Tick-Borne Encephalitis Virus Infection in a Two-Year-Old Child Returning from Switzerland (July–August 2023): Is It Time for TBE Immunization of Serbian Travelers?
Abstract
1. Introduction
2. Case Description
Phylogenetic Analysis of TBEV
3. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Genus: Orthoflavivirus|ICTV. Available online: https://ictv.global/report/chapter/flaviviridae/flaviviridae/orthoflavivirus (accessed on 1 November 2024).
- Taba, P.; Schmutzhard, E.; Forsberg, P.; Lutsar, I.; Ljøstad, U.; Mygland, Å.; Levchenko, I.; Strle, F.; Steiner, I. EAN Consensus Review on Prevention, Diagnosis and Management of Tick-Borne Encephalitis. Eur. J. Neurol. 2017, 24, 1214-e61. [Google Scholar] [CrossRef] [PubMed]
- Kunze, M.; Banović, P.; Bogovič, P.; Briciu, V.; Čivljak, R.; Dobler, G.; Hristea, A.; Kerlik, J.; Kuivanen, S.; Kynčl, J.; et al. Recommendations to Improve Tick-Borne Encephalitis Surveillance and Vaccine Uptake in Europe. Microorganisms 2022, 10, 1283. [Google Scholar] [CrossRef] [PubMed]
- Banović, P.; Mijatović, D.; Bogdan, I.; Simin, V.; Meletis, E.; Kostoulas, P.; Resman Rus, K.; Knap, N.; Korva, M.; Avšič-Županc, T.; et al. Evidence of Tick-Borne Encephalitis Virus Neutralizing Antibodies in Serbian Individuals Exposed to Tick Bites. Front. Microbiol. 2023, 14, 1314538. [Google Scholar] [CrossRef] [PubMed]
- Banović, P.; Jakimovski, D.; Bogdan, I.; Simin, V.; Mijatović, D.; Bosilkovski, M.; Mateska, S.; Díaz-Sánchez, A.A.; Foucault-Simonin, A.; Zając, Z.; et al. Tick-Borne Diseases at the Crossroads of the Middle East and Central Europe. Infect. Dis. Now 2024, 54, 104959. [Google Scholar] [CrossRef]
- Bogovic, P.; Strle, F. Tick-Borne Encephalitis: A Review of Epidemiology, Clinical Characteristics, and Management. World J. Clin. Cases 2015, 3, 430–441. [Google Scholar] [CrossRef]
- Vilibic-Cavlek, T.; Krcmar, S.; Bogdanic, M.; Tomljenovic, M.; Barbic, L.; Roncevic, D.; Sabadi, D.; Vucelja, M.; Santini, M.; Hunjak, B.; et al. An Overview of Tick-Borne Encephalitis Epidemiology in Endemic Regions of Continental Croatia, 2017–2023. Microorganisms 2024, 12, 386. [Google Scholar] [CrossRef]
- Hills, S.L. Tick-Borne Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023. MMWR Recomm. Rep. 2023, 72, 1–29. [Google Scholar] [CrossRef]
- Marano, C.; Moodley, M.; Melander, E.; De Moerlooze, L.; Nothdurft, H.D. Perceptions of Tick-Borne Encephalitis Risk: A Survey of Travellers and Travel Clinics from Canada, Germany, Sweden and the UK. J. Travel Med. 2019, 26, S10–S16. [Google Scholar] [CrossRef] [PubMed]
- Steffen, R. Epidemiology of Tick-Borne Encephalitis (TBE) in International Travellers to Western/Central Europe and Conclusions on Vaccination Recommendations. J. Travel Med. 2016, 23, taw018. [Google Scholar] [CrossRef]
- Haditsch, M.; Kunze, U. Tick-Borne Encephalitis: A Disease Neglected by Travel Medicine. Travel Med. Infect. Dis. 2013, 11, 295–300. [Google Scholar] [CrossRef]
- Meltzer, E.; Paran, Y.; Lustig, Y.; Stienlauf, S.; Weinberger, M.; Schwartz, E. Travel-Related Tick-Borne Encephalitis, Israel, 2006–2014. Emerg. Infect. Dis. 2017, 23, 119–121. [Google Scholar] [CrossRef] [PubMed]
- Reusken, C.; Reimerink, J.; Verduin, C.; Sabbe, L.; Cleton, N.; Koopmans, M. Case Report: Tick-Borne Encephalitis in Two Dutch Travellers Returning from Austria, Netherlands, July and August 2011. Euro Surveill. 2011, 16, 20003. [Google Scholar] [CrossRef] [PubMed]
- Vasić, A.; Bjekić, J.; Veinović, G.; Mihaljica, D.; Sukara, R.; Poluga, J.; Filipović, S.R.; Tomanović, S. Knowledge, Attitudes, and Practices on Tick-Borne Encephalitis Virus and Tick-Borne Diseases within Professionally Tick-Exposed Persons, Health Care Workers, and General Population in Serbia: A Questionnaire-Based Study. Int. J. Environ. Res. Public Health 2022, 19, 867. [Google Scholar] [CrossRef]
- Banović, P. TBE in Serbia. In TBE Book; Global Health Press Pte Limited: Singapore, 2024; pp. 329–332. [Google Scholar]
- Popović Dragonjić, L.; Vrbić, M.; Tasić, A.; Simin, V.; Bogdan, I.; Mijatović, D.; Cabezas-Cruz, A.; Banović, P. Fatal Case of Imported Tick-Borne Encephalitis in South Serbia. Trop. Med. Infect. Dis. 2022, 7, 434. [Google Scholar] [CrossRef]
- Veje, M.; Nolskog, P.; Petzold, M.; Bergström, T.; Lindén, T.; Peker, Y.; Studahl, M. Tick-Borne Encephalitis Sequelae at Long-Term Follow-up: A Self-Reported Case-Control Study. Acta Neurol. Scand. 2016, 134, 434–441. [Google Scholar] [CrossRef]
- Sellner, J.; Bogovic, P.; Zajkowska, J. Tick-Borne Encephalitis in Adults. In TBE Book; Global Health Press Pte Limited: Singapore, 2024; pp. 124–139. [Google Scholar]
- Parfut, A.; Laugel, E.; Baer, S.; Gonzalez, G.; Hansmann, Y.; Wendling, M.-J.; Fafi-Kremer, S.; Velay, A. Tick-Borne Encephalitis in Pediatrics: An Often Overlooked Diagnosis. Infect. Dis. Now 2023, 53, 104645. [Google Scholar] [CrossRef] [PubMed]
- Bogdanavičienė, K.; Gudavičiūtė, G.; Šeškutė, M. A Retrospective Analysis of Tick-Borne Encephalitis in Children Treated in Kaunas Hospital During 2012 to 2019. Pediatr. Infect. Dis. J. 2022, 41, 702–705. [Google Scholar] [CrossRef]
- Krbková, L.; Štroblová, H.; Bednářová, J. Clinical Course and Sequelae for Tick-Borne Encephalitis among Children in South Moravia (Czech Republic). Eur. J. Pediatr. 2015, 174, 449–458. [Google Scholar] [CrossRef] [PubMed]
- Veje, M.; Freimane, Z.; Zavadska, D. TBE in Children. In TBE Book; Global Health Press Pte Limited: Singapore, 2024; pp. 118–123. [Google Scholar]
- Hansson, M.E.A.; Orvell, C.; Engman, M.-L.; Wide, K.; Lindquist, L.; Lidefelt, K.-J.; Sundin, M. Tick-Borne Encephalitis in Childhood: Rare or Missed? Pediatr. Infect. Dis. J. 2011, 30, 355–357. [Google Scholar] [CrossRef]
- Estrada-Peña, A. Ticks of Domestic Animals in the Mediterranean Region: A Guide to Identification of Species; University of Zaragoza: Zaragoza, Spain, 2004; ISBN 978-84-96214-18-7. [Google Scholar]
- Gray, J.; Stanek, G.; Kundi, M.; Kocianova, E. Dimensions of Engorging Ixodes Ricinus as a Measure of Feeding Duration. Int. J. Med. Microbiol. 2005, 295, 567–572. [Google Scholar] [CrossRef]
- Schwaiger, M.; Cassinotti, P. Development of a Quantitative Real-Time RT-PCR Assay with Internal Control for the Laboratory Detection of Tick Borne Encephalitis Virus (TBEV) RNA. J. Clin. Virol. 2003, 27, 136–145. [Google Scholar] [CrossRef] [PubMed]
