Tick-borne Encephalitis and Goat Cheese | CDC EID

EID Journal Home > Volume 15, Number 10–October 2009

Volume 15, Number 10–October 2009
Dispatch
Tick-borne Encephalitis from Eating Goat Cheese in a Mountain Region of Austria
Heidemarie Holzmann, Stephan W. Aberle, Karin Stiasny, Philipp Werner, Andreas Mischak, Bernhard Zainer, Markus Netzer, Stefan Koppi, Elmar Bechter, and Franz X. Heinz
Author affiliations: Medical University of Vienna, Vienna, Austria (H. Holzmann, S.W. Aberle, K. Stiasny, F.X. Heinz); Regional Hospital, Rankweil, Austria (P. Werner, S. Koppi); and Austrian Public Health Authorities, Vorarlberg, Austria (A. Mischak, B. Zainer, M. Netzer, E. Bechter)

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Abstract
We report transmission of tick-borne encephalitis virus (TBEV) in July 2008 through nonpasteurized goat milk to 6 humans and 4 domestic pigs in an alpine pasture 1,500 m above sea level. This outbreak indicates the emergence of ticks and TBEV at increasing altitudes in central Europe and the efficiency of oral transmission of TBEV.

Tick-borne encephalitis virus (TBEV) is a human pathogenic flavivirus that is endemic to many European countries and to parts of central and eastern Asia (1). Even though vaccination can effectively prevent TBE (2), >10,000 cases are reported annually for hospitalized persons in areas of Europe and Asia to which TBE is endemic. TBEV occurs in natural foci characterized by ecologic habitats favorable for ticks, especially in wooded areas within the 7°C isotherm (3). The major route of virus transmission is tick bites, but TBEV also can be transmitted during consumption of nonpasteurized milk and milk products from infected animals, primarily goats (3). Outbreaks resulting from oral virus transmission are rare in central Europe but more common in eastern Europe and the Baltic states (3). Our investigation of TBEV transmitted by milk from a goat in an alpine pasture in a mountainous region provides evidence for a changing TBEV epidemiology in central Europe and the expansion of ticks and TBEV to higher regions.

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