Tick-borne Encephalitis Associated with Consumption of Raw Goat Milk, Slovenia, 2012

The Study

Conclusions

References

Table

Suggested Citation

Neda Hudopisk, Miša Korva, Evgen Janet, Marjana Simetinger, Marta Grgič-Vitek, Jakob Gubenšek, Vladimir Natek, Alenka Kraigher, Franc Strle, and Tatjana Avšič-Županc

Author affiliations: Regional Public Health Institute, Ravne na Koroškem, Slovenia (N. Hudopisk, E. Janet, M. Simetinger); Institute of Microbiology and Immunology, Ljubljana, Slovenia (M. Korva, T. Avšič-Županc); National Institute of Public Health, Ljubljana, Slovenia (M. Grgič-Vitek, A. Kraigher); University Medical Centre Ljubljana, Ljubljana (J. Gubenšek, F. Strle); Regional Hospital Slovenj Gradec, Slovenj Gradec, Slovenia (V. Natek)

Abstract

Tick-borne encephalitis (TBE) developed in 3 persons in Slovenia who drank raw milk; a fourth person, who had been vaccinated against TBE, remained healthy. TBE virus RNA was detected in serum and milk of the source goat. Persons in TBE-endemic areas should be encouraged to drink only boiled/pasteurized milk and to be vaccinated.

In Europe, tick-borne encephalitis (TBE) is one of the most common flavivirus infections of the central nervous system and is endemic to several countries. Slovenia is among European countries with the highest reported TBE incidence rates (8.1–18.6 cases/100,000 population in the past decade) (1). TBE virus (TBEV) is mainly transmitted by tick bites but occasionally is transmitted by ingestion of unpasteurized milk/milk products from infected livestock (2).
Previously, large TBE outbreaks linked to a common source had been associated with consumption of dairy products (mostly goat milk); in recent years, smaller, dairy product–associated outbreaks have been reported from several TBEV-endemic countries (3–6). Despite high TBE incidence rates and low uptake of TBE vaccine among the Slovenian population (7), alimentary transmission of TBEV had not been reported in the country. We report a small outbreak of TBE that occurred in 2012 among persons in Slovenia who consumed raw goat milk.