Cent Eur J Public Health 2018, 26(Supplement):S47-S50 | DOI: 10.21101/cejph.a5272

Milk outbreaks of tick-borne encephalitis in Slovakia, 2012–2016

Erik Dorko1, Ján Hockicko2, Kvetoslava Rimárová1, Andrea Bušová1, Peter Popaďák3, Jana Popaďáková4, Ivan Schréter2
1 Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
2 Department of Infectology and Travel Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice and Louis Pasteur University Hospital, Košice, Slovak Republic
3 Department of Forensic Medicine and Pathological Anatomy, Health Care Surveillance Authority, Košice, Slovak Republic
4 Department of Neurology, Hospital Vranov nad Topľou, Vranov nad Topľou, Slovak Republic

Objective: Tick-borne encephalitis virus (TBEV) is most commonly transmitted to humans via the bite of an infected tick. Alimentary infection through the consumption of TBEV-contaminated dairy products is also well-documented and is responsible for some diseases in endemic areas. The aim of the study was to emphasize the risk of contracting tick-borne encephalitis (TBE) by consuming raw milk and dairy products and to describe TBE epidemics in Slovakia for the period 2012-2016.

Methods: The data on epidemics were obtained from the Annual Reports for the period 2012-2016 available on the website of the Public Health Authority of the Slovak Republic. Medical records of patients hospitalized during epidemics were provided by the Department of Infectology and Travel Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, and the Louis Pasteur University Hospital in Košice.

Results: During the period 2012-2016, 13 smaller or larger TBE epidemic outbreaks were recorded in the Slovak Republic. The two outbreaks of TBE reported in 2012 were associated with the consumption of raw goat's milk and dairy products. The first case was an outbreak involving 12 infected people in the Lučenec District. The second case was a family outbreak in the Žilina District, where 3 persons out of 4 family members were infected. In 2013, one epidemic was reported involving 5 persons following the consumption of sheep's cheese from a farm in the Prešov District. One outbreak with 11 cases was reported in 2014. The investigation confirmed its association with the consumption of sheep's cheese in a restaurant located in the Ružomberok District. In 2015, 4 epidemics were described related to the consumption of goat's/sheep's milk and cheese (Žilina District, Krupina District, Kysucké Nové Mesto District, Trenčín District). In 2016, there were 5 TBE epidemics related to the consumption of milk and dairy products. The largest TBE epidemic outbreak in the last 5 years occurred in the Košice District. In this outbreak approximately 500 people were exposed, and 44 contracted the disease. Infected persons confirmed consumption of sheep's cheese from a farm.

Conclusions: Consumption of milk and dairy products made only from pasteurized milk, as well as the immunization of humans and animals are the most effective preventive measures against TBE.

Keywords: tick-borne encephalitis, alimentary infection, outbreaks, cheese, milk, animals

Received: December 5, 2017; Revised: September 5, 2018; Accepted: September 5, 2018; Published: December 31, 2018  Show citation

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Dorko E, Hockicko J, Rimárová K, Bušová A, Popaďák P, Popaďáková J, Schréter I. Milk outbreaks of tick-borne encephalitis in Slovakia, 2012–2016. Cent Eur J Public Health. 2018;26(Supplement):S47-50. doi: 10.21101/cejph.a5272. PubMed PMID: 30817873.
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    References

