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. 2022 Feb;28(2):314-322.
doi: 10.3201/eid2802.204324.

Burden of Tick-Borne Encephalitis, Sweden

Daniel Slunge, Anders Boman, Marie Studahl

Burden of Tick-Borne Encephalitis, Sweden

Daniel Slunge et al. Emerg Infect Dis. 2022 Feb.

Abstract

In recent decades, the incidence of tick-borne encephalitis (TBE) in Sweden has increased. To calculate the burden of disease over a 17-year period, we analyzed data from the Swedish National Health Data Register for TBE cases diagnosed during 1998-2014. We compared healthcare use and sick leave associated with 2,429 persons with TBE with a referent cohort of 7,287 persons without TBE. Patients with TBE were hospitalized for significantly more days during the first year after disease onset (11.5 vs. 1.1 days), logged more specialist outpatient visits (3.6 vs. 1.2 visits), and logged more sick leave days (66 vs. 10.7 days). These differences generally increased over time. The case-fatality rate for TBE was 1.1%. Our calculated cost of TBE to society provides a baseline for decisions on immunization programs. Analyzing register data, our study adds to clinical studies of smaller cohorts and model-based studies that calculate disease burden.

Keywords: Sweden; TBEV; Tick-borne encephalitis; disease cost; economic burden of disease; global burden of disease; hospitalization; meningitis/encephalitis; mortality; parasites; sick leave; tick-borne encephalitis virus; vector-borne infections.

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Figures

Figure 1
Figure 1
Reported tick-borne encephalitis cases per year, Sweden, 1956–2021. Tick-borne encephalitis became a notifiable disease in Sweden in July 2004; thus, the number of reported cases before 2005 is less certain than the number of cases from 2005 on. Source: Swedish Public Health Agency (https://www.folkhalsomyndigheten.se), 2021.
Figure 2
Figure 2
Sources and periods of matched and nonmatched data used in study of tick-borne encephalitis, Sweden. Swedish National Patient Register, https://www.socialstyrelsen.se; Swedish Social Insurance Agency, https://www.forsakringskassan.se; Register for Primary Health in Region Vastra Gotaland, https://www.vgregion.se; Public Health Agency of Sweden, https://www.folkhalsomyndigheten.se; Swedish National Cause of Death Register, https://www.socialstyrelsen.se.
Figure 3
Figure 3
Percentage of hospitalized tick-borne encephalitis case-patients, by age, during 1998–2014 and percentage of population of Sweden in 2014, by age.
See this image and copyright information in PMC

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