Skip to main content

Military Health System

Surveillance Snapshot: Tick-borne Encephalitis in Military Health System Beneficiaries, 2012–2021

Image of iStock—The castor bean tick (Ixoedes ricinus). Credit: Erik Karits. iStock—The castor bean tick (Ixoedes ricinus). Credit: Erik Karits

Recommended Content:

Medical Surveillance Monthly Report

Tick-borne encephalitis (TBE) is a viral infection of the central nervous system that is transmitted by the bite of infected ticks, mostly found in wooded habitats in parts of Europe and Asia.1 In Germany, the rate of 0.5 confirmed cases per 100,000 people in 2019 was the third highest of the 25 European countries reporting data on TBE.1 TBE has been of historical military significance because there are a large number of U.S. service members stationed in Germany, with an estimate of about 35,000 active duty members as of September 2021.2 In the Department of Defense (DOD) reportable medical event guidelines, TBE is a notifiable event listed under arboviral diseases.3

In August 2021, the U.S. Food and Drug Administration (FDA) approved a TBE vaccine (“TICOVAC”) for U.S. travelers visiting or living in endemic areas.4 In February 2022, the U.S. Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted to recommend Pfizer’s TICOVAC vaccine for use in U.S. populations who travel or move to endemic areas and will have extensive exposure to ticks based on their planned outdoor activities, including many service members serving in these locations.5

A 2019 MSMR report described the cases of TBE occurring among U.S. military service members and other beneficiaries between 2006 and 2018.6 This snapshot updates these results through the end of 2021 using confirmed and probable medical event reports of TBE cases contained in the U.S. military’s Disease Reporting System internet, with a focus on the past 10-year surveillance period.

The reported TBE cases between 2012 and 2018 have been previously described,6 consisting of 1 active component service member in 2012, 4 in 2017, and 3 other beneficiaries in 2018 (Figure). In 2019, there was 1 probable case reported in a 45 year-old male Army active component service member, and in 2020 there was 1 confirmed case in a 38 year-old male Army active component service member. In 2021, there were 2 cases reported: 1 probable case in a 6 year-old female Army dependent, and 1 probable case in a 34 year-old Army active component service member. All cases reported between 2019 and 2021 occurred in Germany in the months of June and July. Case comments were available for 2 of the 4 cases; both indicated that tick exposure likely occurred from living or exercising in a wooded area. None of the cases had a prior history of TBE vaccination.

The number of TBE cases per 5-year period among military health system beneficiaries grew from 1 in 2012–2016 to 11 in 2017–2021. Although the total number of cases is small, the increase in recent years provides information that should be considered when contemplating use of the FDA-approved vaccine for U.S. service members and beneficiaries who live or participate in extensive outdoor activities in a TBE-endemic area.

References

1. European Centre for Disease Prevention and Control. Tick-borne Encephalitis – Annual Epidemiologic report for 2019. Accessed 1 April 2022. https://www.ecdc.europa.eu/en/publications-data/tick-borne-encephalitis-annual-epidemiological-report-2019

2. Defense Manpower Data Center. Number of Military and DoD Appropriated Fund (APF) Civilian Personnel Permanently Assigned By Duty Location and Service/Component. September 30, 2021. Accessed 24 March 2022. https://dwp.dmdc.osd.mil/dwp/app/dod-data-reports/workforce-reports

3. Armed Forces Health Surveillance Branch. Armed Forces Reportable Medical Events, Guidelines and Case Definitions. January 2020. Accessed 2 April 2022. https://health.mil/Reference-Center/Publications/2020/01/01/Armed-Forces-Reportable-Medical-Events-Guidelines

4. Pfizer Press Release. U.S. FDA Approves TICOVAC, Pfizer’s Tick-Borne Encephalitis (TBE) Vaccine. 13 August 2021. Accessed 1 April 2022. https://www.pfizer.com/news/press-release/press-release-detail/us-fda-approves-ticovactm-pfizers-tick-borne-encephalitis

5. Pfizer Press Release. CDC Advisory Committee on Immunization Practices Votes to Recommend TICOVAC, Pfizer’s Tick-Borne Encephalitis (TBE) Vaccine, For Those at Risk of Virus Exposure. 23 February 2022. Accessed 1 April 2022. https://www.pfizer.com/news/press-release/press-release-detail/cdc-advisory-committee-immunization-practices-votes

6. Mancuso JD, Bazaco S, Stahlman S, Clausen SS, Cost AA. Tick-borne encephalitis surveillance in U.S. military service members and beneficiaries, 2006–2018. MSMR. 2019;26(11):4–10.

