COVID-19 vaccinations are about to begin in various countries or are already ongoing. This is an unprecedented operation that is also met with a loud response from anti-vaccine communities—currently using all available channels to manipulate public opinion. At the same time, the strategy to educate on vaccinations, explain their mechanism of action, and build trust in science is subdued in different world parts. Such actions should go much beyond campaigns promoting the COVID-19 vaccines solely on the information provided by the health institutions and national authorities. In this paper, actions provided by independent expert groups needed to counteract the anti-vaccine propaganda and provide scientific-based information to the general public are offered. These actions encompass organizing groups continuously communicating science on COVID-19 vaccines to the general public; tracking and tackling emerging and circulating fake news; and equipping celebrities and politicians with scientific information to ensure the quality of messages they communicate, as well as public letters, and statements of support for vaccination by healthcare workers, recognized scientists, VIPs, and scientific societies; and no tolerance to false and manipulated claims on vaccination spread via traditional and social media as well as by health professionals, scientists, and academics. These activities should be promptly implemented worldwide, regardless of the current status and availability of the COVID-19 vaccine in a particular region. If we are about to control the pandemic for the sake of public benefit, it is high time to collectively speak out as academic and medical societies with support from decision-makers. Otherwise, the battle will be lost to those who stand against scientific evidence while offering no feasible solution to the problem.

Tick-borne encephalitis (TBE) virus is a major cause of central nervous system infections in endemic countries. Here, we present clinical and laboratory characteristics of a large international cohort of patients with confirmed TBE using a uniform clinical protocol. Patients were recruited in eight centers from six European countries between 2010 and 2017. A detailed description of clinical signs and symptoms was recorded. The obtained information enabled a reliable classification in 553 of 555 patients: 207 (37.3%) had meningitis, 273 (49.2%) meningoencephalitis, 15 (2.7%) meningomyelitis, and 58 (10.5%) meningoencephalomyelitis; 41 (7.4%) patients had a peripheral paresis of extremities, 13 (2.3%) a central paresis of extremities, and 25 (4.5%) had single or multiple cranial nerve palsies. Five (0.9%) patients died during acute illness. Outcome at discharge was recorded in 298 patients. Of 176 (59.1%) patients with incomplete recovery, 80 (27%) displayed persisting symptoms or signs without recovery expectation. This study provides further evidence that TBE is a severe disease with a large proportion of patients with incomplete recovery. We suggest monitoring TBE in endemic European countries using a uniform protocol to record the full clinical spectrum of the disease.

Tick-borne encephalitis (TBE) is a serious acute central nervous system infection that can result in death or long-term neurological dysfunctions. We hypothesize that changes in sphingosine-1-phosphate (S1P) concentration occur during TBE development. S1P and interleukin-6 (IL-6) concentrations in blood plasma and cerebrospinal fluid (CSF) were measured using HPLC and ELISA, respectively. The effects of S1P on cytoskeletal structure and IL-6 production were assessed using rat astrocyte primary cultures with and without addition of plasma gelsolin and the S1P receptor antagonist fingolimod phosphate (FTY720P). We report that acute inflammation due to TBE virus infection is associated with elevated levels of S1P and IL-6 in the CSF of infected patients. This elevated concentration is observed even at the earliest neurologic stage of disease, and may be controlled by glucocorticosteroid anti-inflammatory treatment, administered to patients unresponsive to antipyretic drugs and who suffer from a fever above 39 °C. In vitro, treatment of confluent rat astrocyte monolayers with a high concentration of S1P (5 μM) results in cytoskeletal actin remodeling that can be prevented by the addition of recombinant plasma gelsolin, FTY720P, or their combination. Additionally, gelsolin and FTY720P significantly decreased S1P-induced release of IL-6. TBE is associated with increased concentration of S1P and IL-6 in CSF, and this increase might promote development of inflammation. The consequences of increased extracellular S1P can be modulated by gelsolin and FTY720P. Therefore, blocking the inflammatory response at sites of infection by agents modulating S1P pathways might aid in developing new strategies for TBE treatment.

Serologic assays detecting antibodies to Borrelia burgdorferi are useful in the routine diagnosis of Lyme disease. Despite the presence of new and improved assays, current laboratory diagnosis still requires optimization. The variety of genospecies and their different geographic distributions are the reasons why standards and recommendations are not the same for all of the main geographic regions, ie, USA, Asia, and Europe. Moreover, the variety and variability of antigens represents a significant challenge in assay design. This is due to the various antigens among the genospecies responsible for Lyme borreliosis; the changing antigens presented during infection; and the variability of single antigens. This review article discusses the immunologic response in Lyme disease over time, and the advantages and disadvantages of existing serological tests. Two tier testing is also introduced. Antigens useful for diagnosis, the properties of individual antigens and their appearance in infection - especially the antigens appearing during mammalian infection, so-called “in vivo” antigens are introduced. To determine antibodies confirming infection in the nervous system, the same restrictions with regard to interpretation of enzyme-linked immunosorbent assay results in serum apply to cerebrospinal fluid. Furthermore, concentrations of antibodies in the two compartments, ie, blood and cerebrospinal fluid, are variable depending on compartmentalization (anatomic sequestration) and immunologic phenomena at immunologically privileged sites, such as the intrathecal space. To confirm neuroborreliosis, synthesis of antibodies in cerebrospinal fluid, should be measured in the form of a so-called antibody index. Further studies should focus on detecting the lowest concentration of antibodies and looking for useful new antigens, and the relationship between composition of such antigens and the patient's clinical status.

Acute disseminated encephalomyelitis (ADEM) is a rare and an immune- mediated inflammatory illness of the central nervous system that normally demonstrates as a monophasic disorder connected with multifocal neurologic symptoms. Herein, we report atypical presentation of ADEM presenting as single lesions in a middle-aged woman after tick-borne encephalitis.