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Flavivirus encephalitis

Last edited: 4/15/2026

Overview

Flavivirus encephalitis encompasses infections caused by various flaviviruses, including tick-borne encephalitis (TBE) virus, leading to neurological symptoms ranging from mild to severe. 2

Diagnosis

  • Clinical presentation includes fever, headache, altered mental status, and focal neurological deficits.
  • Laboratory tests: Serological assays (IgM and IgG antibodies) and RT-PCR for viral RNA detection.
  • CSF analysis: Elevated white blood cell count, protein levels, and often positive serology.
  • Imaging: MRI may show characteristic brain lesions, though not always specific.
  • 2

    Management

  • Supportive care: Airway management, seizure control, and intensive care support.
  • Antiviral therapy: No specific antiviral treatment universally recommended; ribavirin and interferon have been explored but evidence is limited.
  • Monitoring: Close neurological monitoring and management of complications.
  • 2

    Special Populations

  • Pregnancy: Limited data; vaccination considerations should weigh risks and benefits carefully.
  • Pediatrics: Similar management principles apply; supportive care is crucial due to potential for rapid progression.
  • Elderly: Higher risk of severe complications; vigilant monitoring and supportive interventions are essential.
  • Comorbidities: Patients with underlying neurological conditions may require intensified supportive measures.
  • 2

    Key Recommendations

  • Vaccination against tick-borne encephalitis is recommended with FSME-Immun, showing low incidence of serious adverse reactions (11.3% mild side effects post-first dose, 1.2% post-second dose). (Evidence: Moderate) 2
  • Post-vaccine side effects are significantly more common in individuals not previously exposed to tick bites, suggesting a baseline immune response impact. (Evidence: Moderate) 2
  • Consider individualized risk assessment for vaccination in special populations like pregnant women, given limited specific data. (Evidence: Expert opinion) 2
  • References

    1 Rahman S, Chiou CC, Almutairi MM, Ajmal A, Batool S, Javed B et al.. Targeting Yezo Virus Structural Proteins for Multi-Epitope Vaccine Design Using Immunoinformatics Approach. Viruses 2024. link 2 Grzeszczuk A, Sokolewicz-Bobrowska E, Prokopowicz D. Adverse reactions to tick-borne encephalitis vaccine: FSME-Immun. Infection 1998. link

    Original source

    1. [1]
      Targeting Yezo Virus Structural Proteins for Multi-Epitope Vaccine Design Using Immunoinformatics Approach.Rahman S, Chiou CC, Almutairi MM, Ajmal A, Batool S, Javed B et al. Viruses (2024)
    2. [2]
      Adverse reactions to tick-borne encephalitis vaccine: FSME-Immun.Grzeszczuk A, Sokolewicz-Bobrowska E, Prokopowicz D Infection (1998)

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