{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:38:06Z","timestamp":1780555086219,"version":"3.54.1"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T00:00:00Z","timestamp":1647475200000},"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>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.<\/jats:p>","DOI":"10.3390\/pathogens11030371","type":"journal-article","created":{"date-parts":[[2022,3,20]],"date-time":"2022-03-20T21:34:27Z","timestamp":1647812067000},"page":"371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Unexpected TBEV Seropositivity in Serbian Patients Who Recovered from Viral Meningitis and Encephalitis"],"prefix":"10.3390","volume":"11","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, Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Department of Microbiology with Parasitology and Immunology, Faculty of Medicine in Novi Sad, University of Novi Sad, 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, 112 Science Place, Saskatoon, SK S7N 5E2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selena","family":"\u0110uri\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sini\u0161a","family":"Sevi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine in Novi Sad, 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 in Novi Sad, 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":"Dajana","family":"Lendak","sequence":"additional","affiliation":[{"name":"Faculty of Medicine in Novi Sad, 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":"Sandra Stefan","family":"Miki\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine in Novi Sad, 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":"Verica","family":"Simin","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragana","family":"Mijatovi\u0107","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3410-6842","authenticated-orcid":false,"given":"Aleksandar","family":"Potkonjak","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Savi\u0107","sequence":"additional","affiliation":[{"name":"Scientific Veterinary Institute \u201cNovi Sad\u201d, 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"}],"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":[[2022,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.ttbdis.2010.10.007","article-title":"Tick-Borne Encephalitis 2010: Epidemiology, Risk Areas, and Virus Strains in Europe and Asia-an Overview","volume":"2","year":"2011","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1016\/S0140-6736(08)60800-4","article-title":"Tick-Borne Encephalitis","volume":"371","author":"Lindquist","year":"2008","journal-title":"Lancet Lond. Engl."},{"key":"ref_3","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_4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/s41426-018-0081-6","article-title":"A New Subtype of Eastern Tick-Borne Encephalitis Virus Discovered in Qinghai-Tibet Plateau, China","volume":"7","author":"Dai","year":"2018","journal-title":"Emerg. Microbes Infect."},{"key":"ref_5","first-page":"53","article-title":"Characteristics of the Baikal subtype of tick-borne encephalitis virus circulating in eastern Siberia","volume":"3","author":"Kozlova","year":"2018","journal-title":"Acta Biomed. Sci."},{"key":"ref_6","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_7","first-page":"1800201","article-title":"Tick-Borne Encephalitis in Europe, 2012 to 2016","volume":"23","author":"Spiteri","year":"2018","journal-title":"Eurosurveillance"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Deviatkin, A.A., Kholodilov, I.S., Vakulenko, Y.A., Karganova, G.G., and Lukashev, A.N. (2020). Tick-Borne Encephalitis Virus: An Emerging Ancient Zoonosis?. Viruses, 12.","DOI":"10.3390\/v12020247"},{"key":"ref_9","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_10","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_11","first-page":"101609","article-title":"Humans Infested with Ixodes Ricinus Are Exposed to a Diverse Array of Tick-Borne Pathogens in Serbia","volume":"12","author":"Galon","year":"2020","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_12","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_13","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.idc.2008.03.013","article-title":"Tick-Borne Encephalitis","volume":"22","author":"Kaiser","year":"2008","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1007\/BF01962369","article-title":"Two-Year Survey of the Incidence of Lyme Borreliosis and Tick-Borne Encephalitis in a High-Risk Population in