Banović et al.
Unexpected TBEV seropositivity in Serbian patients who recovered from viral meningitis and encephalitis
Pathogens. 2022; 11(3):371. doi: 10.3390/pathogens11030371.

In general, there is a lack of awareness about clinical forms and incidence of TBE among physicians, epidemiologists, and virologists in various regions of Europe, including Serbia. This is mostly pronounced in regions which are not officially TBE risk areas.

Clinical reports about TBE in Serbia are scarce and it is assumed that underreporting exists in this country. To assess this assumption, a retrospective study has been conducted in which seropositivity was tested in patients from northern Serbia who were hospitalized at the Clinical Center of Vojvodina in the period between January 1, 2018 to December 31, 2019 due to viral meningitis and/or viral encephalitis of unknown etiology, and who have neither been diagnosed positive for a TBE virus infection nor had recovered from their illness.

From a total of 103 persons previously hospitalized in the above-mentioned hospital, 16 patients accepted to be enrolled in the study. West Nile virus RNA was revealed in the CSF in one of these patients; thus, this person was removed from the study. In three of the remaining patients, TBE antibodies were detected (20%), and none of these patients had been immunized against TBE (or Yellow fever). The clinical picture of these three patients were described in detail. All convalescents with TBE antibodies enrolled in this study reported to the hospital with signs and symptoms related to meningitis (headache, fever, and fatigue), but none had vomiting or vertigo.

This study highlights the necessity to increase the awareness of TBE among physicians and perform active and systematic screening of TBE antibodies among patients with viral meningitis and/or encephalitis.

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