{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:14:31Z","timestamp":1787681671903,"version":"build-2784847793"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"TBFVnet","award":["2018-1-0659 EEA"],"award-info":[{"award-number":["2018-1-0659 EEA"]}]},{"name":"TBFVnet","award":["20200422"],"award-info":[{"award-number":["20200422"]}]},{"name":"EU Interreg V-A program Scandtick Innovation project","award":["2018-1-0659 EEA"],"award-info":[{"award-number":["2018-1-0659 EEA"]}]},{"name":"EU Interreg V-A program Scandtick Innovation project","award":["20200422"],"award-info":[{"award-number":["20200422"]}]},{"name":"University of Southeastern Norway","award":["2018-1-0659 EEA"],"award-info":[{"award-number":["2018-1-0659 EEA"]}]},{"name":"University of Southeastern Norway","award":["20200422"],"award-info":[{"award-number":["20200422"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Tick-borne encephalitis virus (TBEV) is an emerging pathogen that initially causes flu-like symptoms and can progress to central nervous system (CNS) infections. Tick-borne encephalitis (TBE) is an endemic disease in southern coastal counties with regular human cases, while the causative agent, TBEV, is prevalent in ticks in most of the coastal regions of Norway. This study was aimed to understand TBEV infection status across Norway including both TBE endemic and non-endemic areas. For this, we analyzed a total of 1940 residual serum samples from 19 counties of Norway (as of 2016). The samples were initially screened by ELISA, followed by virus neutralization tests for TBEV confirmation. We found a similar TBEV seroprevalence of 1.7% in TBE endemic and 1.6% in non-endemic areas. Since TBE cases are only reported from endemic regions, our findings suggest a potential subclinical or asymptomatic infection and underdiagnosis in non-endemic areas. Notably, only 43% of the ELISA-positive samples were confirmed by virus neutralization tests indicating that not all ELISA positives are true TBEV infections. Additionally, 137 samples of patients presenting with symptoms of CNS infections from a non-endemic area were included. Of these samples, 11 ELISA-positive samples were analyzed for cross-reactivity among flaviviruses. Cross-reactivity was detected with Dengue virus, West Nile Virus, and non-specific reactions. This underscores the importance of using multiple diagnostic tests to confirm TBEV infections. None of the patients with CNS infection was found to be TBE positive, and in the whole cohort, we found a low TBEV seroprevalence of 0.7%.<\/jats:p>","DOI":"10.3390\/v17030291","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T04:03:17Z","timestamp":1740024197000},"page":"291","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Retrospective Sero-Surveillance Study for Antibodies Against Tick-Borne Encephalitis Virus in Norway"],"prefix":"10.3390","volume":"17","author":[{"given":"Alaka","family":"Lamsal","sequence":"first","affiliation":[{"name":"Department of Virology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"},{"name":"Department of Natural Sciences and Environmental Health, Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Campus B\u00f8, 3800 B\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrine M\u00f8rk","family":"Paulsen","sequence":"additional","affiliation":[{"name":"Department of Virology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Juul","family":"Diekmann","sequence":"additional","affiliation":[{"name":"Department of Virology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olav","family":"Hungnes","sequence":"additional","affiliation":[{"name":"Department of Virology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5903-9239","authenticated-orcid":false,"given":"Kristian","family":"Alfsnes","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Else","family":"Quist-Paulsen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4655-2380","authenticated-orcid":false,"given":"Daniel","family":"Ruzek","sequence":"additional","affiliation":[{"name":"Department of Experimental Biology, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic"},{"name":"Veterinary Research Institute, 601 77 Brno, Czech Republic"},{"name":"Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, 37005 Ceske Budejovice, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9915-8953","authenticated-orcid":false,"given":"Jiri","family":"Salat","sequence":"additional","affiliation":[{"name":"Veterinary Research Institute, 601 77 Brno, Czech Republic"},{"name":"Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, 37005 Ceske Budejovice, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3130-933X","authenticated-orcid":false,"given":"Petra","family":"Strakova","sequence":"additional","affiliation":[{"name":"Veterinary Research Institute, 601 77 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7536-3453","authenticated-orcid":false,"given":"Karen Angeliki","family":"Krogfelt","sequence":"additional","affiliation":[{"name":"Department of Science and Environment, Molecular and Medical Biology, Pandemix Center, University of Roskilde, 4000 Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnulf","family":"Soleng","sequence":"additional","affiliation":[{"name":"Department of Virology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3706-1603","authenticated-orcid":false,"given":"Rose","family":"Vikse","sequence":"additional","affiliation":[{"name":"Department of Virology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1614-6747","authenticated-orcid":false,"given":"\u00c5shild K.","family":"Andreassen","sequence":"additional","affiliation":[{"name":"Department of Virology, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, 0456 Oslo, Norway"},{"name":"Department of Natural Sciences and Environmental Health, Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Campus B\u00f8, 3800 B\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"ref_1","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"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1099\/0022-1317-70-1-37","article-title":"Antigenic Relationships between Flaviviruses as Determined by Cross-neutralization Tests with Polyclonal 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