Zusammenfassung
Eines der Hauptziele der 11. Jahrestagung der International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) im Jahr 2009 war es, die erste Aktualisierung des Positionspapiers zur Frühsommer-Meningoenzephalitis (FSME) in der 50-plus-Generation auszuarbeiten und die wichtigsten Aspekte der Erkrankung in dieser Altersgruppe zusammenzufassen. Die Morbidität infolge FSME ist auch in der letzten Jahren weiter angestiegen, wofür ein Zusammenspiel zwischen sozialen, politischen, ökologischen, ökonomischen und demographischen Faktoren in Kombination mit dem Klimawandel verantwortlich gemacht werden. Die 50-plus-Generation von heute ist gesünder und mobiler, führt einen aktiveren Lebensstil und verbringt einen Gutteil ihrer Zeit mit Reisen und Freizeitaktivitäten im Freien. Dies erhöht auch ihr Infektionsrisiko. Dabei kommt es mit zunehmendem Alter zu einer quantitativen und qualitativen Schwächung der angeborenen und erworbenen Immunität, weshalb ältere Personen anfälliger für Infektionen und schwerere Krankheitsverläufe sind als jüngere Menschen. Auch die Immunreaktion älterer Personen auf Impfungen ist in der Regel langsamer und die erreichten Antikörperkonzentrationen sind niedriger und sinken früher als im jüngeren Lebensalter. Laufend belegen Studienergebnisse, dass dies auch für die FSME-Impfung zutrifft. Dies unterstreicht, wie wichtig es ist, die erste FSME-Auffrischungsimpfung in dieser Altersgruppe wie empfohlen spätestens 3 Jahre nach Abschluss der Grundimmunisierung durchzuführen, eventuell sogar früher. Gleichzeitig allerdings zeigen jüngste Studienergebnisse auch, dass die Wirksamkeit der FSME-Impfung in der breiten Anwendung über 97 % liegt und zwischen verschiedenen Altersgruppen keine signifikanten Unterschiede vorliegen.
Summary
One of the primary goals of the 11th Annual Meeting of the International Scientific Working Group on Tick-borne encephalitis (ISW-TBE) held in 2009 was to develop the first update of the Position Paper on TBE in Golden Agers, summarizing the most essential aspects of the disease in this age group. TBE morbidity has continued to increase in recent years, which is thought to be due to an interplay of social, political, ecological, economic and demographic factors combined with climate changes. Today's golden agers i.e. individuals aged 50 years or above, are healthier and more mobile, lead more active lifestyles and spend more time travelling and performing outdoor leisure activities. This places them at an increased risk of infection. At the same time, increasing age is associated with a quantitative and qualitative decline in innate and adaptive immunity, which is why elderly individuals are more susceptible to infection and severe disease than younger people. Also, their response to vaccination tends to be slower, antibody titres generally reach lower levels and titres tend to decrease earlier than in younger individuals. Evidence is accumulating that this is also the case with TBE vaccination, emphasizing the importance of administering the first TBE booster vaccination no later than 3 years after the completion of primary immunization or at an even shorter interval. Encouragingly, recent data have shown that the field effectiveness of TBE vaccination exceeds 97%, with no significant differences between age groups.
References
International Scientific Working Group on TBE. www.tbe-info.com
Kunze U, Baumhackl U, Bretschneider R, et al. The golden agers and tick-borne encephalitis. Conference report and position paper of the International Scientific Working Group on Tick-borne encephalitis. Wien Med Wochenschr, 155: 289–294, 2005
Kunze U. Combating tick-borne encephalitis: vaccination rates on the rise. Wien Med Wochenschr, 158: 518–521, 2008
Süss J. Tick-borne encephalitis in Europe and beyond – the epidemiological situation as of 2007. Euro Surveill, 13: 18916, 2008
Randolph SE. Tick-borne encephalitis incidence in Central and Eastern Europe: consequences of political transition. Microbes Infect, 10: 209–216, 2008
Sumilo D, Asokliene L, Avsic-Zupanc T, et al. Behavioural responses to perceived risk of tick-borne encephalitis: vaccination and avoidance in the Baltics and Slovenia. Vaccine, 26: 2580–2588, 2008