- Jakimovski, D.; Mateska, S.; Dimitrova, E.; Bosilkovski, M.; Mijatović, D.; Simin, V.; Bogdan, I.; Grujić, J.; Budakov-Obradović, Z.; Meletis, E.; et al. Tick-Borne Encephalitis Virus and Borrelia Burgdorferi Seroprevalence in Balkan Tick-Infested Individuals: A Two-Centre Study. Pathogens 2023, 12, 922. [Google Scholar] [CrossRef]
- Kuno, G.; Chang, G.J.; Tsuchiya, K.R.; Karabatsos, N.; Cropp, C.B. Phylogeny of the Genus Flavivirus. J. Virol. 1998, 72, 73–83. [Google Scholar] [CrossRef]
- Scaramozzino, N.; Crance, J.M.; Jouan, A.; DeBriel, D.A.; Stoll, F.; Garin, D. Comparison of Flavivirus Universal Primer Pairs and Development of a Rapid, Highly Sensitive Heminested Reverse Transcription-PCR Assay for Detection of Flaviviruses Targeted to a Conserved Region of the NS5 Gene Sequences. J. Clin. Microbiol. 2001, 39, 1922–1927. [Google Scholar] [CrossRef] [PubMed]
- Hall, T. BioEdit: A User-Friendly Biological Sequence Alignment Editor and Analysis Program for Windows 95/98/NT. Nucleic Acids Symp. Ser. 1999, 41, 95–98. [Google Scholar]
- Tamura, K.; Stecher, G.; Kumar, S. MEGA11: Molecular Evolutionary Genetics Analysis Version 11. Mol. Biol. Evol. 2021, 38, 3022–3027. [Google Scholar] [CrossRef]
- Bianchini, G.; Sánchez-Baracaldo, P. TreeViewer: Flexible, Modular Software to Visualise and Manipulate Phylogenetic Trees. Ecol. Evol. 2024, 14, e10873. [Google Scholar] [CrossRef]
- Gillingham, E.L.; Cull, B.; Pietzsch, M.E.; Phipps, L.P.; Medlock, J.M.; Hansford, K. The Unexpected Holiday Souvenir: The Public Health Risk to UK Travellers from Ticks Acquired Overseas. Int. J. Environ. Res. Public Health 2020, 17, 7957. [Google Scholar] [CrossRef]
- Hills, S.L.; Broussard, K.R.; Broyhill, J.C.; Shastry, L.G.; Cossaboom, C.M.; White, J.L.; Machesky, K.D.; Kosoy, O.; Girone, K.; Klena, J.D.; et al. Tick-Borne Encephalitis among US Travellers, 2010–2020. J. Travel Med. 2022, 29, taab167. [Google Scholar] [CrossRef]
- Centers for Disease Control and Prevention (CDC). Tick-Borne Encephalitis among U.S. Travelers to Europe and Asia—2000–2009. MMWR Morb. Mortal Wkly Rep. 2010, 59, 335–338. [Google Scholar]
- Kunze, U. Is There a Need for a Travel Vaccination against Tick-Borne Encephalitis? Travel Med. Infect. Dis. 2008, 6, 380–383. [Google Scholar] [CrossRef] [PubMed]
- Cabezas-Cruz, A.; Banović, P. Understanding Tick-Borne Encephalitis Virus Foci, a Tale of Two Mountains. Pathogens 2023, 12, 265. [Google Scholar] [CrossRef] [PubMed]
- Banović, P.; Obregón, D.; Mijatović, D.; Simin, V.; Stankov, S.; Budakov-Obradović, Z.; Bujandrić, N.; Grujić, J.; Sević, S.; Turkulov, V.; et al. Tick-Borne Encephalitis Virus Seropositivity among Tick Infested Individuals in Serbia. Pathogens 2021, 10, 301. [Google Scholar] [CrossRef]
- Banović, P.; Díaz-Sánchez, A.A.; Đurić, S.; Sević, S.; Turkulov, V.; Lendak, D.; Mikić, S.S.; Simin, V.; Mijatović, D.; Bogdan, I.; et al. Unexpected TBEV Seropositivity in Serbian Patients Who Recovered from Viral Meningitis and Encephalitis. Pathogens 2022, 11, 371. [Google Scholar] [CrossRef]
