{"id":28858,"date":"2026-09-03T13:54:12","date_gmt":"2026-09-03T05:54:12","guid":{"rendered":"https:\/\/tbenews.com\/tbe\/?p=28858"},"modified":"2026-09-03T15:27:55","modified_gmt":"2026-09-03T07:27:55","slug":"snapshot-week-37-2026-tbe-antibodies-in-hospitalized-neurological-patients-israel","status":"publish","type":"post","link":"https:\/\/tbenews.com\/tbe\/snapshot-week-37-2026-tbe-antibodies-in-hospitalized-neurological-patients-israel\/","title":{"rendered":"Snapshot week 37\/2026
TBE antibodies in hospitalized neurological patients, Israel"},"content":{"rendered":"\n

Fratty et al.
Serological evidence of tick-borne encephalitis virus (TBEV) exposure among hospitalized neurological patients in Israel, 2010-2019. Vector Borne Zoonotic Dis.<\/em> Published online August 13, 2026. doi:10.1177\/15303667261479500<\/p>\n\n\n\n

Israel is not considered endemic for TBE virus. However, travel-related TBE has been documented in Israeli returning travelers. Israel is endemic for West Nile virus (WNV), another flavivirus whose antibodies can cross-react with those against other flaviviruses, including TBE virus. A retrospective study was carried out in hospitalized neurological patients to investigate whether acute TBE infections might have been missed in routine clinical practice and to assess evidence of previous TBEV exposure.<\/p>\n\n\n\n

Among 12,651 patients with suspected meningitis or encephalitis during the period 2010 to 2019, a subset of 1,280 (10.1%) serum samples was selected for TBEV serological screening using a commercial TBE-IgG ELISA. Positive or borderline sera were further investigated by virus neutralization testing (VNT) against both TBEV and WNV. Samples with confirmed TBEV-neutralizing antibodies were additionally tested for TBEV IgM and IgG by indirect immunofluorescence assay (IFA).<\/p>\n\n\n\n

Among the 1,280 sera screened, 63 (4.9%) were positive or borderline for TBEV IgG by ELISA. VNT confirmed TBEV-neutralizing antibodies in nine samples (0.7% of all screened sera), while 51 of the 63 ELISA-reactive samples showed WNV-neutralizing antibodies. Two samples neutralized both viruses. All nine TBEV-VNT-positive samples were negative for TBEV IgM, indicating no evidence of acute TBEV infection.<\/p>\n\n\n\n

These results suggest that confirmed TBEV exposure among hospitalized neurological patients in Israel was rare, with no evidence that acute TBE infections had been missed or that TBEV is circulating endemically in Israel. The few TBEV-VNT-positive sera may reflect previous vaccination or infections acquired abroad, although the study cannot distinguish between these possibilities. Most apparent TBEV ELISA reactivity was attributable to WNV cross-reactivity. The findings therefore highlight the diagnostic challenge posed by flavivirus cross-reactivity and the importance of confirmatory or discriminatory testing, particularly in settings where WNV circulates.<\/p>\n\n\n\n

\n\n
\n Editor\u2018s note\n <\/div>\n\n

\n The diagnostic challenge of differentiating TBEV from WNV infections is becoming increasingly relevant in European countries where the geographical distributions of the two viruses overlap. In Italy, for example, 312 confirmed human WNV infections had been reported as of August 19, 2026, while WNV circulation had been documented in 60 provinces across 16 regions. Several of these areas overlap geographically with areas of known TBE risk.\n <\/p>\n\n

\n According to the European Centre for Disease Prevention and Control (ECDC), as of August 26, 2026, locally acquired human WNV infections had been reported in 15 European countries: Albania, Austria, Croatia, Cyprus, France, Germany, Greece, Hungary, Italy, Kosovo, the Netherlands, North Macedonia, Romania, Serbia and Spain. Several of these countries also have established or emerging areas of TBEV circulation.\n <\/p>\n\n

\n This epidemiological overlap increases the importance of accurate flavivirus differential diagnosis. Conventional serological assays may show cross-reactivity between TBEV and WNV antibodies. Differentiation can be achieved using virus neutralization assays, although these are relatively time-consuming and resource-intensive, as well as through appropriately validated assays targeting more species-specific antibody responses, including antibodies against non-structural protein 1 (NS1).\n <\/p>\n\n

\n The findings from Israel may therefore also have implications for diagnostic practice in Europe. In regions where WNV and TBEV increasingly overlap, including parts of eastern Germany, TBE diagnostics may need to account more explicitly for WNV-related cross-reactivity. Whether broader use of serological assays capable of discriminating between WNV and TBEV antibodies will become necessary is likely to become clearer as the epidemiology of both viruses evolves.\n <\/p>\n\n<\/div>\n<\/span>","protected":false},"excerpt":{"rendered":"

