TBE In Italy

Abstract

Italy is considered a low-incidence country for tick-borne encephalitis (TBE) in Europe.1 Areas at higher risk for TBE within Italy are geographically clustered in the forested and mountainous regions and provinces of the northeastern part of the country, as suggested by TBE case series published over the last decade. 2–4 A national enhanced surveillance system for TBE has been established since 2017.5 Before this, information on the occurrence of TBE cases at the national level in Italy was lacking. Both incidence rates and the geographical distribution of the disease were mostly inferred from endemic areas where surveillance was already in place, and from ad hoc studies and international literature. TBE has been recorded in Italy since 1967, with foci of infections in the northeast (Trento, Belluno and Gorizia) and central (Florence and Latina) provinces.6–9 TBE presence in central Italy has not been confirmed by further studies on ticks and serosurveys conducted afterwards,10,11 nor by human cases, posing concerns about possible misdiagnosis.