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Table 6 TBE under-testing and under-diagnosis by clinical manifestations and flu-like symptoms

From: Evaluation of under-testing and under-diagnosis of tick-borne encephalitis in Germany

Patients

N

TBE tested, n (%)

Not TBE tested, n (%)

TBE positive, n (%)

Flu-like symptoms

 All patients

1398

848 (60.7)

550 (39.3)

169 (19.9)

 No

716

334 (46.6)

382 (53.4)

37 (11.1)

 Yes

682

514 (75.4)

168 (24.6)

132 (25.7)

Clinical manifestations, flu like symptoms = yes

 All patients

678

513 (75.7)

165 (24.3)

132 (25.7)

 Meningitis only

234

172 (73.5)

62 (26.5)

76 (44.2)

 Encephalitis only

173

143 (82.7)

30 (17.3)

32 (22.4)

 Myelitis only

105

79 (75.2)

26 (24.8)

8 (10.1)

 NSNS only

120

89 (74.2)

31 (25.8)

7 (7.9)

 Myelitis + encephalitis

4

2 (50.0)

2 (50.0)

2 (100.0)

 Myelitis + meningitis

4

3 (75.0)

1 (25.0)

2 (66.7)

 Encephalitis + meningitis

26

17 (65.4)

9 (34.6)

3 (17.6)

 Encephalitis + NSNS

5

3 (60.0)

2 (40.0)

NA

 Meningitis + NSNS

7

5 (71.4)

2 (28.6)

2 (40.0)

Clinical manifestations, flu like symptoms = no

 All patients

709

330 (46.5)

379 (53.5)

37 (11.2)

 Meningitis only

167

77 (46.1)

90 (53.9)

16 (20.8)

 Encephalitis only

174

86 (49.4)

88 (50.6)

9 (10.5)

 Myelitis only

127

56 (44.1)

71 (55.9)

2 (3.6)

 NSNS only

193

80 (41.5)

113 (58.5)

2 (2.5)

 Myelitis + encephalitis

8

8 (100.0)

0 (0.0)

0 (0.0)

 Myelitis + meningitis

0

NA

NA

NA

 Encephalitis + meningitis

25

15 (60.0)

10 (40.0)

7 (46.7)

 Encephalitis + NSNS

7

4 (57.1)

3 (42.9)

NA

 Meningitis + NSNS

8

4 (50.0)

4 (50.0)

1 (25.0)

  1. Percentages values are row percentages. When the number of confirmed TBE cases is 0, there will not be estimates for TBE positive rate, as confirmed TBE cases are needed to estimate these values. In the survey, physicians were asked to report the general signs and symptoms that the patient presented with and could select ≥ 1 of the following options: “bulging soft spot(s)”, “fever (> 38–39 °C)”, “high fever (> 39 °C)”, “flu-like symptoms”, “headache”, “mottled/blotchy skin”, “nausea/vomiting”, “pain”, “tachypnoea”, or “rash (skin/eyes/mouth)”. Data shown in the table reflects the selection of the “flu-like symptoms” response option and was not dependent upon or derived from the selection of any other general signs and symptoms that could be considered flu-like (e.g., headache or fever). NA: not applicable; NSNS: non-specific neurological symptoms; TBE: tick-borne encephalitis