Panatto Donatella, Domnich Alexander, Amicizia Daniela, Reggio Paolo, Iantomasi Raffaella
Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
Hygiene Unit, San Martino Policlinico Hospital, Largo R. Benzi 10, 16132 Genoa, Italy.
Microorganisms. 2022 Feb 18;10(2):464. doi: 10.3390/microorganisms10020464.
Tick-borne encephalitis (TBE) is endemic in several European countries, and its incidence has recently increased. Various factors may explain this phenomenon: social factors (changes in human behavior, duration and type of leisure activities and increased tourism in European high-risk areas), ecological factors (e.g., effects of climate change on the tick population and reservoir animals), and technological factors (improved diagnostics, increased medical awareness). Furthermore, the real burden of TBE is not completely known, as the performance of surveillance systems is suboptimal and cases of disease are under-reported in several areas. Given the potentially severe clinical course of the disease, the absence of any antiviral therapy, and the impossibility of interrupting the transmission of the virus in nature, vaccination is the mainstay of prevention and control. TBE vaccines are effective (protective effect of approximately 95% after completion of the basic vaccination-three doses) and well tolerated. However, their uptake in endemic areas is suboptimal. In the main endemic countries where vaccination is included in the national/regional immunization program (with reimbursed vaccination programs), this decision was driven by a cost-effectiveness assessment (CEA), which is a helpful tool in the decision-making process. All CEA studies conducted have demonstrated the cost-effectiveness of TBE vaccination. Unfortunately, CEA is still lacking in many endemic countries, including Italy. In the future, it will be necessary to fill this gap in order to introduce an effective vaccination strategy in endemic areas. Finally, raising awareness of TBE, its consequences and the benefit of vaccination is critical in order to increase vaccination coverage and reduce the burden of the disease.
蜱传脑炎（TBE）在几个欧洲国家呈地方性流行，且其发病率最近有所上升。多种因素可解释这一现象：社会因素（人类行为的变化、休闲活动的时长和类型以及欧洲高风险地区旅游业的增加）、生态因素（例如气候变化对蜱虫种群和储存宿主动物的影响）以及技术因素（诊断方法的改进、医疗意识的提高）。此外，由于监测系统的效能欠佳且几个地区疾病病例报告不足，蜱传脑炎的实际负担尚不完全清楚。鉴于该疾病潜在的严重临床病程、缺乏任何抗病毒疗法以及无法在自然界中阻断病毒传播，疫苗接种是预防和控制的主要手段。蜱传脑炎疫苗有效（完成基础免疫——三剂后保护效果约为95%）且耐受性良好。然而，其在流行地区的接种率并不理想。在将疫苗接种纳入国家/地区免疫规划（有报销疫苗接种项目）的主要流行国家，这一决定是由成本效益评估（CEA）推动的，成本效益评估是决策过程中的一个有用工具。已开展的所有成本效益评估研究均证明了蜱传脑炎疫苗接种的成本效益。不幸的是，包括意大利在内的许多流行国家仍缺乏成本效益评估。未来，有必要填补这一空白，以便在流行地区引入有效的疫苗接种策略。最后，提高对蜱传脑炎、其后果以及疫苗接种益处的认识对于提高疫苗接种覆盖率和减轻疾病负担至关重要。
