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Seroprevalence of tick-borne encephalitis virus and vaccination coverage of tick-borne encephalitis, Sweden, 2018 to 2019
- Bo Albinsson1,2,* , Tove Hoffman1,* , Linda Kolstad1 , Tomas Bergström4 , Gordana Bogdanovic5 , Anna Heydecke6 , Mirja Hägg5 , Torbjörn Kjerstadius7 , Ylva Lindroth8 , Annika Petersson9 , Marie Stenberg10 , Sirkka Vene1 , Patrik Ellström2,3 , Bengt Rönnberg1,2 , Åke Lundkvist1
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View Affiliations Hide AffiliationsAffiliations: 1 Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden 2 Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden 3 Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden 4 Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden 5 Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden 6 Centre for Research and Development, Uppsala University, Region Gävleborg, Gävle, Sweden 7 Laboratory Medicine, Clinical Microbiology, Central Hospital, Karlstad, Sweden 8 Department of Laboratory Medicine, Medical Microbiology, Lund University, Skåne Laboratory Medicine, Lund, Sweden 9 Department of Clinical Chemistry and Transfusion Medicine, Växjö Central Hospital, Växjö, Sweden 10 Laboratory Medical Center Gotland, Visby hospital, Visby, Sweden * These authors contributed equally to the work and share the first authorship.Bo Albinssonbo.albinsson akademiska.se
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Citation style for this article: Albinsson Bo, Hoffman Tove, Kolstad Linda, Bergström Tomas, Bogdanovic Gordana, Heydecke Anna, Hägg Mirja, Kjerstadius Torbjörn, Lindroth Ylva, Petersson Annika, Stenberg Marie, Vene Sirkka, Ellström Patrik, Rönnberg Bengt, Lundkvist Åke. Seroprevalence of tick-borne encephalitis virus and vaccination coverage of tick-borne encephalitis, Sweden, 2018 to 2019. Euro Surveill. 2024;29(2):pii=2300221. https://doi.org/10.2807/1560-7917.ES.2024.29.2.2300221 Received: 14 Apr 2023; Accepted: 07 Nov 2023
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Abstract
In Sweden, information on seroprevalence of tick-borne encephalitis virus (TBEV) in the population, including vaccination coverage and infection, is scattered. This is largely due to the absence of a national tick-borne encephalitis (TBE) vaccination registry, scarcity of previous serological studies and use of serological methods not distinguishing between antibodies induced by vaccination and infection. Furthermore, the number of notified TBE cases in Sweden has continued to increase in recent years despite increased vaccination.
The aim was to estimate the TBEV seroprevalence in Sweden.
In 2018 and 2019, 2,700 serum samples from blood donors in nine Swedish regions were analysed using a serological method that can distinguish antibodies induced by vaccination from antibodies elicited by infection. The regions were chosen to reflect differences in notified TBE incidence.
The overall seroprevalence varied from 9.7% (95% confidence interval (CI): 6.6–13.6%) to 64.0% (95% CI: 58.3–69.4%) between regions. The proportion of vaccinated individuals ranged from 8.7% (95% CI: 5.8–12.6) to 57.0% (95% CI: 51.2–62.6) and of infected from 1.0% (95% CI: 0.2–3.0) to 7.0% (95% CI: 4.5–10.7). Thus, more than 160,000 and 1,600,000 individuals could have been infected by TBEV and vaccinated against TBE, respectively. The mean manifestation index was 3.1%.
A difference was observed between low- and high-incidence TBE regions, on the overall TBEV seroprevalence and when separated into vaccinated and infected individuals. The estimated incidence and manifestation index argue that a large proportion of TBEV infections are not diagnosed.
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