FIGURE. Confirmed or probable TBE cases among U.S. military service members and other beneficiaries, 2012–2021

 

 

You also may be interested in...

Early Identification of SARS-CoV-2 Emergence in the Department of Defense via Retrospective Analysis of 2019–2020 Upper Respiratory Illness Samples

Article
6/1/2021
Army Maj. Raymond Nagley, S-3 officer assigned to the 50th Regional Support Group (RSG), receives a nasal swab to screen for COVID-19 at Fort Hood, Texas, on Feb. 5, 2021, from Spc. Yoali Muniz, a lab tech assigned to the 7406th Troop Medical Clinic, based in Columbia, Missouri. The 50th RSG, a Florida Guard unit based in Homestead, Florida, is preparing for deployment to Poland. (U.S. Army Guard photo by Sgt. 1st Class Shane Klestinski)

Early Identification of SARS-CoV-2 Emergence in the Department of Defense via Retrospective Analysis of 2019–2020 Upper Respiratory Illness Samples

Recommended Content:

Medical Surveillance Monthly Report

Brief Report: Medical Encounters for Snakebite Envenomation, Active and Reserve Components, U.S. Armed Forces, 2016–2020

Article
6/1/2021
Masters of camouflage, the Sidewinder Rattlesnakes are out and about aboard Marine Corps Logistics Base Barstow, California, May 11. Watch where you put your hands and feet, and observe children and pets at all times, as this is the natural habitat for these venomous snakes and a bite can cause serious medical problems. Notice the sharp arrow-shaped head with pronounced jaws, and the raised eye sockets, as well as the telltale rattles. Keep in mind, however, that rattles can be broken or lost, so you may or may not hear a rattle before they strike to protect themselves.

Brief Report: Medical Encounters for Snakebite Envenomation, Active and Reserve Components, U.S. Armed Forces, 2016–2020

Recommended Content:

Medical Surveillance Monthly Report

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Active Component, U.S. Armed Forces, 2020

Article
5/1/2021
U.S. Air Force Capt. Sean Wilson, a native of Winston-Salem, N.C., and a physical therapist with the 59th Orthopedic and Rehabilitation Squadron, teaches a patient some home exercises that he can perform on his own at the Craig Joint-Theater Hospital, Jan. 23, 2012. (U.S. Air Force photo by Spc.Cody Barber, Bagram Air Field, Afghanistan/Released)

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Active Component, U.S. Armed Forces, 2020

Recommended Content:

Medical Surveillance Monthly Report

Morbidity Burdens Attributable to Various Illnesses and Injuries, Deployed Active and Reserve Component Service Members, U.S. Armed Forces, 2020

Article
5/1/2021
Navy Lt. James E. Lamb, left, and Sgt. Ryan Eskandary exercise aboard USS Pearl Harbor

Morbidity Burdens Attributable to Various Illnesses and Injuries, Deployed Active and Reserve Component Service Members, U.S. Armed Forces, 2020

Recommended Content:

Medical Surveillance Monthly Report

Medical Evacuations out of the U.S. Central Command, Active and Reserve Components, U.S. Armed Forces, 2020

Article
5/1/2021
U.S. Army Soldiers from the 115th Brigade Support Battalion, 1st Armored Brigade Combat Team, evacuate casualties onto waiting HH-60M MEDEVAC Blackhawk helicopters from Charlie Company, 6th Battalion, 101st Combat Aviation Brigade during Combined Resolve XV, Feb. 27, 2021, at Hohenfels Training Area. Combined Resolve XV is a Headquarters Department of the Army directed Multinational exercise designed to build 1st Armored Brigade Combat Team, 1st Cavalry Division’s readiness and enhance interoperability with allied forces and partner nations to fight and win against any adversary.(U.S. Army photo by Sgt. 1st Class Garrick W. Morgenweck)

Medical Evacuations out of the U.S. Central Command, Active and Reserve Components, U.S. Armed Forces, 2020

Recommended Content:

Medical Surveillance Monthly Report

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Non-service Member Beneficiaries of the Military Health System, 2020

Article
5/1/2021
MAYPORT, Fla. (Sept. 18, 2020) – Cmdr. Mary Gracia, a pediatric nurse practitioner at Naval Branch Health Clinic Mayport, checks five-year-old Gabriella’s ears. Gracia, a native of McAllen, Texas, says, “It's been an honor and a privilege to impart my expertise to the children of our active duty members who are graciously serving our country. These children, our future leaders, prayers lifted and bountiful blessings for each one. And to the children I've helped during overseas deployments, prayers continued.” (U.S. Navy photo by Jacob Sippel, Naval Hospital Jacksonville/Released).

