Tick-borne encephalitis in Norway: A cohort study of clinical course and health-related QoL at three- and twelve-month follow-up, 2025, Skudal et al

[Midnattsol]

Full title: Tick-borne encephalitis in Norway: A cohort study of clinical course and health-related quality of life at three- and twelve-month follow-up

Purpose
Knowledge of tick-borne encephalitis (TBE) prognosis is limited. This study aimed to describe the disease course in the first year and assess one-year outcomes, focusing on clinical recovery and health-related quality of life (HR-QoL).

Methods
In this cohort study, we recruited hospitalized patients ≥ 16 years with confirmed TBE from hospitals in Norway’s endemic area. A composite clinical score consisting of variables on symptoms and neurological findings was scored at baseline (during hospitalization), 3- and 12 months. HR-QoL at 12 months was measured using RAND 36-item short form health survey and compared to the Norwegian reference population.

Results
Among the 93 patients included, clinical improvement from baseline to 3 months was 68%, increasing to 77% by 12 months. The proportion of patients with symptoms or neurological findings influencing daily life was 98% at baseline, 52% at 3 months, and 41% at 12 months. 14% required inpatient rehabilitation, and 4/56 (7%) of active workers were on full-time sick leave at 12 months. Severe disease and comorbidities were linked to poorer outcomes. Most common symptoms influencing daily life at 12 months were fatigue (28%), concentration issues (13%) memory and sleep difficulties (12% each), while 8% had clinical findings where impaired balance and tremor dominated. Patients scored lower in physical health and social functioning regarding HR-QoL than reference population.

Conclusion
Most improvements occur during the first three months; however, 41% of patients experience ongoing complaints at 12 months, impacting HR-QoL regarding physical health. Severe disease and comorbidities correlate with poorer prognoses.

Trial registration
Project #2,296,959 – The NOrwegian Tick-borne Encephalitis Study – NOTES. An Observational Study on Clinical Features, Long-term Outcomes and Immune Characteristics – Cristin.

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[bicentennial]

Most common symptoms influencing daily life at 12 months were fatigue (28%), concentration issues (13%) memory and sleep difficulties (12% each)

From that description one would never guess that ME/CFS is not also an encephalitis, or else its aftermath

I didn't realise tick-borne disease was endemic in areas of Norway. Not long ago, the news had it spreading in South East England. Now I hear it gets hospitalised.

Its only recently I read that hillwalkers in Scotland are liable and so its in the scope of Dr Scott (in charge of the assocated programs). Is that Lymes not encephalitis?

It is a big surpise to keep finding it taken seriously, after all that denial in England

I had thought it a hazard of the USA, not recognised by my local establishment, and how the protective cover-up does sound like an unimaginable nuisance if out playing in the long grass, as one did. I'd rather wear a face-mask.

Spoiler: maybe off-topic

People actually coat and recoat themselves and their children in liquid sunscreen. I can't imagine doing that either. And what with the sewage dumped in the water, we might be treated to those African river fluke thingies that climb in though the soles of paddling feet, travel to distant sites and go ballistic, holistically.

There were odd cases of strange paralytic reactions to swimming of the south coast. Even before water got privatised to dement the offices of environmental health - since cutting back on pesticides increased profit but exploded rat populations.

its all a bit of a shock to the English, so accustomed to moderate climate with no air conditioning, no mosquito nets, no wolves, tigers, not lots of poisonous snakes and no scorpions.

I wonder if these ticks can be neutered like some other flying insects were neutered by releasing infected insects makes them infertile. But without upsetting an ecology