇综述中探索的疾病表型。重要的是,TBE的发病率正在增加,由于全球变暖,它的流行病学正在演变,欧洲和英国报道了新的传播重点。因此,对症状的更好理解,诊断,治疗,预防TBE需要告知医疗保健专业人员前进,这篇评论详细讨论了这一点。为此,需要关于使用各种抗病毒药物的可靠的国家监测数据和随机对照试验数据(例如,加利地韦和7-deaza-2'-CMA),单克隆抗体,需要糖皮质激素来改善TBE的管理和结局。