Pediatric tick-borne encephalitis in 371 cases from an endemic region in Slovenia, 1959 to 2000

Background. With the exception of Lyme borreliosis, tick-borne encephalitis (TBE) is the most prevalent tick-transmitted disease in Europe. Here we report clinical and epidemiologic features of the largest number of children with TBE reported to date and the longest (i.e. 42-year) retrospective survey of pediatric TBE cases from one geographic region. Methods. Case records of 371 patients, age 0 to 15 years, with serologically confirmed TBE and hospitalized between 1959 and 2000 at the Department of Infectious Diseases of the General Hospital Celje, Slovenia were reviewed and analyzed. Results. Children represented 23.5% of 1578 confirmed TBE cases in the study period. Children were admitted to hospital throughout the year, but the majority were treated during summer months. In 178 (47.9%) children, a tick bite was noticed before admission. A biphasic course of illness occurred in 249 (67.1%) patients. The most common symptoms and signs of TBE were raised body temperature [>38degreesC (n = 371)], headache and meningeal signs (n = 346), fatigue (n = 337) and vomiting (n = 327). Meningitis was diagnosed in 232 (62.5%) children, and meningoencephalitis was diagnosed in 139 (37.5%). There was a tendency for greater severity of TBE with increasing age. None of the children with TBE died, and none had permanent sequelae. Conclusions. The results of our study indicate that pediatric TBE is relatively mild disease with favorable outcome.