Continued expansion of tick-borne pathogens: Tick-borne encephalitis virus complex and Anaplasma phagocytophilum in Denmark

Nanna Skaarup Andersen*, Sanne Løkkegaard Larsen, Carsten Riis Olesen, Karin Stiasny, Hans Jørn Kolmos, Per Moestrup Jensen, Sigurdur Skarphédinsson

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Tick-borne encephalitis virus (TBEV) is a tick-transmitted flavivirus within the tick-borne encephalitis (TBE) complex. The TBE complex is represented by both TBEV and louping ill virus (LIV) in Denmark. Anaplasma phagocytophilum is also transmitted by ticks and is believed to play an essential role in facilitating and aggravating LIV infection in sheep. This study aimed to describe the distribution of TBE complex viruses in Denmark, to establish the possible emergence of new foci and their association with the distribution of A. phagocytophilum. We performed a nationwide seroprevalence study of TBE complex viruses using roe deer (Capreolus capreolus) as sentinels and determined the prevalence of A. phagocytophilum in roe deer. Danish hunters obtained blood samples from roe deer during the hunting season of 2013-14. The samples were examined for TBEV-specific antibodies by virus neutralization tests (NT). A. phagocytophilum infection was assessed by specific real-time-PCR. The overall seroprevalence of the TBE complex viruses in roe deer was 6.9% (51/736). The positive samples were primarily obtained from a known TBE endemic foci and risk areas identified in previous sentinel studies. However, new TBE complex risk areas were also identified. The overall prevalence of A. phagocytophilum was 94.0% (173 PCR-positive of 184 roe deer), which is twice the rate observed ten years ago. These results point to an expansion of these tick-borne diseases geographically and within reservoir populations and, therefore, rationalize the use of sentinel models to monitor changes in transmission of tick-borne diseases and development of new risk areas. We found no association between TBE complex-positive roe deer and the prevalence of A. phagocytophilum, as almost all roe deer were infected. Based on our findings we encourage health care providers to be attentive to tick-borne illnesses such as TBE when treating patients with compatible symptoms.

Original languageEnglish
JournalTicks and Tick-borne Diseases
Issue number1
Pages (from-to)115-123
Publication statusPublished - Jan 2019

Bibliographical note

Copyright © 2018 Elsevier GmbH. All rights reserved.


  • Anaplasma phagocytophilum
  • Capreolus capreolus
  • Ixodes ricinus
  • Louping ill virus
  • Sentinel surveillance
  • Tick-borne encephalitis virus
  • Arachnid Vectors/virology
  • Prevalence
  • Tick Infestations/veterinary
  • Male
  • Seroepidemiologic Studies
  • Ixodidae/virology
  • Louping Ill/epidemiology
  • Deer
  • Ehrlichiosis/epidemiology
  • Denmark/epidemiology
  • Animals
  • Anaplasma phagocytophilum/isolation & purification
  • Female
  • Encephalitis Viruses, Tick-Borne/isolation & purification
  • Sentinel Surveillance/veterinary
  • Encephalitis, Tick-Borne/epidemiology


Dive into the research topics of 'Continued expansion of tick-borne pathogens: Tick-borne encephalitis virus complex and Anaplasma phagocytophilum in Denmark'. Together they form a unique fingerprint.

Cite this