Fratty et al. Serological evidence of tick-borne encephalitis virus (TBEV) exposure among hospitalized neurological patients in Israel, 2010-2019. Vector Borne Zoonotic Dis. Published online August 13, 2026. doi:10.1177\/15303667261479500 Israel is not considered endemic for TBE virus. However, travel-related TBE has been documented in Israeli returning travelers. Israel is endemic for West Nile virus (WNV), another flavivirus whose antibodies can cross-react with those against other flaviviruses, including TBE virus. A retrospective study was carried out in hospitalized neurological patients to investigate whether acute TBE infections might have been missed in routine clinical practice and to assess evidence of previous TBEV exposure. Among 12,651 patients with suspected meningitis or encephalitis during the period 2010 to 2019, a subset of 1,280 (10.1%) serum samples was selected for TBEV serological screening using a commercial TBE-IgG ELISA. Positive or borderline sera were further investigated by virus neutralization testing (VNT) against both TBEV and WNV. Samples with confirmed TBEV-neutralizing antibodies were additionally tested for TBEV IgM and IgG by indirect immunofluorescence assay (IFA). Among the 1,280 sera screened, 63 (4.9%) were positive or borderline for TBEV IgG by ELISA. VNT confirmed TBEV-neutralizing antibodies in nine samples (0.7% of all screened sera), while 51 of the 63 ELISA-reactive samples showed WNV-neutralizing antibodies. Two samples neutralized both viruses. All nine TBEV-VNT-positive samples were negative for TBEV IgM, indicating no evidence of acute TBEV infection. These results suggest that confirmed TBEV exposure among hospitalized neurological patients in Israel was rare, with no evidence that acute TBE infections had been missed or that TBEV is circulating endemically in Israel. The few TBEV-VNT-positive sera may reflect previous vaccination or infections acquired abroad, although the study cannot distinguish between these possibilities. Most apparent TBEV ELISA reactivity was attributable to WNV cross-reactivity. The findings therefore highlight the diagnostic challenge posed by flavivirus cross-reactivity and the importance of confirmatory or discriminatory testing, particularly in settings where WNV circulates. Editor\u2018s note The diagnostic challenge of differentiating TBEV from WNV infections is becoming increasingly relevant in European countries where the geographical distributions of the two viruses overlap. In Italy, for example, 312 confirmed human WNV infections had been reported as of August 19, 2026, while WNV circulation had been documented in 60 provinces across 16 regions. Several of these areas overlap geographically with areas of known TBE risk. According to the European Centre for Disease Prevention and Control (ECDC), as of August 26, 2026, locally acquired human WNV infections had been reported in 15 European countries: Albania, Austria, Croatia, Cyprus, France, Germany, Greece, Hungary, Italy, Kosovo, the Netherlands, North Macedonia, Romania, Serbia and Spain. Several of these countries also have established or emerging areas of TBEV circulation. This epidemiological overlap increases the importance of accurate flavivirus differential diagnosis. Conventional serological assays may show cross-reactivity between TBEV and WNV antibodies. Differentiation can be achieved using virus neutralization assays, although these are relatively time-consuming and resource-intensive, as well as through appropriately validated assays targeting more species-specific antibody responses, including antibodies against non-structural protein 1 (NS1). The findings from Israel may therefore also have implications for diagnostic practice in Europe. In regions where WNV and TBEV increasingly overlap, including parts of eastern Germany, TBE diagnostics may need to account more explicitly for WNV-related cross-reactivity. Whether broader use of serological assays capable of discriminating between WNV and TBEV antibodies will become necessary is likely to become clearer as the epidemiology of both viruses evolves.<\/p>\n","protected":false},"author":94681,"featured_media":20968,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[18,1324],"tags":[223,1492,536,843,60],"coauthors":[1108],"class_list":["post-28858","post","type-post","status-publish","format-standard","has-post-thumbnail","category-snapshot","category-snapshot-2026","tag-cross-reactivity","tag-israel","tag-neutralizing-antibodies","tag-seroepidemiology","tag-west-nile-virus"],"yoast_head":"\nSnapshot week 37\/2026 TBE antibodies in hospitalized neurological patients, Israel - TBE Book<\/title>\n<meta name=\"description\" content=\"A study found rare TBEV antibodies among hospitalized neurological patients in Israel, highlighting WNV cross-reactivity and diagnostic challenges.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/tbenews.com\/tbe\/snapshot-week-37-2026-tbe-antibodies-in-hospitalized-neurological-patients-israel\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Snapshot week 37\/2026 TBE antibodies in hospitalized neurological patients, Israel - 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