TBE infection in an incomplete immunized person at-risk who lives in a high-endemic area—Impact on current recommendations for immunization of high-risk groups

This is a case report on a 50-year-old patient, working as a forest guard in a high-endemic region. The subject was immunized with two doses of FSME Immun 0.5 Baxter vaccine (with a time interval of 18 days between the two doses). Approx. two months after the second vaccination the subject developed symptoms of Tick-borne encephalitis. Clinical course and laboratory findings confirmed diagnosis of meningo-encephalo-myelitis with moderate sequelae 1 year after infection. Based on this clinical case we recommend in subjects with an accumulation of risk factors, as age older than 50 years who are living and working in high-endemic areas, a vaccination with conventional schedule (at least two doses applied at 0 to 1-3 months) ahead of TBE season or a rapid schedule with three doses (0, 7 and 21 days) of vaccine.