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Systematic review on the non-vectorial transmission of Tick-borne encephalitis virus (TBEv)


Elisa Martello

Emma L. Gillingham

Revati Phalkey

Constantine Vardavas

Katerina Nikitara

Tamas Bakonyi


Professor of Medical Statistics and Epidemiology


Tick-borne encephalitis (TBE) is an infection caused by the Tick-borne encephalitis virus (TBEv) and it is common in Europe. The virus is predominantly transmitted by ticks, but other non-vectorial modes of transmission are possible. This systematic review synthesises the epidemiological impact of non-vectorial modes of TBEv transmission in Europe. 41 studies were included comprising of 1308 TBE cases. Alimentary (36 studies), handling infected material (3 studies), blood-borne (1 study), solid organ transplant (1 study) were identified as potential routes of TBEv transmission; however, no evidence of vertical transmission from mother to offspring was reported (2 studies). Consumption of unpasteurised milk/milk products was the most common vehicle of transmission and significantly increased the risk of TBE by three-fold (pooled RR 3.05, 95% CI 1.53 to 6.11; 4 studies). This review also confirms handling infected material, blood-borne and solid organ transplant as potential routes of TBEv transmission. It is important to tracing back to find the vehicle of the viral infection and to promote vaccination as it remains a mainstay for the prevention of TBE.


Martello, E., Gillingham, E. L., Phalkey, R., Vardavas, C., Nikitara, K., Bakonyi, T., …Leonardi-Bee, J. (2022). Systematic review on the non-vectorial transmission of Tick-borne encephalitis virus (TBEv). Ticks and Tick-borne Diseases, 13(6), Article 102028.

Journal Article Type Article
Acceptance Date Aug 10, 2022
Online Publication Date Aug 26, 2022
Publication Date Nov 1, 2022
Deposit Date Sep 9, 2022
Publicly Available Date Sep 9, 2022
Journal Ticks and Tick-borne Diseases
Print ISSN 1877-959X
Electronic ISSN 1877-9603
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 13
Issue 6
Article Number 102028
Keywords Infectious Diseases; Insect Science; Microbiology; Parasitology
Public URL
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