Tick-borne encephalitis. Clinical data and incidence in the Black Forest 1994

The clinical data and courses of 145 patients (meningitis, meningoencephalitis, myelitis, radiculitis) with serologically proven tick-borne encephalitis (TBE) are presented. All cases occurred in the black forest and the upper rhine valley in the year 1994. In comparison to former years the incidence had increased considerably. Endemic areas for TBE were the valleys of Kinzig, Elz and Dreisam. With 19 cases of TBE the area around Pforzheim was recognized as a new endemic region. About one third of patients were treated in the hospitals of Freiburg. A previous tick bite was recalled by 87/145 patients (60%), a prodromal stage by 77/145 patients (53%). The disease ran a light course in 87 patients, a moderate course in 38, and a severe course in 20 patients. Two thirds of severe courses were associated with myelitis and/or radiculitis. One patient died (0.7%), nine patients had flaccid tetraparesis for more than six months. No correlation could be demonstrated between the clinical course and particular regional areas of infection.