{"id":322,"date":"2025-11-17T10:21:27","date_gmt":"2025-11-17T09:21:27","guid":{"rendered":"https:\/\/blog.rwth-aachen.de\/scicom\/?p=322"},"modified":"2025-11-17T10:21:27","modified_gmt":"2025-11-17T09:21:27","slug":"tick-tock-tbe-oclock-your-exam-ready-guide-about-tick-borne-encephalitis","status":"publish","type":"post","link":"https:\/\/blog.rwth-aachen.de\/scicom\/2025\/11\/17\/tick-tock-tbe-oclock-your-exam-ready-guide-about-tick-borne-encephalitis\/","title":{"rendered":"Tick Tock, TBE O\u2019Clock: Your Exam-Ready Guide about Tick-Borne Encephalitis"},"content":{"rendered":"<div class=\"twoclick_social_bookmarks_post_322 social_share_privacy clearfix 1.6.4 locale-de_DE sprite-de_DE\"><\/div><div class=\"twoclick-js\"><script type=\"text\/javascript\">\/* <![CDATA[ *\/\njQuery(document).ready(function($){if($('.twoclick_social_bookmarks_post_322')){$('.twoclick_social_bookmarks_post_322').socialSharePrivacy({\"txt_help\":\"Wenn Sie diese Felder durch einen Klick aktivieren, werden Informationen an Facebook, Twitter, Flattr, Xing, t3n, LinkedIn, Pinterest oder Google eventuell ins Ausland \\u00fcbertragen und unter Umst\\u00e4nden auch dort gespeichert. N\\u00e4heres erfahren Sie durch einen Klick auf das <em>i<\\\/em>.\",\"settings_perma\":\"Dauerhaft aktivieren und Daten\\u00fcber-tragung zustimmen:\",\"info_link\":\"http:\\\/\\\/www.heise.de\\\/ct\\\/artikel\\\/2-Klicks-fuer-mehr-Datenschutz-1333879.html\",\"uri\":\"https:\\\/\\\/blog.rwth-aachen.de\\\/scicom\\\/2025\\\/11\\\/17\\\/tick-tock-tbe-oclock-your-exam-ready-guide-about-tick-borne-encephalitis\\\/\",\"post_id\":322,\"post_title_referrer_track\":\"Tick+Tock%2C+TBE+O%E2%80%99Clock%3A+Your+Exam-Ready+Guide+about+Tick-Borne+Encephalitis\",\"display_infobox\":\"on\"});}});\n\/* ]]> *\/<\/script><\/div><blockquote><p>Disclaimer!<\/p>\n<p>This article and its major media content are produced by students to train science communication as part of a <a href=\"https:\/\/blog.rwth-aachen.de\/scicom\/\">lecture about human infectious pathogens<\/a>. <strong>The article does not represent official advice from the authorities. For authorized information about the disease in question, please refer to the official health authorities in your country or the <\/strong><a href=\"https:\/\/www.who.int\/\"><strong>World Health Organization<\/strong><\/a><strong>.<\/strong><\/p><\/blockquote>\n<p><em>By Franziska Fohn, Gina Auerswald &amp; Jana Egner-Walter<\/em><\/p>\n<p>Do you know this moment, where you realize you procrastinated a bit too long and now your virology exam is approaching? Don\u2019t worry! In just a few minutes, here you will learn all the important molecular mechanisms and clinically relevant facts about Tick-borne encephalitis (TBE)\u2014everything you need to answer every question with confidence!<\/p>\n<h3>How can TBE replicate and invade the brain?<\/h3>\n<h3><span style=\"color: #ffffff;\">_<\/span><\/h3>\n<h3><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-328 size-large\" src=\"https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/AI-image-Fohn-Auerswald-Egner-Walter-1024x683.png\" alt=\"\" width=\"1024\" height=\"683\" srcset=\"https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/AI-image-Fohn-Auerswald-Egner-Walter-1024x683.png 1024w, https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/AI-image-Fohn-Auerswald-Egner-Walter-300x200.png 300w, https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/AI-image-Fohn-Auerswald-Egner-Walter-768x512.png 768w, https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/AI-image-Fohn-Auerswald-Egner-Walter.png 1536w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/h3>\n<p>TBE is an infectious disease caused by the TBE-virus (TBEV), a member of the Flaviviridae family. It\u2019s a <strong>+ssRNA<\/strong> virus that is transmitted by the saliva during the bite of infected ticks, in Europe mainly <em>Ixodes ricinus<\/em>. Different properties of tick saliva, such as its antihaemostatic, vasodilatory, and local immunomodulatory activity contribute to the facilitated transmission of TBEV. The virus\u2019s life cycle starts with the uptake of the virion into dendritic skin cells and macrophages via the <strong>viral envelope E protein<\/strong>. In these cells, the virus replicates and reaches the lymphatic system. From here on, the TBEV reaches systemic blood circulation, spreading to local lymph nodes and later the spleen, liver and bone marrow. If it breaches the blood-brain barrier (BBB), it reaches the central nervous system (CNS), leading to meningitis or meningoencephalitis. Possible routes by which TBEV may breach the BBB include peripheral nerves; olfactory neurons; transcytosis through vascular endothelial cells of brain capillaries; and diffusion of the virus between capillary endothelial cells. The primary targets of TBEV infection in central nervous system are neurons.<\/p>\n<p>\u25b6 Want a visual explanation of the replication cycle, spread and how neural tissue is affected by TBEV? Check out this<strong> 3-minute video<\/strong> from our YouTube Playlist: <strong>\u201cVirology with Dr. Vee\u201d<\/strong>*!<\/p>\n<div class=\"lyte-wrapper fourthree\" style=\"width:420px;max-width:100%;margin:5px;\"><div class=\"lyMe\" id=\"WYL_2BAbwmFW9VI\"><div id=\"lyte_2BAbwmFW9VI\" data-src=\"\/\/i.ytimg.com\/vi\/2BAbwmFW9VI\/hqdefault.jpg\" class=\"pL\"><div class=\"tC\"><div class=\"tT\"><\/div><\/div><div class=\"play\"><\/div><div class=\"ctrl\"><div class=\"Lctrl\"><\/div><div class=\"Rctrl\"><\/div><\/div><\/div><noscript><a href=\"https:\/\/youtu.be\/2BAbwmFW9VI\" rel=\"nofollow\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i.ytimg.com\/vi\/2BAbwmFW9VI\/0.jpg\" alt=\"YouTube-Video-Vorschaubild\" width=\"420\" height=\"295\" \/><br \/>Dieses Video auf YouTube ansehen<\/a><\/noscript><\/div><\/div><div class=\"lL\" style=\"max-width:100%;width:420px;margin:5px;\"><\/div><\/p>\n<h3>How does TBE present clinically and how would you diagnose it?<\/h3>\n<p>TBE progresses in a biphasic manner:<\/p>\n<ul>\n<li><strong>Phase 1<\/strong> (~ 5 days): After an incubation of about 8 days, the infection starts with <strong>flu-like symptoms <\/strong>\u2192 fever, fatigue, body aches<\/li>\n<li><strong>Phase 2<\/strong>: After an asymptomatic week (which may include <strong>leukopenia<\/strong> and <strong>thrombocytopenia<\/strong>), the virus may attack the CNS \u2192 high fever, headache, nausea vomiting, impaired consciousness \u2192 <strong>meningitis, meningoencephalitis, meningoencephalomyelitis<\/strong>.<\/li>\n<\/ul>\n<p>During this second phase, typical lab findings include lymphocytic pleocytosis and a higher erythrocyte sedimentation rate (ESR). To confirm TBE diagnosis, two criteria must be met:<\/p>\n<ol>\n<li style=\"list-style-type: none;\">\n<ol>\n<li>Clinical signs of <strong>CNS inflammation<\/strong><\/li>\n<li>Detection of <strong>TBE-specific IgM or IgG<\/strong> in the serum or cerebrospinal fluid (CSF)<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<p>Additionally,<strong> C-reactive protein (CRP)<\/strong> <strong>levels<\/strong> may also be elevated and serve as a marker for disease severity.<\/p>\n<p>\u25b6 Want more information about the clinical experience? Listen to the TBE episode of the <strong>podcast \u201cHealth Talks\u201d<\/strong>*, in which a patient shares their story, and neurologist <strong>Dr. Bennett<\/strong>** provides additional medical insights.<\/p>\n<audio class=\"wp-audio-shortcode\" id=\"audio-322-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Audio_Fohn-Auerswald-Egner-Walter.mp3?_=1\" \/><a href=\"https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Audio_Fohn-Auerswald-Egner-Walter.mp3\">https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Audio_Fohn-Auerswald-Egner-Walter.mp3<\/a><\/audio>\n<h3><span style=\"color: #ffffff;\">_<\/span><\/h3>\n<h3>How does the TBE vaccine protect from infection?<\/h3>\n<p>Since there is<strong> no treatment<\/strong> for TBE, prevention through active immunization is crucial. All licensed vaccines against TBEV are based on <strong>inactivated whole viruses<\/strong>, containing various TBEV strains. The E-proteins on these inactivated viruses are recognized by dendritic cells through their toll-like receptors (TLRs), leading to the phagocytosis of the particle. The viral proteins are processed and presented on the dendritic cell\u2019s surface via the MHC class II. When migrating to the lymph nodes, they activate CD4+ T-cells, which induce the <strong>production of specific antibodies<\/strong> against the TBEV surface markers in plasma cells. In case of a future exposure to TBEV, the antibodies enable a fast recognition of the virus.<\/p>\n<h3>Self-test for optimal understanding:<\/h3>\n<p>So now that you\u2019ve read all the information, can you answer these (extremely exam-relevant) questions?<\/p>\n<ul>\n<li>Through which routes may TBEV breach the BBB?<\/li>\n<li>How does TBEV replicate?<\/li>\n<li>Which symptoms indicate TBE and how can you confirm the diagnosis?<\/li>\n<\/ul>\n<p>Don\u2019t forget to follow our Mastodon Account <span style=\"color: #3366ff;\">@EasyVirology<\/span> to stay tuned about upcoming virology study posts!<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-325\" src=\"https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Social-Media-Post-Fohn-Auerswald-Egner-Walter-1024x647.png\" alt=\"\" width=\"612\" height=\"387\" srcset=\"https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Social-Media-Post-Fohn-Auerswald-Egner-Walter-1024x647.png 1024w, https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Social-Media-Post-Fohn-Auerswald-Egner-Walter-300x189.png 300w, https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Social-Media-Post-Fohn-Auerswald-Egner-Walter-768x485.png 768w, https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Social-Media-Post-Fohn-Auerswald-Egner-Walter-1536x970.png 1536w, https:\/\/blog.rwth-aachen.de\/scicom\/files\/2025\/06\/Social-Media-Post-Fohn-Auerswald-Egner-Walter.png 1542w\" sizes=\"auto, (max-width: 612px) 100vw, 612px\" \/><\/p>\n<p>*fictional YouTube Playlist\/Podcast<br \/>\n**fictional character<\/p>\n<hr \/>\n<h3><span style=\"color: #ffffff;\">_<\/span><\/h3>\n<h4>References<\/h4>\n<ol>\n<li>Chiffi G, Grandgirard D, Leib SL, Chrdle A, R\u016f\u017eek D. Tick-borne encephalitis: a comprehensive review of the epidemiology, virology, and clinical picture. Rev Med Virol. 2023; 33(5):e2470. <a href=\"https:\/\/doi.org\/10.1002\/rmv.2470\">https:\/\/doi.org\/10.1002\/rmv.2470<\/a><\/li>\n<li>Bogovic, P, and Franc S. Tick-Borne Encephalitis: a review of epidemiology, clinical characteristics, and management.&#8220; The Lancet Infectious Diseases, vol. 19, no. 4, 2019, pp. 469\u2013478. <a href=\"https:\/\/doi.org\/10.1016\/S1473-3099(18)30454-1\">https:\/\/doi.org\/10.1016\/S1473-3099(18)30454-1<\/a><\/li>\n<li>Kaiser, R. Clinical manifestations and diagnosis of tick-borne encephalitis. Journal of Neurology, vol. 267, no. 2, 2020, pp. 276\u2013282. <a href=\"https:\/\/doi.org\/10.1007\/s00415-020-09936-w\">https:\/\/doi.org\/10.1007\/s00415-020-09936-w<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Disclaimer! This article and its major media content are produced by students to train science communication as part of a lecture about human infectious pathogens. The article does not represent [&hellip;]<\/p>\n","protected":false},"author":4770,"featured_media":345,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"c2c_always_allow_admin_comments":false,"footnotes":""},"categories":[9],"tags":[47,32,48,46,49,50,30],"class_list":["post-322","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-student-contribution","tag-encephalitis","tag-meningitis","tag-meningoencephalitis","tag-tbe","tag-ticks","tag-virology","tag-virus"],"_links":{"self":[{"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/posts\/322","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/users\/4770"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/comments?post=322"}],"version-history":[{"count":24,"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/posts\/322\/revisions"}],"predecessor-version":[{"id":487,"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/posts\/322\/revisions\/487"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/media\/345"}],"wp:attachment":[{"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/media?parent=322"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/categories?post=322"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.rwth-aachen.de\/scicom\/wp-json\/wp\/v2\/tags?post=322"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}