Sumilo D, Bormane A, Asokliene L, et al. Socio-economic factors in the differential upsurge of tick-borne encephalitis in Central and Eastern Europe. Rev Med Virol, 18: 81–95, 2008
Sumilo D, Asokliene L, Bormane A, Vasilenko V, Golovljova I, Randolph SE. Climate change cannot explain the upsurge of tick-borne encephalitis in the Baltics. PLoS ONE, 2: e500, 2007
Süss J. Epidemiology and ecology of TBE relevant to the production of effective vaccines. Vaccine, S1/19–35, 2003
European Communities (eurostat). Inbound and outbound tourism in the European Union. Statistics in focus, 5, 2006
European Travel Commission. European Tourism Insights 2006
Kunze U. Tick-borne encephalitis: from epidemiology to vaccination recommendations in 2007. New issues – best practices. Wien Med Wochenschr, 157: 228–232, 2007
Rendi-Wagner P. Risk and prevention of tick-borne encephalitis in travelers. J Travel Med, 11: 307–312, 2004
Haglund M, Gunther G. Tick-borne encephalitis – pathogenesis, clinical course and long-term follow-up. Vaccine, 21(Suppl 1): S11–S18, 2003
Fessl GFK. TBE vaccination in Austria: Results of a representative survey of the Austrian population Fessl GFK Institute, Vienna, Austria, 2006
Gruver AL, Hudson LL, Sempowski GD. Immunosenescence of ageing. J Pathol, 211: 144–156, 2007
Gomez CR, Boehmer ED, Kovacs EJ. The ageing innate immune system. Curr Opin Immunol, 17: 457–462, 2005
Renshaw M, Rockwell J, Engleman C, Gewirtz A, Katz J, Sambhara S. Cutting edge: impaired toll-like receptor expression and function in ageing. J Immunol, 169: 4697–4701, 2002
Grewe M. Chronological ageing and photoageing of dendritic cells. Clin Exp Dermatol, 26: 608–612, 2001
Allman D, Miller JP. B cell development and receptor diversity during ageing. Curr Opin Immunol 17: 463–467, 2005
Gavazzi G, Krause KH. Ageing and infection. Lancet Infect Dis, 2: 659–666, 2002
Haglund M, Forsgren M, Lindh G, Lindquist L. A 10-year follow-up study of tick-borne encephalitis in the Stockholm area and a review of the literature: need for a vaccination strategy. Scand J Infect Dis, 28: 217–224, 1996
Kaiser R. Tick-borne encephalitis (TBE) in Germany and clinical course of the disease. Int J Med Microbiol, 291(Suppl 33): 58–61, 2002
Mickiene A, Laiskonis A, Gunther G, Vene S, Lundkvist A, Lindquist L. Tickborne encephalitis in an area of high endemicity in lithuania: disease severity and long-term prognosis. Clin Infect Dis, 35: 650–658, 2002
Hainz U, Aigner K, Asch E, et al. Vaccine protection in the elderly: are Austrian seniors adequately protected by vaccinations? Wien Klin Wochenschr, 114: 187–193, 2002
Hainz U, Jenewein B, Asch E, Pfeiffer KP, Berger P, Grubeck-Loebenstein B. Insufficient protection for healthy elderly adults by tetanus and TBE vaccines. Vaccine, 23: 3232–3235, 2005
Jilkova E, Vejvalkova P, Stiborova I, Skorkovsky J, Kral V. Serological response to tick-borne encephalitis (TBE) vaccination in the elderly – results from an observational study. Expert Opin Biol Ther, 9: 797–803, 2009
Paulke-Korinek M, Rendi-Wagner P, Kundi M, Laaber B, Wiedermann U, Kollaritsch H. Booster vaccinations against tick-borne encephalitis: 6 years follow-up indicates long-term protection. Vaccine, 27: 7027–7030, 2009
Loew-Baselli A, Poellabauer EM, Pavlova BG, et al. Seropersistence of tick-borne encephalitis antibodies, safety and booster response to FSME-IMMUN 0.5 ml in adults aged 18–67 years. Hum Vaccin, 5: 551–556, 2009
Demicheli V, Debalini MG, Rivetti A. Vaccines for preventing tick-borne encephalitis. Cochrane Database Syst Rev, CD000977, 2009
Aspinall R, Del Giudice G, Effros RB, Grubeck-Loebenstein B, Sambhara S. Challenges for vaccination in the elderly. Immun Ageing, 4: 9, 2007
Heinz FX, Holzmann H, Essl A, Kundi M. Field effectiveness of vaccination against tick-borne encephalitis. Vaccine, 25: 7559–7567, 2007
Kunz C. TBE vaccination and the Austrian experience. Vaccine, 21(Suppl 1): S50–S55, 2003
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Jelenik, Z., Keller, M., Briggs, B. et al. Tick-borne encephalitis and golden agers: position paper of the International Scientific Working Group on Tick-borne encephalitis (ISW-TBE). Wien Med Wochenschr 160, 247–251 (2010). https://doi.org/10.1007/s10354-010-0758-5
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DOI: https://doi.org/10.1007/s10354-010-0758-5