Mannelli, Alessandro

Martello, Elisa

Tomassone, Laura

English

Institutional Research Information System University of Turin

20 November 2023AperTO - Archivio Istituzionale Open Access dell'Università di TorinoOriginal Citation:A systematic review on the prevalence of tick-borne encephalitis infection in milk and milkproducts in EuropeTerms of use:Open Access(Article begins on next page)Anyone can freely access the full text of works made available as "Open Access". Works made availableunder a Creative Commons license can be used according to the terms and conditions of said license. Useof all other works requires consent of the right holder (author or publisher) if not exempted from copyrightprotection by the applicable law.Availability:This is the author's manuscriptThis version is available http://hdl.handle.net/2318/1917611 since 2023-07-04T10:41:48ZA systematic review on the prevalence of tick-borne encephalitis infection in milk and milk products in EuropeIntroductionTick-borne encephalitis virus (TBEv) is a Flavivirus responsible for one of the most important zoonoses in Europe, whose incidence isincreasing. Although tick-borne encephalitis (TBE) is a vector-borne disease and is mainly transmitted to humans through the bite ofinfected ticks, it can also be contracted through the consumption of raw milk and dairy products from viremic domestic ruminants (1).We conducted a systematic review to assess the prevalence of TBEv in milk and milk products from domestic ruminants in Europe, andto evaluate the usefulness of monitoring TBEv infection in dairy products for the early identification of the viral circulation in ageographic area.Laura Tomassone1, Elisa Martello2, Aurora Vicentini1, Jo Leonardi-Bee2, Alessandro Mannelli11Dept. of Veterinary Sciences, University of Turin, Grugliasco, Italy; 2Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, UKReferences: (1) ECDC, 2022: https://www.ecdc.europa.eu/en/tick-borne-encephalitis/facts/factsheet; (2) JBI Critical Appraisal Tool: https://jbi.global/critical-appraisaltools (3) Pautienius et al. Bulk Milk Tank Samples Are Suitable to Assess Circulation of Tick-Borne Encephalitis Virus in High Endemic Areas. Viruses. 2021; (4) Imhoff et al., Review: Sentinels of tick-borne encephalitis risk. Ticks Tick Borne Dis. 2015; (5) Bormane et al. Vectors of tick-borne diseases and epidemiological situation in Latvia in 1993-2002. Int J Med Microbiol. 2004Materials and methodsFollowing protocol registration (PROSPERO: CRD 42021279317), a comprehensive search was performed in three databases (Medline,EMBASE and CAB Abstracts) to identify relevant studies published from Jan 1980-Nov 2022. Screening, data extraction and criticalappraisal (2) were conducted independently by two reviewers. Meta-analysis of prevalence were estimated using random effects.Separate meta-analyses were conducted based on type of sample collected (individual milk, bulk milk, cheese). Where possible,subgroup analyses were performed by animal species.ResultsFifteen studies were included in the review (Fig.1),ten of which were outbreak investigations,following TBE cases in humans, and 5 weresurveys. Goat products were analysed in 10studies, cow in 6, and sheep in 4. 29 prevalenceestimates used direct diagnostic (PCR & VNT) and6 used indirect diagnostic (ELISA). The sample sizeused for estimating prevalence ranged from 1-1363 samples.The pooled prevalence of TBEv in individual rawmilk samples was 4% (95% CI 0-10%; Fig.2), withsimilar findings for cow milk (4%, 95% CI 0-11%)and goat milk (3%, 95% CI 0-13%); however, theprevalence was 22% (95% CI 11-41%) in the onestudy in sheep milk. The prevalence estimates forTBEv in bulk milk tanks were too heterogeneous,with most values either 0% or 100% in studieswith sample sizes of one or two, therefore meta-analysis was not conducted (Fig.3). The pooledprevalence of TBEv in cheese made from raw milkwas 3% (95% CI 0-13%; Fig.4).DiscussionEpidemiological surveillance of TBEv in field ticksand wild vertebrate hosts can be challenging, duethe focal nature of TBEv occurrence, to the specificexpertise required and limits in laboratory tests(3). Our systematic review shows that a variableprevalence of TBEv in milk products can be found(3-22%) as well as in ticks (0.1-37.3%) (4, 5).However, surveillance on milk and milk productsfrom grazing domestic ruminants can be avaluable tool for studying TBEv prevalence andassessing the epidemiological situation in ageographic area. Dairy products can be easilyobtained and their testing can be helpful for riskassessment and for the epidemiologicalsurveillance of TBE in a One Health perspective.15th International Symposium on Ticks and Tick-borne Diseases, 29–31 March 2023, Weimar (DE)Fig.2 Pooled prevalence of TBEv in individual samples of raw milkFig.1 PRISMA Flow chartFig.3 Pooled prevalence of TBEv in bulk milk tank samples of raw milkFig.4 Prevalence estimates of TBEv in cheese made from raw milk

A systematic review on the prevalence of tick-borne encephalitis infection in milk and milk products in Europe

https://iris.unito.it/bitstream/2318/1917611/1/TBEVmilk_poster_Weimar_090323.pdf

A systematic review on the prevalence of tick-borne encephalitis infection in milk and milk products in Europe

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