Neuropediatrics 2012; 43 - PS16_03
DOI: 10.1055/s-0032-1307121

Tick-borne encephalitis: four cases in young vaccinated children

M Müller 1, U Gruber-Sedlmayr 1, W Zenz 1
  • 1Univ. Klinik f. Kinder- und Jugendheilkunde, Abteilung für Allgemeinpädiatrie, Medizinische Universität Graz, Graz, Austria

Aims: We describe four cases of tick-borne encephalitis (TBE) after complete vaccination in young children.

Methods: We analysed patient records of four patients diagnosed with TBE. All of them underwent complete TBE vaccination according to the Austrian vaccination schedule.

Results: Case 1: A 5 year old girl with high fever and vomiting was admitted to hospital. Her clinical status detoriated, the patient developed meningism and seizures and had to be transferred to the intensive care unit (ICU). Lumbal puncture was performed (53 cells/µl). A central venous catheter became necessary for parenteral feeding. TBE infection could be identified in repeated virological testings. The patient was dismissed after 6 weeks of intensive care treatment with severe sequelae (left-sided hemiparesis).

Case 2: A 3 year old girl was admitted with high fever. Due to episodes of changing vigilance, lumbure puncture was performed (134 cells/µl). Serology findings confirmed fresh infection with TBE. The patient had full recovery and could be dismissed after 10 days without sequelae.

Case 3: A 7 year old boy was admitted with fever and headache. In lumbure puncture, 206 cells/µl could be found. TBE was confirmed in repeated serological findings. He was dismissed after 9 days without sequelae

Case 4: A 4 year old girl was admitted directly to the ICU with fever, headache and seizures. Intubation was necessary. Lumbure puncture showed 43 cells/µl. Serological finding confirmed fresh TBE infection. She was dismissed without sequelae after 10 days.

Conclusion: TBE vaccination offers a very high protection against TBE. Only single cases of vaccination failure are reported. There is a study in adults that describes that adult vaccine failures are associated with a more severe clinical course. The authors of this study correlate the more severe clinical courses in these patients with their higher age of life. Further studies are needed to examine the underlying pathology of vaccination failure and its influence in the course of disease.

TBE - vaccination failure