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Non-service Member Beneficiaries of the Military Health System, 2020

Recommended Content:

Medical Surveillance Monthly Report

Ambulatory Visits, Active Component, U.S. Armed Forces, 2020

Article
5/1/2021
Tech. Sgt. Kimberly Weaver, 606th Air Control Squadron noncommissioned officer in charge of medical readiness, measures an Airman’s blood pressure at Aviano Air Base, Italy, May 10, 2021.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance snapshot: Illness and injury burdens, recruit trainees, U.S. Armed Forces, 2020

Article
5/1/2021
A U.S. Marine Corps drill instructor motivates a recruit during a Marine Corps Martial Arts Program (MCMAP) training session

Recommended Content:

Medical Surveillance Monthly Report

Surveillance snapshot: Illness and injury burdens, reserve component, U.S. Armed Forces, 2020

Article
5/1/2021
U.S. Army Col. Kris Marshall, co-director of Exercise Agile Spirit 2021, salutes during a closing ceremony August 6, 2021 at Orpholo Training Area, Georgia. Agile Spirit 21 promotes regional stability and security, while increasing readiness, strengthening partner capabilities and fostering trust. Agile Spirit provides vital opportunities, not only for multiple U.S. services to work together, but also for integrated, total force training with U.S. Reserve and National Guard units and our partner nations’ militaries to ensure interoperability. (U.S. Army National Guard photo by Cpl. Rydell Tomas)

Surveillance snapshot: Illness and injury burdens, reserve component, U.S. Armed Forces, 2020

Recommended Content:

Medical Surveillance Monthly Report

Hospitalizations, Active Component, U.S. Armed Forces, 2020

Article
5/1/2021
Army Medicine surgeons in the operating room

Hospitalizations, Active Component, U.S. Armed Forces, 2020

Recommended Content:

Medical Surveillance Monthly Report

Update: Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2016–2020

Article
4/1/2021
Marine Corps Recruit Depot, San Diego  Recruits with Bravo Company, 1st Recruit Training Battalion, hydrate after a physical training session

Recommended Content:

Medical Surveillance Monthly Report

Skin and Soft Tissue Infections, Active Component, U.S. Armed Forces, January 2016–September 2020

Article
4/1/2021
Detailed view of elbow with carbuncle or furuncle

Recommended Content:

Medical Surveillance Monthly Report

Update: Heat Illness, Active Component, U.S. Armed Forces, 2020

Article
4/1/2021
Fort Jackson, SC. A trainee with 2nd Battalion, 60th Infantry Regiment puts his arms in an arm immersion cooling tank during training. The tanks allow Soldiers to rapidly cool by putting their forearms into a tank of ice water. (Photo by Saskia Gabriel)

Recommended Content:

Medical Surveillance Monthly Report

Disparities in COVID-19 Vaccine Initiation and Completion Among Active Component Service Members and Health Care Personnel, 11 December 2020–12 March 2021

Article
4/1/2021
Capt. Shamira Conerly, 149th Medical Group, gives Staff Sgt. Timmy Sanders, 149th Maintenance Squadron, his first dose of COVID-19 vaccine

Recommended Content:

Medical Surveillance Monthly Report

Update: Exertional Hyponatremia, Active Component, U.S. Armed Forces, 2005–2020

Article
4/1/2021
Tech. Sgt. Kimberly Weaver, 606th Air Control Squadron noncommissioned officer in charge of medical readiness, measures an Airman’s blood pressure at Aviano Air Base, Italy, May 10, 2021.

Recommended Content:

Medical Surveillance Monthly Report
<< < 1 2 3 4 5  ... > >> 
Showing results 61 - 75 Page 5 of 13
Refine your search
Last Updated: August 17, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery