{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T23:55:24Z","timestamp":1783641324881,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>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\u201319; 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 Fru\u0161ka 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.<\/jats:p>","DOI":"10.3390\/pathogens10030301","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T01:59:28Z","timestamp":1614909568000},"page":"301","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Tick-Borne Encephalitis Virus Seropositivity among Tick Infested Individuals in Serbia"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7902-6606","authenticated-orcid":false,"given":"Pavle","family":"Banovi\u0107","sequence":"first","affiliation":[{"name":"Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5786-1114","authenticated-orcid":false,"given":"Dasiel","family":"Obreg\u00f3n","sequence":"additional","affiliation":[{"name":"School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada"},{"name":"Center for Nuclear Energy in Agriculture, University of S\u00e3o Paulo, Piracicaba, SP 13400-970, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragana","family":"Mijatovi\u0107","sequence":"additional","affiliation":[{"name":"Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verica","family":"Simin","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srdjan","family":"Stankov","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zorana","family":"Budakov-Obradovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7331-5562","authenticated-orcid":false,"given":"Nevenka","family":"Bujandri\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3092-4768","authenticated-orcid":false,"given":"Jasmina","family":"Gruji\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sini\u0161a","family":"Sevi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Clinic for Infectious Diseases, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna","family":"Turkulov","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Clinic for Infectious Diseases, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7743-7794","authenticated-orcid":false,"given":"Adrian Alberto","family":"D\u00edaz-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Saskatchewan, Saskatoon, SK S7N 5E2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8660-730X","authenticated-orcid":false,"given":"Alejandro","family":"Cabezas-Cruz","sequence":"additional","affiliation":[{"name":"Anses, INRAE, Ecole Nationale V\u00e9t\u00e9rinaire d\u2019Alfort, UMR BIPAR, Laboratoire de Sant\u00e9 Animale, F-94700 Maisons-Alfort, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.antiviral.2019.01.014","article-title":"Tick-Borne Encephalitis in Europe and Russia: Review of Pathogenesis, Clinical Features, Therapy, and Vaccines","volume":"164","author":"Ruzek","year":"2019","journal-title":"Antivir. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.ttbdis.2015.12.018","article-title":"The International Scientific Working Group on Tick-Borne Encephalitis (ISW TBE): Review of 17 Years of Activity and Commitment","volume":"7","author":"Kunze","year":"2016","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.virol.2006.09.015","article-title":"Genetic Characterization of Tick-Borne Flaviviruses: New Insights into Evolution, Pathogenetic Determinants and Taxonomy","volume":"361","author":"Grard","year":"2007","journal-title":"Virology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1017\/S0950268815000485","article-title":"Factors Affecting the Ecology of Tick-Borne Encephalitis in Slovenia","volume":"143","author":"Knap","year":"2015","journal-title":"Epidemiol. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ijmm.2005.12.005","article-title":"TBE Incidence versus Virus Prevalence and Increased Prevalence of the TBE Virus in Ixodes Ricinus Removed from Humans","volume":"296","author":"Klaus","year":"2006","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2694","DOI":"10.1080\/21645515.2016.1218098","article-title":"Tick-Borne Encephalitis: What Travelers Should Know When Visiting an Endemic Country","volume":"12","author":"Chrdle","year":"2016","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.ijppaw.2019.05.011","article-title":"Parasites and Wildlife in a Changing World: The Vector-Host- Pathogen Interaction as a Learning Case","volume":"9","author":"Rizzoli","year":"2019","journal-title":"Int. J. Parasitol. Parasites Wildl."