- Rakić, V.; Šaponjić, D.; Lončarević, G.; Simić, D.; Dimitrijević, D.; Plavša, D.; Milosavljević, Z.; Stošić, M.; Milić, M.; Kanazir, M.; et al. Report on Infectious Diseases in the Republic of Serbia for 2022; Institute for Public Health of Serbia “Dr. Milan Jovanović Batut”: Belgrade, Serbia, 2022. [Google Scholar]
- Sundin, M. Chapter 6: TBE in Children. In TBE Book; Global Health Press Pte Limited: Singapore, 2016; Volume 7. [Google Scholar]
- Logar, M.; Arnez, M.; Kolbl, J.; Avsic-Zupanc, T.; Strle, F. Comparison of the Epidemiological and Clinical Features of Tick-Borne Encephalitis in Children and Adults. Infection 2000, 28, 74–77. [Google Scholar] [CrossRef]
- Pustijanac, E.; Buršić, M.; Talapko, J.; Škrlec, I.; Meštrović, T.; Lišnjić, D. Tick-Borne Encephalitis Virus: A Comprehensive Review of Transmission, Pathogenesis, Epidemiology, Clinical Manifestations, Diagnosis, and Prevention. Microorganisms 2023, 11, 1634. [Google Scholar] [CrossRef] [PubMed]
- Alrubaye, R.; Choudhury, H. Severe Rhabdomyolysis in a 35-Year-Old Woman with COVID-19 Due to SARS-CoV-2 Infection: A Case Report. Am. J. Case Rep. 2020, 21, e926733. [Google Scholar] [CrossRef]
- Schley, K.; Friedrich, J.; Pilz, A.; Huang, L.; Balkaran, B.L.; Maculaitis, M.C.; Malerczyk, C. Evaluation of Under-Testing and under-Diagnosis of Tick-Borne Encephalitis in Germany. BMC Infect. Dis. 2023, 23, 139. [Google Scholar] [CrossRef]
- Meyer, P.M.; Zimmermann, H.; Goetschel, P. Tick-Borne Encephalitis Presenting as Fever without Localising Signs—A Case Series. Eur. J. Pediatr. 2010, 169, 767–769. [Google Scholar] [CrossRef]
- Schmolck, H.; Maritz, E.; Kletzin, I.; Korinthenberg, R. Neurologic, Neuropsychologic, and Electroencephalographic Findings after European Tick-Borne Encephalitis in Children. J. Child Neurol. 2005, 20, 500–508. [Google Scholar] [CrossRef]
- Nygren, T.M.; Pilic, A.; Böhmer, M.M.; Wagner-Wiening, C.; Went, S.-B.; Wichmann, O.; Hellenbrand, W. Tick-Borne Encephalitis: Acute Clinical Manifestations and Severity in 581 Cases from Germany, 2018–2020. J. Infect. 2023, 86, 369–375. [Google Scholar] [CrossRef] [PubMed]
- Lesnicar, G.; Poljak, M.; Seme, K.; Lesnicar, J. Pediatric Tick-Borne Encephalitis in 371 Cases from an Endemic Region in Slovenia, 1959 to 2000. Pediatr. Infect. Dis. J. 2003, 22, 612–617. [Google Scholar] [CrossRef] [PubMed]
- Hedin, W.; Bergman, P.; Akhirunessa, M.; Söderholm, S.; Buggert, M.; Granberg, T.; Gredmark-Russ, S.; Smith, C.I.E.; Pettke, A.; Wahren Borgström, E. Severe Tick-Borne Encephalitis (TBE) in a Patient with X-Linked Agammaglobulinemia; Treatment with TBE Virus IgG Positive Plasma, Clinical Outcome and T Cell Responses. J. Clin. Immunol. 2024, 44, 116. [Google Scholar] [CrossRef] [PubMed]
- Elsterova, J.; Palus, M.; Sirmarova, J.; Kopecky, J.; Niller, H.H.; Ruzek, D. Tick-Borne Encephalitis Virus Neutralization by High Dose Intravenous Immunoglobulin. Ticks Tick-Borne Dis. 2017, 8, 253–258. [Google Scholar] [CrossRef]
- Kleiter, I.; Jilg, W.; Bogdahn, U.; Steinbrecher, A. Delayed Humoral Immunity in a Patient with Severe Tick-Borne Encephalitis after Complete Active Vaccination. Infection 2007, 35, 26–29. [Google Scholar] [CrossRef]
