Page 195 - TBE_Book_V2_2019

Chapter 10: Diagnosis

flavivirus of the first infection or vaccination, 4. Saksida A, Duh D, Lotric-Furlan S, Strle F,
which might cause disturbance and may lead Petrovec M, Avsic- Zupanc T. The importance of
to a wrong diagnosis. tick-borne encephalitis virus RNA detection for
early differential diagnosis of tick-borne
These cross-reactions are also important for encephalitis. J Clin Virol. 2005;33:331-5.
defining an immunity. Cross-reacting anti-
bodies are non-protective. If a vaccinee gets 5. Caracciolo I, Bassetti M, Paladini G, et al.
Persistent viremia and urine shedding of tick-
e.g. yellow fever vaccine and Japanese
borne encephalitis virus in an infected
encephalitis vaccine, there may be also cross-
immunosuppressed patient from a new
reacting antibodies against TBEV. If only an epidemic cluster in North-Eastern Italy. J Clin
ELISA test is conducted this test may become Virol. 2015;69:48-51.
positive and lead to the suspicion of immunity,
which is not the case in this situation. 6. Pogodina VV, Frolova MP, Malenko GV, et al.
Therefore, the diagnosis and immunity testing Persistence of tick-borne encephalitis virus in
of flaviviruses should always include the monkeys. I. Features of experimental infection.
reaction against different flaviviruses like Acta Virol. 1981;25:337-43.
TBEV, yellow fever virus, Japanese encephalitis
7. Whitby JE, Ni H, Whitby HE, et al. Rapid
virus, dengue viruses and West Nile virus. Only
detection of viruses of the tick-borne
the anamnesis of the patient resp. vaccinee encephalitis virus complex by RT-PCR of viral
together with the serological results against RNA. J Virol Methods. 1993;45:103-14.
the most common flaviviruses and flavivirus
vaccinations will give a realistic picture of the 8. Puchhammer-Stockl E, Kunz C, Mandl CW,
immune status and of a potential infection. Heinz FX. Identification of tick-borne
encephalitis virus ribonucleic acid in tick

suspensions and in clinical specimens by a
reverse transcription-nested polymerase chain
Contact: gerharddobler@bundeswehr.org
reaction assay. Clin Diagn Virol. 1995;4:321-6.

9. Suess J, Beziat P, Ramelow C, Kahl O. Tick-borne
Citation: encephalitis virus (TBEV)-specific RT-PCR for
Dobler G: Diagnosis. Chapter 10. In: Dobler G, characterization of natural foci of TBE and for
Erber W, Bröker M, Schmitt HJ, eds. The TBE other applications. Zentralbl Bakteriol.
Book. 2nd ed. Singapore: Global Health Press; 1997;286:125-38.
2019. doi ; 10.33442/978-981-14-0914-1_10
10. Schwaiger M, Cassinotti P. Development of a
quantitative real-time RT-PCR assay with
References internal control for the laboratory detection of
tick-borne encephalitis virus (TBEV) RNA. J Clin
Virol. 2003;27:136-45.
1. Holzmann H. Diagnosis of tick-borne
encephalitis. Vaccine. 2003;21 Suppl 1:S36-40.
11. Veje M, Studahl M, Norberg P, et al. Detection
of tick-borne encephalitis virus RNA in urine. J
2. Lindquist L, Vapalahti O. Tick-borne
encephalitis. Lancet. 2008;371:1861-71. Clin Microbiol. 2014;52:4111-2.

12. Kunz C, Krausler J. Bildung und Überdauern der
3. Ruzek D, Dobler G, Donoso Mantke O. Tick-
borne encephalitis: pathogenesis and clinical komplementbindenden Antikörper nach
implications. Travel Med Infect Dis. 2010;8:223- Infektion mit Frühsommer-Meningoenzephalitis
32. (Tick-borne encephalitis virus). Arch
Virusforsch. 1964;14:499-507.

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