This observational study follows children and adults who were hospitalized with tick-borne encephalitis (TBE) in the Czech Republic. The aim is to better understand how individuals recover from TBE, which symptoms may persist after the infection, and which patients may require additional support during their recovery. Participants are examined several times after hospital discharge (at 2-4 weeks, 3 months, 6 months, and 12 months) to observe changes in symptoms, functional status, and daily activities. Follow-up assessments include evaluation of common post-infection problems such as tiredness, headaches, memory or concentration difficulties, sleep issues, or limb weakness. Symptoms lasting for several months are categorized as post-encephalitic syndrome (PES).
The study also assesses how TBE affects daily functioning, school and work performance, and overall quality of life using questionnaires and short functional assessments. In addition, the study includes a public-health component that estimates the broader impact of TBE in the population and evaluates the potential benefits of vaccination in preventing long-term health complications.
The findings aim to support improved patient care, follow-up planning, and evidence-based public-health decision-making in the Czech Republic.
Hospitalization due to suspected central nervous system (CNS) infection.
All age groups (children and adults).
Ability to participate in scheduled follow-up (in person or via telephone).
Informed consent provided by the patient or legal guardian (for minors).
Alternative diagnosis explaining the CNS symptoms
Missing essential clinical or laboratory data required to confirm TBE or assess outcomes.
Refusal or inability to provide informed consent.
Inability to complete follow-up assessments, including situations where reliable contact cannot be maintained.
Hospitalized children and adults with confirmed tick-borne encephalitis (TBE) treated at four infectious disease centers in the Czech Republic. All participants had clinical symptoms of central nervous system involvement, cerebrospinal fluid pleocytosis, and laboratory confirmation of TBEV infection. Patients were enrolled during their acute hospitalization and followed prospectively for up to 12 months as part of a standardized clinical and functional outcome assessment program.
Cohort
Prospective
No intervention
Other interventionObservational study only. Participants receive standard clinical care; no experimental or study-specific interventions are administered.
Presence and Severity of Post-Encephalitic Syndrome (PES)
PES is defined as the presence of ≥1 neurological, cognitive, or functional symptom persisting ≥6 months after acute TBE. PES severity is graded as: Mild: mRankin = 1, no limitation of usual activities Moderate: mRankin = 2 and/or limited but preserved independence, or poor self-perceived health (MEHM) Severe: mRankin ≥3, severe limitation of daily activities, very poor self-perceived health, or death.
Persistent Motor Deficit
Presence of persistent paresis or other objective motor impairment at follow-up attributed to TBE.
Acute Disease Severity Classification
Acute course categorized as severe if any of the following criteria are present: motor deficit (paresis) during hospitalization, ICU admission, hospitalization \>10 days, death. All others classified as mild.
Functional Status by Modified Rankin Scale (mRankin)
Global functional disability assessed by mRankin (0-6).
Self-perceived Health and Activity Limitation (MEHM Score)
Minimum European Health Module (MEHM), including perceived health, activity limitation, and chronic morbidity.
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Charles University, Czech Republic
Lead sponsor
České Budějovice Hospital
Collaborator
University Hospital Ostrava
Collaborator
Hospital Pardubice
Collaborator
Bulovka Hospital
Collaborator