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bournez, L., Umhang, G., Moinet, M., Boucher, J.-M., Demerson, J.-M., Caillot, C., Legras, L., Devillers, E., Hansmann, Y., and Velay, A. (2020). Disappearance of TBEV Circulation among Rodents in a Natural Focus in Alsace, Eastern France. Pathogens, 9.","DOI":"10.3390\/pathogens9110930"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ttbdis.2013.07.009","article-title":"Tick-Borne Encephalitis Virus in Ticks Detached from Humans and Follow-up of Serological and Clinical Response","volume":"5","author":"Lindblom","year":"2014","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"101513","DOI":"10.1016\/j.ttbdis.2020.101513","article-title":"Tick-Borne Encephalitis Outbreak Following Raw Goat Milk Consumption in a New Micro-Location, Croatia, June 2019","volume":"11","author":"Ilic","year":"2020","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/s10354-012-0100-5","article-title":"Epidemiology and Distribution of Tick-Borne Encephalitis","volume":"162","author":"Dobler","year":"2012","journal-title":"Wien. Med. Wochenschr."},{"key":"ref_12","unstructured":"European Centre for Disease Prevention and Control (2019). Tick-Borne Encephalitis: Annual Epidemiological Report for 2018, ECDC."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejim.2019.01.004","article-title":"Tick-Borne Encephalitis in Europe: A Brief Update on Epidemiology, Diagnosis, Prevention, and Treatment","volume":"62","author":"Riccardi","year":"2019","journal-title":"Eur. J. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"101327","DOI":"10.1016\/j.ttbdis.2019.101327","article-title":"Genetic Diversity and Geographical Distribution of the Siberian Subtype of the Tick-Borne Encephalitis Virus","volume":"11","author":"Tkachev","year":"2020","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Nah, K., Bede-Fazekas, \u00c1., Tr\u00e1jer, A.J., and Wu, J. (2020). The Potential Impact of Climate Change on the Transmission Risk of Tick-Borne Encephalitis in Hungary. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-019-4734-4"},{"key":"ref_16","first-page":"173","article-title":"Arbovirus infections in Serbia","volume":"29","author":"Bordoski","year":"1972","journal-title":"Vojnosanit. Pregl."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1089\/vbz.2017.2167","article-title":"Molecular Detection and Serological Evidence of Tick-Borne Encephalitis Virus in Serbia","volume":"17","author":"Potkonjak","year":"2017","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"510","DOI":"10.3855\/jidc.11516","article-title":"Tick-Borne Encephalitis in Serbia: A Case Series","volume":"13","author":"Poluga","year":"2019","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2298\/MPNS1604093H","article-title":"Tick-Borne Encephalitis Virus Infection in Humans","volume":"69","author":"Cvjetkovic","year":"2016","journal-title":"Med. Pregl."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Estrada-Pe\u00f1a, A., Mihalca, A.D., and Petney, T.N. (2018). Ticks of Europe and North Africa: A Guide to Species Identification, Springer International Publishing.","DOI":"10.1007\/978-3-319-63760-0"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.ijmm.2005.05.008","article-title":"Dimensions of Engorging Ixodes Ricinus as a Measure of Feeding Duration","volume":"295","author":"Gray","year":"2005","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_22","unstructured":"Thrusfield, M.V. (2007). Veterinary Epidemiology, Blackwell Science. [3rd ed.]. Reissued in Paperback with Updates."},{"key":"ref_23","first-page":"1800201","article-title":"Tick-Borne Encephalitis in Europe, 2012 to 2016","volume":"23","author":"Spiteri","year":"2018","journal-title":"Eurosurveillance"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1080\/22221751.2019.1612279","article-title":"Recent Establishment of Tick-Borne Encephalitis Foci with Distinct Viral Lineages in the Helsinki Area, Finland","volume":"8","author":"Smura","year":"2019","journal-title":"Emerg. Microbes Infect."},{"key":"ref_25","unstructured":"European Centre for Disease Prevention and Control (2012). Epidemiological Situation of Tick-Borne Encephalitis in the European Union and European Free Trade Association Countries, Publications Office."