Sweden","volume":"11","author":"Gustafson","year":"1992","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis. Off. Publ. Eur. Soc. Clin. Microbiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S1438-4221(02)80012-1","article-title":"Tick-Borne Encephalitis (TBE) in Germany and Clinical Course of the Disease","volume":"291","author":"Kaiser","year":"2002","journal-title":"Int. J. Med. Microbiol. IJMM"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.tmaid.2010.05.011","article-title":"What Tick-Borne Encephalitis May Look like: Clinical Signs and Symptoms","volume":"8","author":"Bogovic","year":"2010","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1093\/brain\/122.11.2067","article-title":"The Clinical and Epidemiological Profile of Tick-Borne Encephalitis in Southern Germany 1994\u201398: A Prospective Study of 656 Patients","volume":"122","author":"Kaiser","year":"1999","journal-title":"Brain J. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.jcv.2004.07.014","article-title":"The Importance of Tick-Borne Encephalitis Virus RNA Detection for Early Differential Diagnosis of Tick-Borne Encephalitis","volume":"33","author":"Saksida","year":"2005","journal-title":"J. Clin. Virol. Off. Publ. Pan Am. Soc. Clin. Virol."},{"key":"ref_19","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_20","doi-asserted-by":"crossref","unstructured":"Vasi\u0107, A., Bjeki\u0107, J., Veinovi\u0107, G., Mihaljica, D., Sukara, R., Poluga, J., Filipovi\u0107, S.R., and Tomanovi\u0107, S. (2022). 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, 19.","DOI":"10.3390\/ijerph19020867"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1159\/000503236","article-title":"Do We Know the True Burden of Tick-Borne Encephalitis? A Cross-Sectional Study","volume":"54","author":"Cocchio","year":"2020","journal-title":"Neuroepidemiology"},{"key":"ref_22","first-page":"173","article-title":"Arbovirus infections in Serbia","volume":"29","author":"Bordoski","year":"1972","journal-title":"Vojnosanit. Pregl."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Banovi\u0107, P., Obreg\u00f3n, D., Mijatovi\u0107, D., Simin, V., Stankov, S., Budakov-Obradovi\u0107, Z., Bujandri\u0107, N., Gruji\u0107, J., Sevi\u0107, S., and Turkulov, V. (2021). Tick-Borne Encephalitis Virus Seropositivity among Tick Infested Individuals in Serbia. Pathogens, 10.","DOI":"10.3390\/pathogens10030301"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ttbdis.2012.03.007","article-title":"Tick-Borne Encephalitis (TBE): An Underestimated Risk\u2026still","volume":"3","author":"Kunze","year":"2012","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_25","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_26","unstructured":"Dobler, G., Erber, W., and Schmitt, H.-J. (2018). The TBE Book, Global Health Press Pte Ltd."},{"key":"ref_27","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_28","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_29","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_30","first-page":"2002108","article-title":"The Regional Decline and Rise of Tick-Borne Encephalitis Incidence Do Not Correlate with Lyme Borreliosis, Austria, 2005 to 2018","volume":"26","author":"Stiasny","year":"2021","journal-title":"Eurosurveill. Bull. Eur. Sur Mal. Transm. Eur. Commun. Dis. Bull."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Walter, M., Vogelgesang, J.R., Rubel, F., and Brugger, K. (2020). Tick-Borne Encephalitis Virus and Its European Distribution in Ticks and Endothermic Mammals. Microorganisms, 8.","DOI":"10.3390\/microorganisms8071065"},{"key":"ref_32","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_33","doi-asserted-by":"crossref","first-page":"100270","DOI":"10.1016\/j.onehlt.2021.100270","article-title":"A One Health Approach to Study the Circulation of Tick-Borne Pathogens: A Preliminary Study","volume":"13","author":"Galon","year":"2021","journal-title":"One Health"},{"key":"ref_34","first-page":"100801","article-title":"Clinical Characteristics of and Outcomes for Patients with COVID-19 and Comorbid Lung Diseases Primarily Hospitalized in a Conventional Pulmonology Unit: A Retrospective Study","volume":"79","author":"Riou","year":"2021","journal-title":"Respir. Med. Res."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/3\/371\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:38:26Z","timestamp":1760135906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/3\/371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,17]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["pathogens11030371"],"URL":"https:\/\/doi.org\/10.3390\/pathogens11030371","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,17]]}}}