{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:35:59Z","timestamp":1785411359564,"version":"3.56.0"},"reference-count":45,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["320030L_231465"],"award-info":[{"award-number":["320030L_231465"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"award":["320030L_231465"],"award-info":[{"award-number":["320030L_231465"]}],"id":[{"id":"https:\/\/ror.org\/00yjd3n13","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005289","name":"Provincial Secretariat for Higher Education and Scientific Research of Vojvodina","doi-asserted-by":"publisher","award":["003874431 2025 09418 003 000 000 001"],"award-info":[{"award-number":["003874431 2025 09418 003 000 000 001"]}],"id":[{"id":"10.13039\/501100005289","id-type":"DOI","asserted-by":"publisher"}]},{"award":["003874431 2025 09418 003 000 000 001"],"award-info":[{"award-number":["003874431 2025 09418 003 000 000 001"]}],"id":[{"id":"https:\/\/ror.org\/0279n3m18","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Tick-borne encephalitis (TBE) is an emerging vector-borne disease in Europe, but its epidemiology remains poorly defined in Serbia. In orthoflavivirus-endemic settings, diagnostic challenges may contribute to underrecognition of TBE, particularly among patients with suspected West Nile virus (WNV) infection. We conducted a multicenter retrospective study including patients hospitalized between 2018 and 2023 with suspected WNV neuroinvasive disease or viral encephalitis of unknown etiology. Serum samples were tested for TBEV-neutralizing antibodies using a microneutralization assay. Among 79 patients, TBEV-neutralizing antibodies were detected in four (5.1%). Most reactive cases occurred in patients initially classified as having suspected WNV-associated meningoencephalitis, while TBE had not been considered in the differential diagnosis at admission. These findings suggest that TBE may be underrecognized in Serbia and highlight the importance of confirmatory testing in orthoflavivirus-endemic settings. Strengthening clinical awareness and surveillance will be essential to better define the burden of TBE and inform prevention strategies.<\/jats:p>","DOI":"10.3390\/pathogens15060587","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T02:37:26Z","timestamp":1780454246000},"page":"587","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Underrecognized Tick-Borne Encephalitis in Serbia: Evidence from Patients with Suspected West Nile Virus Neuroinvasive Disease"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-0748","authenticated-orcid":false,"given":"Dragana","family":"Mijatovi\u0107","sequence":"first","affiliation":[{"name":"Diagnostics and Laboratory Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7976-0237","authenticated-orcid":false,"given":"Ana Marija","family":"Radevska","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-7223","authenticated-orcid":false,"given":"Dejan","family":"Jakimovski","sequence":"additional","affiliation":[{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"University Clinic for Infectious Diseases and Febrile Conditions, 1000 Skopje, North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3294-9803","authenticated-orcid":false,"given":"Lidija","family":"Popovi\u0107-Dragonji\u0107","sequence":"additional","affiliation":[{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Clinic for Infectology, University Clinical Center, 18000 Ni\u0161, Serbia"},{"name":"Department of Infectious Diseases and Epidemiology, Faculty of Medicine, University of Ni\u0161, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9280-2251","authenticated-orcid":false,"given":"Biljana","family":"Popovska Jovi\u010di\u0107","sequence":"additional","affiliation":[{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Clinic for Infectology, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia"},{"name":"Department of Infectious Diseases, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagoda","family":"Gavrilovi\u0107","sequence":"additional","affiliation":[{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Clinic for Infectology, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia"},{"name":"Department of Infectious Diseases, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sini\u0161a","family":"Sevi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Infectious Diseases, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia"},{"name":"Department of Infectious Diseases, Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4323-1776","authenticated-orcid":false,"given":"Dajana","family":"Lendak","sequence":"additional","affiliation":[{"name":"Clinic for Infectious Diseases, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia"},{"name":"Department of Infectious Diseases, Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0504-7355","authenticated-orcid":false,"given":"Irina","family":"Stojanac","sequence":"additional","affiliation":[{"name":"Clinic for Neurology, University Clinical Center of Vojvodina, 21000 Novi Sad, Serbia"}],"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-3845","authenticated-orcid":false,"given":"Andreas","family":"Pilz","sequence":"additional","affiliation":[{"name":"Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma, 2304 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6355-6781","authenticated-orcid":false,"given":"Tom\u00e1s","family":"Cervantes Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Institute for Research in Biomedicine, Universit\u00e0 della Svizzera Italiana, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7826-6924","authenticated-orcid":false,"given":"Jasmine","family":"Oberti-Cantergiani","sequence":"additional","affiliation":[{"name":"Institute for Research in Biomedicine, Universit\u00e0 della Svizzera Italiana, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7379-3484","authenticated-orcid":false,"given":"Davide F.","family":"Robbiani","sequence":"additional","affiliation":[{"name":"Institute for Research in Biomedicine, Universit\u00e0 della Svizzera Italiana, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7902-6606","authenticated-orcid":false,"given":"Pavle","family":"Banovi\u0107","sequence":"additional","affiliation":[{"name":"Diagnostics and Laboratory Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Institute for Research in Biomedicine, Universit\u00e0 della Svizzera Italiana, 6500 Bellinzona, Switzerland"},{"name":"Clinic 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"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2470","DOI":"10.1002\/rmv.2470","article-title":"Tick-Borne Encephalitis: A Comprehensive Review of the Epidemiology, Virology, and Clinical Picture","volume":"33","author":"Chiffi","year":"2023","journal-title":"Rev. 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