Changes in Knowledge and Practices Regarding Tick-Borne Encephalitis Among Infectious Disease Physicians in Romania: A Repeated Cross-Sectional Survey.
4 affiliations
- 1Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
- 2"Prof. Dr. Matei Bals" National Institute of Infectious Disease, 021105 Bucharest, Romania.
- 3Department of Infectious Diseases, Bucharest Emergency University Hospital, 050098 Bucharest, Romania.
- 4Marius Nasta Institute of Pneumology, 050159 Bucharest, Romania.
Abstract
Background/objectives
Tick-borne encephalitis virus (TBEV) is an emerging vector-borne pathogen in Europe, yet it may be potentially underrecognized in countries reporting few clinical cases. Despite the small number of reported TBE cases, evidence of TBEV circulation in Romania has increased in recent years. Awareness and clinical practices among infectious disease physicians remain insufficiently characterized. This study evaluated changes in knowledge and clinical practices regarding TBEV infection among infectious disease physicians in Romania between 2019 and 2025, following the introduction of TBE vaccination.Methods
We conducted a repeated cross-sectional survey using the same questionnaire in two independent cohorts of infectious disease physicians in Romania (2019, n = 164; 2025 n = 140). Knowledge of tick-borne diseases, TBEV global and local epidemiology, diagnosis, and clinical practice was evaluated and compared.Results
Recognition of TBEV cases in Romania increased significantly from 95/164 (57.9%) in 2019 to 108/140 (77.1%) in 2025 (p = 0.004), while awareness of vaccination as a preventive measure increased from 37.8% to 65.7% (p < 0.001). However, increased awareness did not translate into increased diagnostic testing: TBEV testing remained limited (25.6% in 2019 vs. 20.0% in 2025) and lack of access to serological testing was the most frequently reported diagnostic barrier (65.5% in 2019 vs. 82.1% in 2025). Awareness of alimentary transmission through unpasteurized dairy products also remained limited.Conclusions
Romanian infectious disease physicians' awareness regarding TBEV improved between 2019 and 2025, but diagnostic practice did not improve accordingly. The persistent gap between awareness and testing capacity may contribute to under recognition of TBE and highlights the need to strengthen diagnostic access alongside physician education and vaccination strategies.
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BibTeX
@article{panciu2026changes,
title = {{Changes in Knowledge and Practices Regarding Tick-Borne Encephalitis Among Infectious Disease Physicians in Romania: A Repeated Cross-Sectional Survey.}},
author = {Andreea Madalina Panciu and Cristina Alexandra Cheran and Traian Constantin Panciu and Gheorghita Jugulete and Adriana Hristea},
journal = {Epidemiologia (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/epidemiologia7050148},
url = {https://europepmc.org/article/MED/42930336},
note = {CC BY},
}
RIS
TY - JOUR
TI - Changes in Knowledge and Practices Regarding Tick-Borne Encephalitis Among Infectious Disease Physicians in Romania: A Repeated Cross-Sectional Survey.
AU - Andreea Madalina Panciu
AU - Cristina Alexandra Cheran
AU - Traian Constantin Panciu
AU - Gheorghita Jugulete
AU - Adriana Hristea
PY - 2026
DA - 2026/10/21
JO - Epidemiologia (Basel, Switzerland)
DO - 10.3390/epidemiologia7050148
UR - https://europepmc.org/article/MED/42930336
AB - Background/objectives Tick-borne encephalitis virus (TBEV) is an emerging vector-borne pathogen in Europe, yet it may be potentially underrecognized in countries reporting few clinical cases. Despite the small number of reported TBE cases, evidence of TBEV circulation in Romania has increased in recent years. Awareness and clinical practices among infectious disease physicians remain insufficiently characterized. This study evaluated changes in knowledge and clinical practices regarding TBEV infection among infectious disease physicians in Romania between 2019 and 2025, following the introduction of TBE vaccination.Methods We conducted a repeated cross-sectional survey using the same questionnaire in two independent cohorts of infectious disease physicians in Romania (2019, n = 164; 2025 n = 140). Knowledge of tick-borne diseases, TBEV global and local epidemiology, diagnosis, and clinical practice was evaluated and compared.Results Recognition of TBEV cases in Romania increased significantly from 95/164 (57.9%) in 2019 to 108/140 (77.1%) in 2025 (p = 0.004), while awareness of vaccination as a preventive measure increased from 37.8% to 65.7% (p < 0.001). However, increased awareness did not translate into increased diagnostic testing: TBEV testing remained limited (25.6% in 2019 vs. 20.0% in 2025) and lack of access to serological testing was the most frequently reported diagnostic barrier (65.5% in 2019 vs. 82.1% in 2025). Awareness of alimentary transmission through unpasteurized dairy products also remained limited.Conclusions Romanian infectious disease physicians' awareness regarding TBEV improved between 2019 and 2025, but diagnostic practice did not improve accordingly. The persistent gap between awareness and testing capacity may contribute to under recognition of TBE and highlights the need to strengthen diagnostic access alongside physician education and vaccination strategies.
SN - 2673-3986
ER -