%0 Journal Article
%T Epidemiology of Tick-Borne Encephalitis (TBE) in Germany, 2001每2018
%A Christiane Wagner-Wiening
%A Doris Altmann
%A Gerhard Dobler
%A Merle M. Bˋhmer
%A Ole Wichmann
%A Teresa Kreusch
%A Wiebke Hellenbrand
%J Archive of "Pathogens".
%D 2019
%R 10.3390/pathogens8020042
%X We reviewed tick-borne encephalitis (TBE) surveillance and epidemiology in Germany, as these underlie public health recommendations, foremost vaccination. We performed descriptive analyses of notification data (2001每2018, n = 6063) according to region, demographics and clinical manifestations and calculated incidence trends using negative binomial regression. Risk areas were defined based on incidence in administrative districts. Most cases (89%) occurred in the federal states of Baden-Wurttemberg and Bavaria, where annual TBE incidence fluctuated markedly between 0.7每2.0 cases/100,000 inhabitants. A slight but significantly increasing temporal trend was observed from 2001每2018 (age-adjusted incidence rate ratio (IRR) 1.02 (95% confidence interval (CI): 1.01每1.04)), primarily driven by high case numbers in 2017每2018. Mean incidence was highest in 40每69-year-olds and in males. More males (23.7%) than females (18.0%, p = 0.02) had severe disease (encephalitis or myelitis), which increased with age, as did case-fatality (0.4% overall; 2.1% among ≡70-year-olds). Risk areas increased from 129 districts in 2007 to 161 in 2019. Expansion occurred mainly within existent southern endemic areas, with slower contiguous north-eastern and patchy north-western spread. Median vaccination coverage at school entry in risk areas in 2016每2017 ranged from 20%每41% in 4 states. Increasing TBE vaccine uptake is an urgent priority, particularly in high-incidence risk areas
%K Tick-borne encephalitis (TBE)
%K epidemiology
%K incidence
%K risk areas
%K clinical manifestations
%K temporospatial distribution
%K vaccination
%K Germany
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630332/