Assessment of registered and hidden epidemic process of tick-borne encephalitis in the Republic of Karelia

Abstract

Introduction. The incidence of tick-borne encephalitis in the Russia remains relevant. The assessment of the epidemic process in the Republic of Karelia is important not only in terms of understanding its general patterns, but in connection with the growth of tourist attendance in the region. Aims: To assess the current epidemic situation of tick-borne encephalitis in the Republic of Karelia, and to compare the characteristics of registered and hidden epidemic processes. Materials and methods. The risk of infection and incidence were estimated based on the analysis of the registered cases of seeking medical help in connection with tick bites, the results of a study of tick-borne encephalitis virus (TBEV) infection rate in ticks, and the epidemiological investigation of cases of tick-borne encephalitis in 1992–2022. Clinical, gender and age structure, territorial distribution of patients and victims of the tick bites were compared with the results of serological studies of 2379 blood samples of the adult population, conducted in 2011–2022. Results. Infection rates of ticks removed from humans ranged from 23.6–27.0% in 2002–2005 to 1.0% in 2022. In 2004, the TBEV antigen was detected in mosquitoes. The territory of risk is the southern part of Republic. However, the increase in number of cases of seeking medical help was observed in the northern part of Republic. The incidence rates exceeded the national average, especially in 2003–2004 (15.3–11.6 per 100 thousand). In 2021–2022, it decreased to 1.8–1.5 per 100,000. The dynamics of incidence had a high-degree correlation with the dynamics of seeking medical help and infection rates in ticks (R = 0.92 and 0.73). The reported incidence was lower than the estimated risk of infection. The meningeal forms of infection were most often diagnosed. The risk of the disease was higher in the elderly and in men, which was determined by the conditions of infection. Antibodies to TBEV were detected in 11.8 ± 0.7% of the examined persons. Conclusion. A steady decrease in rates of registered tick-borne encephalitis incidence has been revealed in the Republic of Karelia, mainly due to the action of biological and natural factors. The assessment of seroprevalence made it possible to reveal the hidden part of the epidemic process.