Stefanoff P, Eidson M, Morse D L, Zielinski A
National Institute of Hygiene, Department of Epidemiology, Warsaw, Poland.
Euro Surveill. 2005 Jan;10(1):23-5.
Central European tickborne encephalitis (TBE) is a viral disease of the central nervous system. Despite a surveillance system for TBE existing in Poland since 1970, there are no standardised case definitions and different diagnostic tests are used in various regions. The purpose of this study was to summarise four years of surveillance data using standardised case definitions. From 1999 to 2002, 607 cases of TBE were reported to Poland's national surveillance system: 386 (63.6%) were males, 331 (54.5%) lived in rural areas, and 186 (30.6%) were between 30 and 50 years old. Of 606 diagnosed cases, 453 (74.7%) had aseptic meningitis, 109 (18.0%) had meningoencephalitis, and 44 (7.3%) had meningoencephalomyelitis. Of the 607 reported cases, 602 (99.2%) could be classified: 153 (25.4%) as confirmed, 343 (57.0%) as probable, and 106 (17.6%) as possible cases. There was a significant difference in classified cases by gender: 28.6% of male cases were classified as confirmed, compared with 19.7% of female cases (chi2= 10.48, p=0.0053). There was a significant difference in case classification by clinical diagnosis: 32.4% of cases with meningoencephalitis were classified as confirmed cases, compared with 24.7% of cases with aseptic meningitis (chi2=11.79, p=0.019). There were also significant differences in the distribution by case definition group across geographical regions. For appropriate monitoring of TBE, a uniform and valid case definition should be used in European countries. With only 25% of reported cases meeting the definition for confirmed cases, there is a need for more complete follow-up and standardised testing of suspect cases.
中欧蜱传脑炎（TBE）是一种中枢神经系统的病毒性疾病。尽管波兰自1970年起就存在TBE监测系统，但尚无标准化的病例定义，不同地区使用不同的诊断检测方法。本研究的目的是使用标准化病例定义总结四年的监测数据。1999年至2002年，波兰国家监测系统共报告607例TBE病例：386例（63.6%）为男性，331例（54.5%）居住在农村地区，186例（30.6%）年龄在30至50岁之间。在606例确诊病例中，453例（74.7%）患有无菌性脑膜炎，109例（18.0%）患有脑膜脑炎，44例（7.3%）患有脑膜脑脊髓炎。在607例报告病例中，602例（99.2%）可分类：153例（25.4%）为确诊病例，343例（57.0%）为疑似病例，106例（17.6%）为可能病例。按性别分类的病例存在显著差异：28.6%的男性病例被分类为确诊病例，而女性病例为19.7%（χ2 = 10.48，p = 0.0053）。按临床诊断分类的病例存在显著差异：32.4%的脑膜脑炎病例被分类为确诊病例，而无菌性脑膜炎病例为24.7%（χ2 = 11.79，p = 0.019）。病例定义组在不同地理区域的分布也存在显著差异。为了对TBE进行适当监测，欧洲国家应使用统一且有效的病例定义。由于报告病例中只有25%符合确诊病例定义，因此需要对疑似病例进行更全面的随访和标准化检测。
