Tick-borne encephalitis (TBE) surveillance in Czechia

Controlling TBE requires managing the full transmission cycle: the virus, tick vectors, and animal hosts. Nearly all of Czechia is TBE-endemic, with about a third of infections occurring in South Bohemia and the Highlands Region. Czechia reported 350-850 TBE cases annually from 2012-2020, peaking at 854 cases in 2020; the most-affected age group is 45-64, though child infections are also rising, while older adults face the highest risk of permanent consequences, often being less willing to change habits or get vaccinated. Climate change is one driver of Europe's rising TBE incidence, expanding the climatically suitable range and season for tick populations, including further north. Effective surveillance requires continuously updated climate and epidemiological data and a multidisciplinary (medical, biological, meteorological, IT, sociological) approach.

Deliver a comprehensive, nationwide TBE surveillance system integrating forecasting, disease reporting and prevention, to reduce population health risk and strengthen medium- and long-term response capacity as TBE incidence rises.

Three integrated components: (i) Forecasting -- the Czech Hydrometeorological Institute and National Health Institute developed tick-activity models from multi-year tick-presence and meteorological data, feeding a public early-warning system that gives a daily three-day-ahead forecast of tick activity and risk levels plus recommended precautions, explained for non-expert audiences; (ii) Reporting -- physicians report each laboratory-confirmed TBE case (IgM antibodies in cerebrospinal fluid) to public health authorities; a medical epidemiologist then interviews the patient using a standardised questionnaire to establish likely infection time, place and route; the computerised national reporting system (EPIDAT, in place since 1993) transmits data weekly to the Ministry of Health and then the National Institute of Public Health; (iii) Prevention -- risk areas are delineated from modelled tick activity to prioritise vaccination and education efforts, precautionary advice (repellents, avoiding vegetated areas) is disseminated via the early-warning website and media (including TV advertising), and vaccination (3 doses, re-vaccination every 5 years) is recommended for everyone over 12 months old; since January 2022 it is free for everyone over 50, while under-50s face costs of about CZK 800-900 (32-37 EUR), partly covered by health insurers.

A specific cost-benefit analysis for the Czech system is not yet available. Expected, though not monetarily quantified, benefits include reduced population exposure to risk areas, reduced disease incidence via vaccination and exposure avoidance, earlier diagnosis enabling more effective treatment, and higher vaccination uptake.

No antiviral treatment exists for TBE, and vector/host control is not a viable strategy, so prevention through exposure avoidance and vaccination is essential; vaccination success depends on public awareness. A 2020 survey found high TBE awareness (94%) and vaccine awareness (82%) in Czechia, yet only 33% of the population is vaccinated, with the lowest uptake (25%) among the over-60s -- the group most at risk of severe outcomes -- although free vaccination for over-50s since January 2022 is expected to help. The system's success rests on efficient coordination between health centres and national/local authorities, plus partial vaccine-cost reimbursement from insurers' preventive funds.