- Amicizia, D.; Domnich, A.; Panatto, D.; Lai, P.L.; Cristina, M.L.; Avio, U.; Gasparini, R. Epidemiology of Tick-Borne Encephalitis (TBE) in Europe and Its Prevention by Available Vaccines. Hum. Vaccin. Immunother. 2013, 9, 1163–1171. [Google Scholar] [CrossRef]
- Poellabauer, E.; Angermayr, R.; Behre, U.; Zhang, P.; Harper, L.; Schmitt, H.J.; Erber, W. Seropersistence and Booster Response Following Vaccination with FSME-IMMUN in Children, Adolescents, and Young Adults. Vaccine 2019, 37, 3241–3250. [Google Scholar] [CrossRef]
- Müller, M.; Lintener, H.; Henkel, V.; Pilz, A.; Halsby, K.; Malerczyk, C.; Madhava, H.; Moïsi, J.C.; Yu, H.; Schley, K. Does the Vaccination against Tick-Borne Encephalitis Offer Good Value for Money for Incidence Rates below the WHO Threshold for Endemicity? A Case Study for Germany. Vaccines 2024, 12, 1165. [Google Scholar] [CrossRef]
- Angulo, F.J.; Zhang, P.; Halsby, K.; Kelly, P.; Pilz, A.; Madhava, H.; Moïsi, J.C.; Jodar, L. A Systematic Literature Review of the Effectiveness of Tick-Borne Encephalitis Vaccines in Europe. Vaccine 2023, 41, 6914–6921. [Google Scholar] [CrossRef]
- WHO Publication. Vaccines against Tick-Borne Encephalitis: WHO Position Paper--Recommendations. Vaccine 2011, 29, 8769–8770. [Google Scholar] [CrossRef]
- Loew-Baselli, A.; Poellabauer, E.M.; Pavlova, B.G.; Fritsch, S.; Firth, C.; Petermann, R.; Barrett, P.N.; Ehrlich, H.J. Prevention of Tick-Borne Encephalitis by FSME-IMMUN Vaccines: Review of a Clinical Development Programme. Vaccine 2011, 29, 7307–7319. [Google Scholar] [CrossRef] [PubMed]
- Rampa, J.E.; Askling, H.H.; Lang, P.; Zens, K.D.; Gültekin, N.; Stanga, Z.; Schlagenhauf, P. Immunogenicity and Safety of the Tick-Borne Encephalitis Vaccination (2009–2019): A Systematic Review. Travel Med. Infect. Dis. 2020, 37, 101876. [Google Scholar] [CrossRef] [PubMed]
- Berens-Riha, N.; Andries, P.; Aerssens, A.; Ledure, Q.; Van Der Beken, Y.; Heyndrickx, L.; Genbrugge, E.; Tsoumanis, A.; Van Herrewege, Y.; Ariën, K.K.; et al. Five Accelerated Schedules for the Tick-Borne Encephalitis Vaccine FSME-Immun® in Last-Minute Travellers: An Open-Label, Single-Centre, Randomized Controlled Pilot Trial. J. Travel Med. 2024, 31, taad053. [Google Scholar] [CrossRef] [PubMed]
- Zacharias, C.; Torgler, R.; Cummins, J. What Makes Patients Tick? Vaccine Preferences against Tick-Borne Encephalitis in Four European Countries. BMC Infect. Dis. 2024, 24, 1151. [Google Scholar] [CrossRef]
Lab Parameters | Normal Range | ||||
---|---|---|---|---|---|
Day of disease | 3 | 7 (Hospital admission) | 12 | 16 (Hospital discharge) | |
Direct pathogen detection | |||||
TBEV in blood (PCR) | (+) | (−) | |||
TBEV in CSF (PCR) | (−) | (−) | |||
CBC | |||||
RBC (×1012/L) | 4.17 | 4.44 | 4.45 | 4.26 | 4.1–5 |
Hemoglobin (g/L) | 118 | 124 | 121 | 117 | 107–138 |
WBC (×109/L) | 4.95(↓) | 4.22(↓) | 5.7 | 8.8 | 5.5–12.3 |
Neutrophils (×109/L) | 2.68 | 0.47(↓) | 1.05(↓) | 2.61 | 2.1–7.9 |
Lymphocytes (×109/L) | 1.53 | 3.25 | 3.96 | 5.46(↑) | 1.3–4.6 |
Basophiles (×109/L) | 0.01 | 0.02 | 0.06 | 0.03 | 0–0.2 |
Eosinophils (×109/L) | 0.04 | 0.01 | 0.04 | 0.02 | 0–0.4 |
Monocytes(×109/L) | 0.7 | 0.5 | 0.6 | 0.7 | 0.3–1.2 |