    1. World Health Organization. Vaccines against tick-borne encephalitis: WHO position paper. Wkly Epidemiol Rec. 2011 Jun;86(24):241-56. Go to PubMed...
    2. Amicizia D, Domnich A, Panatto D, Lai PL, Cristina ML, Avio U, et al. Epidemiology of tick-borne encephalitis (TBE) in Europe and its prevention by available vaccines. Hum Vaccin Immunother. 2013 May;9(5):1163-71. Go to original source... Go to PubMed...
    3. Petri E, Gniel D, Zent O. Tick-borne encephalitis (TBE) trends in epidemiology and current and future management. Travel Med Infect Dis. 2010 Jul;8(4):233-45. Go to original source... Go to PubMed...
    4. Offerdahl DK, Clancy NG, Bloom ME. Stability of a tick-borne Flavivirus in milk. Front Bioeng Biotechnol. 2016 May;4:40. doi: 10.3389/fbioe.2016.00040. Go to original source... Go to PubMed...
    5. Holzmann H, Aberle SW, Stiasny K, Werner P, Mischak A, Zainer B, et al. Tick-borne encephalitis from eating goat cheese in a mountain region of Austria. Emerg Infect Dis. 2009 Oct;15(10):1671-3. Go to original source... Go to PubMed...
    6. Kříž B, Beneš C, Daniel M. Alimentary transmission of tick-borne encephalitis in the Czech Republic (1997-2008). Epidemiol Mikrobiol Imunol. 2009 Apr;58(2):98-103.
    7. Cisak E, Wójcik-Fatla A, Zając V, Sroka J, Buczek A, Dutkiewicz J. Prevalence of tick-borne encephalitis virus (TBEV) in samples of raw milk taken randomly from cows, goats and sheep in eastern Poland. Ann Agric Environ Med. 2010;17(2):283-6. Go to original source...
    8. Caini S, Szomor K, Ferenczi E, Székelyné Gáspár Á, Csohán Á, Krisztalovics K, et al. Tick-borne encephalitis transmitted by unpasteurised cow milk in western Hungary, September to October 2011. Euro Surveill. 2012 Mar;17(12). pii=20128. Go to original source...
    9. Labuda M, Eleckova E, Lickova M, Sabo A. Tick-borne encephalitis virus foci in Slovakia. Int J Med Microbiol. 2002 Jun;291 Suppl 33:43-7. Go to original source...
    10. Hudopisk N, Korva M, Janet E, Simetinger M, Grgič-Vitek M, Gubenšek J, et al. Tick-borne encephalitis associated with consumption of raw goat milk, Slovenia, 2012. Emerg Infect Dis. 2013 May;19(5):806-8. Go to original source... Go to PubMed...
    11. Bogovic P, Strle F. Tick-borne encephalitis: a review of epidemiology, clinical characteristics, and management. World J Clin Cases. 2015 May;3(5):430-41. Go to original source... Go to PubMed...
    12. Růžek D, Dobler G, Mantke OD. Tick-borne encephalitis: pathogenesis and clinical implications. Travel Med Infect Dis. 2010 Jul;8(4):223-32. Go to original source... Go to PubMed...
    13. Public Health Authority of the Slovak Republic. Annual report [Internet]. Bratislava: Public Health Authority of the Slovak Republic; c2009 [cited 2017 Sep 13]. Available from: ttp://www.uvzsr.sk/index.php?option=com_content&view=category&layout=blog&id=25&Itemid=34 (In Slovak.)
    14. Markovinovic L, Kosanovic Ličina ML, Tešic V, Vojvodic D, Vladušic Lucic I, Kniewald T, et al. An outbreak of tick-borne encephalitis associated with raw goat milk and cheese consumption, Croatia, 2015. Infection. 2016 Oct;44(5):661-5. Go to original source... Go to PubMed...
    15. Kerbo N, Donchenko I, Kutsar K, Vasilenko V. Tickborne encephalitis outbreak in Estonia linked to raw goat milk, May-June 2005. Euro Surveill. 2005 Jun;10(25). pii=2730. Go to original source... Go to PubMed...
    16. Breeding services of the Slovak Republic. Central register of livestock [Internet]. Bratislava: Breeding services of the Slovak Republic; 2010 [cited 2017 Oct 3]. Available from: https://www.cehz.sk/index.jsp. (In Slovak.)
    17. International Dairy Foods Association. Pasteurization [Internet]. Washington: International Dairy Foods Association; 2017 [cited 2017 Oct 3]. Available from: https://www.idfa.org/news-views/media-kits/milk/pasteurization.
    18. Balogh Z, Egyed L, Ferenczi E, Bán E, Szomor KN, Takács M, et al. Experimental infection of goats with tick-borne encephalitis virus and the possibilities to prevent virus transmission by raw goat milk. Intervirology. 2012;55(3):194-200. Go to original source... Go to PubMed...
    19. Decree No. 343 of Ministry of Agriculture and Rural Development of the Slovak Republic of December 8, 2016, which defines details on some dairy products. Zbierka zákonov SR. 2016;Pt 112. (In Slovak.)
    20. Pfeffer M, Dobler G. Tick-borne encephalitis virus in dogs - is this an issue? Parasit Vectors. 2011 Apr;4:59. doi: 10.1186/1756-3305-4-59. Go to original source... Go to PubMed...
    21. Klaus C, Hoffmann B, Moog U, Schau U, Beer M, Süss J. Can goats be used as sentinels for tick-borne encephalitis (TBE) in non-endemic areas? Experimental studies and epizootiological observations. Berl Munch Tierarztl Wochenschr. 2010 Nov-Dec;123(11-12):441-5. Go to PubMed...
    22. Klaus C, Ziegler U, Kalthoff D, Hoffmann B, Beer M. Tick-borne encephalitis virus (TBEV) - findings on cross reactivity and longevity of TBEV antibodies in animal sera. BMC Vet Res. 2014 Apr;10:78. doi: 10.1186/1746-6148-10-78. Go to original source... Go to PubMed...
    23. Klaus C, Beer M, Saier R, Schubert H, Bischoff S, Süss J. Evaluation of serological tests for detecting tick-borne encephalitis virus (TBEV) antibodies in animals. Berl Munch Tierarztl Wochenschr. 2011 Nov-Dec;124(11-12):443-9. Go to PubMed...

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