Tickborne Encephalitis Outbreak in Estonia
Linked to Raw Goat Milk

From Eurosurveillance Weekly, June 23, 2005

In May and June 2005, 27 cases of tickborne encephalitis (TBE) were reported to the Estonia's Health Protection Inspectorate. Encephalitis is a viral infection of the brain. Left untreated, the resulting inflammation can lead to brain damage, coma, and death. However, the majority of victims recover completely.

Patients reported the onset of symptoms over a span of 3 weeks in May that included flu-like symptoms (fever and/or headache), vomiting and neurological symptoms. None of them reported being bitten by ticks before symptoms appeared. So what was the cause of this sudden illness in the local population? Based on the results of the investigation all cases were associated with the consumption of raw (unpasteurized) goat milk that had been offered to customers to taste at a local supermarket earlier in May as part of a promotion. Blood test results on the goats from which the milk originated revealed that one goat was clearly positive for TBE infection.

Information about the outbreak was disseminated to ministries of health and public health institutes throughout Europe via the Early Warning and Response System in order to seek information on TBE cases in tourists who may have visited the supermarket in the affected region of Estonia and tasted raw goat milk.
Three additional outbreaks of tickborne encephalitis associated with the consumption of raw goat and cow milk have been noted in Estonia since 1990.

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