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Tick-Borne Encephalitis Virus Seropositivity among Tick Infested Individuals in Serbia

Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
Center for Nuclear Energy in Agriculture, University of São Paulo, Piracicaba, SP 13400-970, Brazil
Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia
Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia
Clinic for Infectious Diseases, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
Department of Biology, University of Saskatchewan, Saskatoon, SK S7N 5E2, Canada
Anses, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, F-94700 Maisons-Alfort, France
Authors to whom correspondence should be addressed.
Equal contribution.
Academic Editor: Sergio E. Bermúdez
Pathogens 2021, 10(3), 301;
Received: 3 February 2021 / Revised: 13 February 2021 / Accepted: 2 March 2021 / Published: 5 March 2021
(This article belongs to the Collection Regional Impact of Ticks and Tick-Borne Diseases)
Tick-borne encephalitis (TBE), caused by the TBE virus (TBEV), is a life-threatening disease with clinical symptoms ranging from non-specific to severe inflammation of the central nervous system. Despite TBE is a notifiable disease in Serbia since 2004, there is no active TBE surveillance program for the serologic or molecular screening of TBEV infection in humans in the country. This prospective cohort study aimed to assess the TBEV exposure among tick-infested individuals in Serbia during the year 2020. A total of 113 individuals exposed to tick bites were recruited for the study and screened for anti-TBEV antibodies using a commercial indirect fluorescent antibody test (IFA) test. Blood samples from 50 healthy donors not exposed to tick bites were included as a control group. Most of the enrolled patients reported infestations with one tick, being I. ricinus the most frequent tick found in the participants. The TBEV seroprevalence was higher (13.27%, 15 total 113) in tick-infested individuals than in healthy donors (4%, 2 total 50), although the difference was not significant. Notably, male individuals exposed to tick bites showed five times higher relative risk (RR) of being TBEV-seropositive than healthy donors of the same gender (RR= 5.1, CI = 1.6–19; p = 0.007). None of the seropositive individuals developed clinical manifestations of TBE, but the first clinical-stage of Lyme borreliosis (i.e., erythema migrans) was detected in seven of them. Potential TBEV foci were identified in rural areas, mostly in proximity or within the Fruška Gora mountain. We conclude that the Serbian population is at high risk of TBEV exposure. Further epidemiological studies should focus on potential TBEV foci identified in this study. The implementation of active surveillance for TBEV might contribute to evaluating the potential negative impact of TBE in Serbia. View Full-Text
Keywords: TBEV; risk factors; seroprevalence TBEV; risk factors; seroprevalence
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MDPI and ACS Style

Banović, P.; Obregón, D.; Mijatović, D.; Simin, V.; Stankov, S.; Budakov-Obradović, Z.; Bujandrić, N.; Grujić, J.; Sević, S.; Turkulov, V.; Díaz-Sánchez, A.A.; Cabezas-Cruz, A. Tick-Borne Encephalitis Virus Seropositivity among Tick Infested Individuals in Serbia. Pathogens 2021, 10, 301.

AMA Style

Banović P, Obregón D, Mijatović D, Simin V, Stankov S, Budakov-Obradović Z, Bujandrić N, Grujić J, Sević S, Turkulov V, Díaz-Sánchez AA, Cabezas-Cruz A. Tick-Borne Encephalitis Virus Seropositivity among Tick Infested Individuals in Serbia. Pathogens. 2021; 10(3):301.

Chicago/Turabian Style

Banović, Pavle, Dasiel Obregón, Dragana Mijatović, Verica Simin, Srdjan Stankov, Zorana Budakov-Obradović, Nevenka Bujandrić, Jasmina Grujić, Siniša Sević, Vesna Turkulov, Adrian Alberto Díaz-Sánchez, and Alejandro Cabezas-Cruz. 2021. "Tick-Borne Encephalitis Virus Seropositivity among Tick Infested Individuals in Serbia" Pathogens 10, no. 3: 301.

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