Factors associated with severity of tick-borne encephalitis: A prospective observational study

Travel Med Infect Dis. 2018 Nov-Dec:26:25-31. doi: 10.1016/j.tmaid.2018.10.003. Epub 2018 Oct 6.

Abstract

Background: Information on parameters associated with the severity of tick-borne encephalitis (TBE) is limited.

Methods: The association between 15 pre-defined parameters and the severity of TBE was evaluated in 717 consecutive adult patients diagnosed in Slovenia 2007-2012.

Results: Multivariable logistic regression showed that patient age (odds ratio, OR 1.26, 95% CI 1.11-1.44; P = 0.001), previous vaccination against TBE (OR 14.23, 95% CI 1.72-117.87; P = 0.014), blood leukocyte count (OR 1.45, 95% CI 1.13-1.85; P = 0.004), and level of specific TBE virus serum IgG antibodies (OR 0.85, 95% CI 0.75-0.96; P = 0.009) were associated with severe acute illness based on the clinical diagnosis. When severity of TBE was based on the severity score and linear regression was used, corresponding association was found for age (estimated coefficient, EC 1.70, 95% CI 1.06-2.33; P<0.001), previous vaccination against TBE (EC 11.16, 95% CI 5.05-17.27; P < 0.001), serum C-reactive protein level (EC 1.20, 95% CI 0.48-1.91; P = 0.001), and level of specific TBE virus serum IgG antibodies (EC -0.74, 95% CI -1.27-0.20; P = 0.007).

Conclusions: Previous vaccination against TBE, low levels of TBE virus serum IgG antibodies, older age, higher blood leukocyte count, and higher serum C-reactive protein levels are associated with more severe TBE.

Keywords: Age; Predictors; Previous vaccination; Serum IgG antibodies; Severity; Tick-borne encephalitis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Antibodies, Viral / blood
  • C-Reactive Protein / analysis
  • Encephalitis Viruses, Tick-Borne / immunology*
  • Encephalitis, Tick-Borne / blood
  • Encephalitis, Tick-Borne / immunology
  • Encephalitis, Tick-Borne / pathology*
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Leukocyte Count
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Slovenia / epidemiology
  • Vaccination*
  • Viral Vaccines / therapeutic use

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Viral Vaccines
  • C-Reactive Protein