Neutrophils (%) | 52.4 | 11.2(↓) | 18.4(↓) | 29.6(↓) | 31.7–75.4 |
Lymphocytes (%) | 30.9 | 77(↑) | 69.4(↑) | 61.9(↑) | 13.5–52.8 |
Basophiles (%) | 0.2 | 0.5 | 1.1 | 0.4 | 0–0.9 |
Eosinophils (%) | 0.8 | 0.2 | 0.7 | 0.2 | 0–4.2 |
Monocytes (%) | 13.9(↑) | 11.1(↑) | 10.4(↑) | 7.9(↑) | 3.5–7.8 |
Platelets (×109/L) | / | 200 | 303 | 484(↑) | 150–450 |
Inflammation markers | |||||
CRP (mg/L) | 2.05 | <0.2 | <0.2 | 0.37 | 0–5 |
Liver enzymes | |||||
ALT (ukat/L) | 0.37 | 2.2(↑) | 1.19(↑) | 0.706 | 0.2–0.98 |
AST (ukat/L) | 0.73 | 3.5(↑) | 1.06(↑) | 0.706 | 0.2–0.95 |
CK (ukat/L) | / | 4.6(↑) | / | / | 0.52–2.53 |
Immunoglobulin levels | |||||
IgG (g/L) | / | 4.19(↓) | / | / | 5–13 |
IgM (g/L) | / | 1.95(↑) | / | / | 0.5–1.5 |
IgA (g/L) | / | 0.36 | / | / | 0.19–2.2 |
CSF analysis | |||||
Proteins (g/L) | / | 0.16 | / | / | 0.15–0.45 |
Chloride (mmol/L) | / | 126 | / | / | 118–132 |
Glucose (mmol/L) | / | 3.57 | / | / | 2.28–4.66 |
WBC (cell/mL) | / | 2 | / | / | <5 |
RBC (cell/mL) | / | 1 | / | / | <5 |
CSF culture | / | negative | / | / | negative |
Serological analysis | |||||
Epstein-Barr virus (IgM/IgG) | / | IgM(−), IgG(−) | / | / | N/A |
Influenza virus (IgM/IgG) | / | IgM(−), IgG(−) | / | / | N/A |
Parainfluenza virus (IgM/IgG) | / | IgM(−), IgG(+) | / | / | N/A |
Adenovirus (IgM/IgG) | / | IgM(−), IgG(+) | / | / | N/A |
TBEV NAbs | / | / | / | 1:40 (+) | <1:5 (−) |
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Simin, V.; Ležakov, O.; Bogdan, I.; Mijatović, D.; Gazibara, D.; Popović-Dragonjić, L.; Vijatov Đurić, G.; Milanović, B.; Kesić, J.; Đuretić, A.; et al. Tick-Borne Encephalitis Virus Infection in a Two-Year-Old Child Returning from Switzerland (July–August 2023): Is It Time for TBE Immunization of Serbian Travelers? Pathogens 2024, 13, 1013. https://doi.org/10.3390/pathogens13111013
Simin V, Ležakov O, Bogdan I, Mijatović D, Gazibara D, Popović-Dragonjić L, Vijatov Đurić G, Milanović B, Kesić J, Đuretić A, et al. Tick-Borne Encephalitis Virus Infection in a Two-Year-Old Child Returning from Switzerland (July–August 2023): Is It Time for TBE Immunization of Serbian Travelers? Pathogens. 2024; 13(11):1013. https://doi.org/10.3390/pathogens13111013
Chicago/Turabian StyleSimin, Verica, Ognjen Ležakov, Ivana Bogdan, Dragana Mijatović, Dragana Gazibara, Lidija Popović-Dragonjić, Gordana Vijatov Đurić, Borko Milanović, Jelena Kesić, Andrea Đuretić, and et al. 2024. "Tick-Borne Encephalitis Virus Infection in a Two-Year-Old Child Returning from Switzerland (July–August 2023): Is It Time for TBE Immunization of Serbian Travelers?" Pathogens 13, no. 11: 1013. https://doi.org/10.3390/pathogens13111013
APA StyleSimin, V., Ležakov, O., Bogdan, I., Mijatović, D., Gazibara, D., Popović-Dragonjić, L., Vijatov Đurić, G., Milanović, B., Kesić, J., Đuretić, A., Ábrahám, Á., Lanszki, Z., Kemenesi, G., Zana, B., Bányai, K., Zając, Z., Jakimovski, D., Cabezas-Cruz, A., & Banović, P. (2024). Tick-Borne Encephalitis Virus Infection in a Two-Year-Old Child Returning from Switzerland (July–August 2023): Is It Time for TBE Immunization of Serbian Travelers? Pathogens, 13(11), 1013. https://doi.org/10.3390/pathogens13111013