Trends in Epidemic Process Development of Tick-Borne Encephalitis in the Russian Federation, Laboratory Diagnosis, Prophylaxis and Forecast for 2021

Abstract

Tick-borne encephalitis is a natural-focal infection damaging central nervous system, caused by the similarly-named virus transmitted by several species of ixodic ticks. Natural foci of tick-borne encephalitis (TBE) are widely spread in the forest and forest-steppe landscape zones of the temperate climate belt in the vast territory of Eurasia from the Atlantic to the Pacific Ocean. New TBE-endemic territories have been recently identified in Japan, the Netherlands, and in the UK – in 2019. The increasing risk of infection due to the development of tourism and visits to natural foci of TBE became a public health issue of international concern. The aim of the study is to identify modern features of TBE incidence dynamics in the Russian Federation, the state of laboratory diagnostics and prevention and to predict the incidence for 2021. The paper shows that there is a persistent downward trend in TBE-cases in Russia, which is observed through the past few years. The characteristic feature of the epidemic season-2020 was a significant reduction in the incidence of TBE: 989 cases were registered in 33 constituent entities of the Russian Federation (morbidity rate – 0.67 per 100 000 of the population). The sharp decrease of TBE cases in 2020 as compared to 2019 against the background of a decrease in vaccination can be explained, along with natural factors, by the introduction of restrictive measures during the COVID-19 epidemic. The paper also reflects the dynamics of morbidity, seeking the medical services because of tick bites, the infection rate of the carrier, the scope of vaccination, seroprophylaxis, acaricide treatments. The coverage of express-diagnostic tests of ticks for markers of associated pathogens and its availability for the population are presented. It is recognized that the epidemiological situation on TBE in the Russian Federation remains unfavorable. It demands constant attention on the part of healthcare organizations and Federal Service for Surveillance in the Sphere of Consumers Rights Protection and Human Welfare, as well as management decision making aimed at further decrement in TBE incidence through the improvement of prevention measures, specifically in the entities that are characterized by high TBE incidence. The situation requires monitoring of natural foci of infection, enhancement of prophylaxis and treatment of TBE. The paper provides the forecast of TBE incidence for 2021 and values of the 95 % confidence range of the indicator fluctuation, taking into account the presence or absence of trends in its changes in the territory of federal districts and constituent entities of the Russian Federation in 2011–2020.