TBE--awareness and protection: the impact of epidemiology, changing lifestyle, and environmental factors.

The International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) held its 12th Annual Meeting in January 2010. The international awareness among the issue of TBE is on the rise, as the European Center for Disease Control considers TBE of high relevance and has launched a series of activities aimed at improving awareness of this tick-transmissible infection and also the World Health Organization has taken up the cause of TBE. The epidemiology of TBE in Europe is characterized by two distinct trends, i.e., a consistent expansion of risk areas on the one hand and major fluctuations in case numbers on the other. TBE risk areas have spread both northward and to higher altitudes - a development thought to be attributable to climate changes having created more favorable living conditions for ticks. Social, political, ecological, economic, and demographic factors also have a role in this development. Preliminary data from 12 European countries show that TBE case numbers in 2009 amounted to 95.8% of those reported in 2006 when Russia is included and to 88% of 2006 data when Russia is excluded. Overall, the level of knowledge of TBE in endemic countries is quite high, but actual vaccination coverage has not kept pace.