Tick-borne encephalitis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.

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Overview

There are three distinct subtypes associated with the tick-borne encephalitis virus. They include a Siberian, a Far Eastern, and a European subtype. Each subtype infection will display with different clinical manifestations. Identifying the subtype responsible for infection may assist in predicting the overall severity of the disease.

Classification

• TBE virus has three subtypes:

1. Siberian subtype (Tick vector: unknown)
2. Far Eastern subtype (Tick vector: Ixodes persulcatus)
3. European subtype (Tick vector: Ixodes ricinus)

• Subtypes may be useful in predicting the severity of infection.
• The following expresses the three major and most common subtypes responsible for human infection, as well as the associated symptoms.

Subtype	Clinical manifestations
Siberian	May persist as a chronic disease. 5% of cases present in focal encephalitic forms 47% present in meningeal forms 40% present in febrile forms 21% present in a biphasic form. Fatality is apporxiamtely 2%, with continuous complications and a potentially chronic condition.
Far Eastern	31-64% of cases present in focal encephalitic forms. 26% present in meningeal forms 14-16% present in febrile forms 3-8% present in biphasic forms 25% of cases recover fully Fatality is approximately 35% and chronic disease develops is an estimated 0.5% of patients.
European	72-87% experience a biphasic illness. The first phase includes an onset of non-specific flu like symptoms. Following phase one is a remission period of approximately 8 days, during which phase most patients will appear asymptomatic. Further neurological manifestations will appear in phase two. 20-30% of patients will progress in to phase two. Clinical characteristic features of the second stage include meningitis, meningoencephalitis, meningoencephalomyelitis, and meningoencephaloradiculitis. Fatality occurs in less than 2% of cases.