Unexpected TBEV Seropositivity in Serbian Patients Who Recovered from Viral Meningitis and Encephalitis
Pavle Banović,
Adrian Alberto Díaz-Sánchez,
Selena Đurić,
Siniša Sević,
Vesna Turkulov,
Dajana Lendak,
Sandra Stefan Mikić,
Verica Simin,
Dragana Mijatović,
Ivana Bogdan,
Aleksandar Potkonjak,
Sara Savić,
Dasiel Obregón,
Alejandro Cabezas-Cruz
Affiliations
Pavle Banović
Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia
Adrian Alberto Díaz-Sánchez
Department of Biology, University of Saskatchewan, 112 Science Place, Saskatoon, SK S7N 5E2, Canada
Selena Đurić
Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
Siniša Sević
Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
Vesna Turkulov
Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
Dajana Lendak
Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
Sandra Stefan Mikić
Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
Verica Simin
Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia
Dragana Mijatović
Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia
Ivana Bogdan
Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia
Aleksandar Potkonjak
Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia
Sara Savić
Scientific Veterinary Institute “Novi Sad”, 21000 Novi Sad, Serbia
Dasiel Obregón
School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
Alejandro Cabezas-Cruz
Anses, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, F-94700 Maisons-Alfort, France
The tick-borne encephalitis virus (TBEV) causes a life-threatening disease named Tick-borne encephalitis (TBE). The clinical symptoms associated with TBE range from non-specific to severe inflammation of the central nervous system and are very similar to the clinical presentation of other viral meningitis/encephalitis. In consequence, TBE is often misclassified by clinical physicians, mainly in the non-identified high-risk areas where none or only a few TBE cases have been reported. Considering this situation, we hypothesized that among persons from northern Serbia who recovered from viral meningitis or encephalitis, there would be evidence of TBEV infection. To test this hypothesis, in this observational study, we evaluated the seroreactivity against TBEV antigens in patients from northern Serbia who were hospitalized due to viral meningitis and/or viral encephalitis of unknown etiology. Three cases of seroreactivity to TBEV antigens were discovered among convalescent patients who recovered from viral meningitis and/or encephalitis and accepted to participate in the study (n = 15). The clinical and laboratory findings of these patients overlap with that of seronegative convalescent patients. Although TBE has been 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 study highlights the necessity to increase the awareness of TBE among physicians and perform active and systematic screening of TBEV antibodies among patients with viral meningitis and/or encephalitis.
