Koprivničko-križevačka županija poznato je endemsko žarište krpeljnog meningoencefalitisa (KME) već punih 60 godina, iako je sigurno da je ta bolest u nas postojala i ranije. S posebnom pažnjom proučavali smo osobitosti KME-a i prikupili nova saznanja o epidemiologiji, klinici i dijagnostici te bolesti, no mnoga su pitanja i danas ostala otvorena. Svrha našeg rada bila je prikazati incidenciju i prostornu raspodjelu bolesnika s KME-om po naseljima, i ustanoviti jesu li se tijekom našeg istraživanja u incidenciji i prostornoj raspodjeli događale promjene. U razdoblju od 1979.godine do 2011. godine liječili smo u Djelatnosti za infektivne bolesti i Djelatnosti za pedijatriju Opće bolnice »Dr. Tomislav Bardek« u Koprivnici 714 bolesnika s KME-om, 599 odrasla i 115-ero djece, u dobi od dvije do 82 godine. Prevladavao muški spol. Svi su bolesnici stanovnici naše županije. Potječu iz 168 naselja. Prosječno smo na 162 stanovnika naše Županije zabilježili jednog bolesnika s KME-om. Iz 57 naselja potječe samo jedan bolesnik s KME-om, iz ostalih 111 između dvoje i 22 bolesnika. Naselja s najviše bolesnika u odnosu na broj stanovnika su: Dedina, Vinarec, Potok Kalnički, Selanec, Podvinje Miholečko, Karane, Sveta Ana, Brodić, Veliki Grabičani i Donji Maslarac. Najviše bolesnika u odnosu na ispitivano razdoblje potječe iz naselja Virje (22), Novigrad (20), Ferdinandovac (18), Molve (18), Hlebine (11), Rasinja (10), Dedina (20), Vinarec (16), Kalnički Potok (13), Selanec (9) i Sveti Petar Čvrstec (9). Obitavalište jedne petine (19,6%) bolesnika s KME-om su naši gradovi. Na temelju prikupljenih podataka ustanovili smo značajne promjene koje se su dogodile u incidenciji i prostornoj raspodjeli bolesnika s KME-om. U prvom promatranom jedanaestogodišnjem razdoblju prosječno smo godišnje liječili 29,6 bolesnika s KME-om u drugom 26,5 i u trećem se incidencija bolesti više od tri puta smanjila. Istražujući raspodjelu bolesnika prema mjestu prebivališta uočili smo sve izrazitiji pad incidencije na križevačkom području i sve učestaliju pojavu bolesti u naseljima uz rijeku Dravu. Pojedina, u početku istraživanja vrlo« aktivna« naselja s vremenom su se »ugasila«, pojedina su povremeno ili stalno ostala« aktivna«, a u posljednjih nekoliko godina aktivna su i nova (Kloštar Podravski npr.). Razlog tako značajnom padu incidencije KME-a i promjene u prostornoj raspodjeli bolesnika teško možemo objasniti. Možda objašnjenje jednim dijelom treba potražiti u, iz ekonomskih razloga smanjenoj dijagnostičkoj obradi, spoznaji kako se nešto događa u načinu življenja našeg stanovništva. Preventivne mjere koje ne obuhvaćaju široku populaciju stanovništva (u nas su u program imunizacije protiv KME-a uglavnom uključene samo rizične skupine stanovnika) ne mogu imati značajniji učinak na pad incidencije ove bolesti. I dok većina europskih endemskih područja (s velikom vjerojatnošću) povezuje porast incidencije i promjene u prostornoj raspodjeli s klimatskim promjenama prvenstveno s povećanjem temperature zraka, ti čimbenici, iako prisutni, ne mogu biti odgovorni za uočene promjene na području Koprivničko–križevačke županije.Koprivnica-Križevci County has been known as an endemic hotspot for tick-borne encephalitis (TBE) for the past 60 years, though it is certain that the disease was present here earlier. Special emphasis was placed on examining the specificity of TBE and in gathering new knowledge about its epidemiology, clinical signs and diagnosing the disease, though many issues have remained unknown to the present day. The objective of this study was to show the prevalence and spatial distribution of patients with TBE by settlements, and to determine whether the prevalence and spatial distribution has changed over the course of the study. Over the period from 1979 to 2011, a total of 714 patients with TBE (599 adults and 115 children, aged 2 to 82 years) were treated at the Infective Diseases ward and Paediatric Ward of the Dr. Tomislav Bardek Clinical Hospital in Koprivnica. There were more male than female patients and all patients were residents of the county, originating from 168 settlements. The average prevalence was one TBE patient per 162 residents in the county. Of the settlements, 57 had only one TBE patient, while the remaining 111 settlements had between 2 and 22 patients. The settlements with the highest number of patients to residents were: Dedina, Vinarec, Potok Kalnički, Selanec, Podvinje Miholečko, Karane, Sveta Ana, Brodić, Veliki Grabičani and Donji Maslarac. The highest numbers of patients in the investigated area originated from the settlements: Virje (22), Novigrad (20), Ferdinandovac (18), Molve (18), Hlebine (11), Rasinja (10), Dedina (20), Vinarec (16), Kalnički potok (13), Selanec (9) and Sveti Petar Čvrstec (9). One-fifth (19.6%) of all TBE patients lived in towns. Based on the collected data, significant changes were established in both the prevalence and spatial distribution of TBE patients. In the first examined 11-year period, a total of 29.6 patients per year were examined, which decreased to 26.5 in the second 11-year period, and decreased by more than three-fold in the third period. In examining the distribution of patients by place of residence, a pronounced drop in prevalence was observed for the Koprivnica area, with an increasing prevalence of the disease in settlements along the Drava River. Over time, several of the initially very “active” settlements, in terms of the disease, were “extinguished” over time, some occasionally or permanently remained “active”, while several new settlements have become active in recent years (e.g. Kloštar Podravski, etc.). The reason for such a significant drop in the incidence of TBE and changes in the spatial distribution of patients is difficult to explain. One possible explanation should be sought, due to the fact that diagnostic testing has been reduced due to the economic situation, that certain changes have been taking place in the lifestyle of the county’s inhabitants. Preventative measures that do not encompass the broader population (immunization programmes for TBE are aimed primarily risk groups of the population) cannot have a significant effect on the prevalence of this disease. And while the majority of Europe’s endemic areas associate (with high significance) an increase in the prevalence and changes in spatial distribution of the disease with climatic changes, primarily with increasing air temperature, these factors, though present, cannot be accountable for the changes observed in the territory of Koprivnica-Križevci County