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.ttbdis.2017.09.015","article-title":"A New Hot Spot for Tick-Borne Encephalitis (TBE): A Marked Increase of TBE Cases in France in 2016","volume":"9","author":"Velay","year":"2018","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jcv.2019.09.009","article-title":"An Evaluation of Serological Methods to Diagnose Tick-Borne Encephalitis from Serum and Cerebrospinal Fluid","volume":"120","author":"Reusken","year":"2019","journal-title":"J. Clin. Virol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"53","DOI":"10.46784\/e-avm.v11i2.26","article-title":"Flaviviruses at the Territory of Serbia\u2014Present Situation and Challenges","volume":"11","author":"Potkonjak","year":"2019","journal-title":"Arch. Vet. Med."},{"key":"ref_29","first-page":"303","article-title":"Immunity against tick borne encephalitis virus (TBE) in population of forest workers in Bialowieza","volume":"64","author":"Siennicka","year":"2010","journal-title":"Przegl. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/S1438-4221(02)80005-4","article-title":"Foci of Tick-Borne Diseases in Southwest Germany","volume":"291","author":"Oehme","year":"2002","journal-title":"Int. J. Med. Microbiol. IJMM"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Borde, J.P., Kaier, K., Hehn, P., Matzarakis, A., Frey, S., Bestehorn, M., Dobler, G., and Chitimia-Dobler, L. (2021). The Complex Interplay of Climate, TBEV Vector Dynamics and TBEV Infection Rates in Ticks\u2014Monitoring a Natural TBEV Focus in Germany, 2009\u20132018. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0244668"},{"key":"ref_32","unstructured":"Hub\u00e1lek, Z. (2009). Epidemiology of Lyme Borreliosis. Lyme Borreliosis, Karger."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Toczylowski, K., Bojkiewicz, E., Barszcz, M., Wozinska-Klepadlo, M., Potocka, P., and Sulik, A. (2020). Etiology, Clinical Presentation and Incidence of Infectious Meningitis and Encephalitis in Polish Children. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082324"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1468-1331.2011.03434.x","article-title":"Tick-Borne Encephalitis in Latvia 1973-2009: Epidemiology, Clinical Features and Sequelae","volume":"19","author":"Karelis","year":"2012","journal-title":"Eur. J. Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0166-3542(02)00206-1","article-title":"Tick-Borne Encephalitis","volume":"57","author":"Gritsun","year":"2003","journal-title":"Antivir. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1051\/parasite\/2010174357","article-title":"Borrelia Burgdorferi in Ticks and Dogs in the Province of Vojvodina, Serbia","volume":"17","author":"Lako","year":"2010","journal-title":"Parasite"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"164","DOI":"10.2298\/VETGL200527008S","article-title":"Borellia Burgdorferi Infection in Removed Ticks and Anti-Borrelia Antibodies in Infested Patients Admitted to the Pasteur Institute, Novi Sad","volume":"74","author":"Simin","year":"2020","journal-title":"Vet. Glas."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Banovi\u0107, P., D\u00edaz-S\u00e1nchez, A.A., Galon, C., Simin, V., Mijatovi\u0107, D., Obreg\u00f3n, D., Moutailler, S., and Cabezas-Cruz, A. (2020). Humans Infested with Ixodes Ricinus Are Exposed to a Diverse Array of Tick-Borne Pathogens in Serbia. Ticks Tick-Borne Dis., 101609.","DOI":"10.1016\/j.ttbdis.2020.101609"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.4161\/hv.23802","article-title":"Epidemiology of Tick-Borne Encephalitis (TBE) in Europe and Its Prevention by Available Vaccines","volume":"9","author":"Amicizia","year":"2013","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Mihalca, A.D., and S\u00e1ndor, A.D. (2013). The Role of Rodents in the Ecology of Ixodes Ricinus and Associated Pathogens in Central and Eastern Europe. Front. Cell. Infect. Microbiol., 3.","DOI":"10.3389\/fcimb.2013.00056"},{"key":"ref_41","first-page":"3","article-title":"The Role of Particular Tick Developmental Stages in the Circulation of Tick-Borne Pathogens Affecting Humans in Central Europe. 2. Tick-Borne Encephalitis Virus","volume":"62","author":"Karbowiak","year":"2016","journal-title":"Ann. Parasitol."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/3\/301\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:33:12Z","timestamp":1760160792000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/3\/301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,5]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["pathogens10030301"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10030301","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,5]]}}}