{"id":4235,"date":"2017-07-24T15:42:28","date_gmt":"2017-07-24T07:42:28","guid":{"rendered":"http:\/\/www.id-ea.info\/?p=4235"},"modified":"2023-05-12T16:44:50","modified_gmt":"2023-05-12T08:44:50","slug":"tbe12b28","status":"publish","type":"post","link":"https:\/\/tbenews.com\/tbe\/tbe12b28\/","title":{"rendered":"Serbia"},"content":{"rendered":"\n
<\/a><\/span>
\n

TBE in Serbia<\/strong><\/h1>\n<\/div>\n\n\n\n

Vladimir Petrovi\u0107, Elizabeta Ristanovi\u0107 and Aleksandar Potkonjak<\/strong><\/p>\n\n\n\n

E-CDC risk status: endemic<\/strong><\/h3>\n\n\n\n

(no new data available as of May 2023)<\/em><\/p>\n\n\n\n

History and current situation<\/strong><\/h3>\n\n\n\n

Tick-borne encephalitis virus (TBEV) was first isolated in the former Yugoslavia in 1953 from the blood of infected human patients in Slovenia.1<\/sup><\/a> The virus was isolated from ticks in 1954, also in Slovenia.2<\/sup><\/a> Thereafter a number of tick-borne encephalitis (TBE) foci were registered in the western part of the country, while in the Republic of Serbia such foci were not registered. In the period following 1969, no new infections with TBEV could be confirmed in the Republic of Serbia through the routine serological testing of samples from more than 1,000 patients with clinical signs of meningitis and encephalitis, as conducted in laboratories of the Institute of Immunobiology and Virology \u201cTorlak\u201d in Belgrade.3<\/sup><\/a><\/p>\n\n\n\n

In the period from 1962 to 1969, a total of 1,726 serum samples collected from healthy individuals in the Republic of Serbia were tested by hemagglutination inhibition for the presence of antibodies to TBEV and 1.1%\u201352.6% were positive. The highest percentage of seropositive persons was registered in the region of Sand\u017eak-Ra\u0161ka (Novi Pazar and its surroundings: 52.6%) in the province of Kosovo (37.8%) and in Western Serbia (19.4%). In the area of Banat in the Province Vojvodina antibodies were found in 8.4% of tested sera, while in the territory of Belgrade city the seropositivity rate was 7.3%. In Eastern Serbia (Zaje\u010dar and surroundings) \u2013 3.6% samples were seroreactive, 2.0% in Central Serbia and 1.1% in the Srem area in Vojvodina. These results clearly document – along with the isolation of the TBEV (Western subtype) from ixodid ticks from the area of Pe\u0161ter, Sand\u017eak-Ra\u0161ka in 1972 \u2013 the existence of TBEV-hot spots, i.e. active foci of tick-borne encephalitis in the Republic of Serbia.4<\/sup><\/a><\/p>\n\n\n\n

Overview of TBE in Serbia<\/strong><\/h3>\n\n\n\n

In the Republic of Serbia, TBE is subject to mandatory reporting under the 2004 law for protecting the population from infectious diseases. In that year, a single case of TBE disease was recorded by the Institute of Public Health of Serbia, followed by 6 cases in 2005 and 1 case in 2006.5<\/sup><\/a> In 2012, the Institute of Public Health of Serbia reported a total of 4 cases of TBE, while in 2013 and 2014, no cases of the disease were registered. In 2015, in central Serbia 4 cases of disease were registered; all cases were males and more than 45 years old.6\u201310<\/sup><\/a><\/p>\n\n\n\n

In the last three years, 19 new cases of TBE disease were officially reported to the Institute of Public Health of Serbia. In 2016, in central Serbia (Belgrade region) 1 case of TBE disease was registered (male, age distribution group 40\u201349 years) and 5 cases of TBE were registered in 2017 (all cases in central Serbia (Belgrade region-3 cases and Podunavlje District-2 cases). All cases were males and more than 20 years old. The largest number of TBE cases (13) was registered in 2018 in central Serbia (Belgrade region: 4 cases; Podunavlje District: 4 cases). Six of these cases were males and 7 cases were females, 1 in the 20\u201329 years age group, 3 cases in the 40\u201349 years group, 1 case in the 50\u201359 year group and 8 cases were older than 60 years.11\u201313<\/sup><\/a><\/p>\n\n\n\n

From January 1, 2014 until October 31, 2015, serum samples from 200 animals (40 dogs, 20 horses, 40 wild boars, 40 cattle, 40 roe deer, and 20 goats) were collected. All serum samples were tested using commercial all-species ELISA kits (Progen Biotechnik, Germany). Anti-TBEV IgG antibodies were found in 7 dogs (17.5%), 1 horse (5%), 5 wild boars (12.5%), 1 cow (2.5%), and 1 roe deer (2.5%). None of the goats tested were positive for anti-TBEV IgG antibodies.11<\/sup><\/a><\/p>\n\n\n\n

At the same time, PCR and sequencing confirmed the presence of the Western subtype of TBEV (TBEV-EU) in Ixodes ricinus<\/em> ticks, detected in 1 of the 50 (2.0%) I. ricinus<\/em> ticks in Vojvodina province (Fru\u0161ka Gora mountain) and in 30 of the 450 (6.6%) I. ricinus<\/em> ticks in the vicinity of Belgrade (Manastirska \u0161uma, Rakovica).14<\/sup><\/a> In 2017, 1 case of TBE disease in horses with acute neurological symptoms was PCR confirmed in Branicevo District.15<\/sup><\/a><\/p>\n\n\n\n

Serbia is “endemic” as several human cases have been reported with seasonal recurrences and the presence of TBEV in I. ricinus<\/em> ticks and\/or animals.<\/p>\n\n\n\n

\n\n\n\n\n\n\n\n
Table 1: Virus, vector, transmission of TBE in Serbia<\/th>\n<\/tr>\n
Viral subtypes, distribution<\/td>\nPresence of Western subtype of TBEV was detected in the regions of Vojvodina province, Belgrade, and Pe\u0161ter4<\/sup><\/a>,<\/sup>14<\/sup><\/a><\/td>\n<\/tr>\n
Reservoir animals<\/td>\nSeropositive species of animals: dogs, horses, wild boars, cattle, and roe deer14<\/sup><\/a><\/td>\n<\/tr>\n
Infected tick species (%)<\/td>\nI. ricinus; <\/em>2% and 6.6% at the two different localities14<\/sup><\/a><\/td>\n<\/tr>\n
Dairy product transmission<\/td>\nNot documented<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>
\n\n\n\n
\n\n\n\n\n\n\n\n\n\n\n
Table 2: TBE reporting and vaccine prevention in Serbia<\/th>\n<\/tr>\n
Mandatory TBE reporting<\/td>\nSince 2004, under the Law on Protection of Population from Infectious Diseases<\/td>\n<\/tr>\n
Other TBE-surveillance<\/td>\nSince January 2020, surveillance according to the EU Clinical Case Definition is introduced in all hospitals in Autonomous Province of Vojvodina, as a part of Special Public Health Program. Program is based on software application for Case Definition detection in all departments for infectious diseases.<\/td>\n<\/tr>\n
Special clinical features<\/td>\nNo information available<\/td>\n<\/tr>\n
Available vaccines<\/td>\nNo information available<\/td>\n<\/tr>\n
Vaccination recommendations and reimbursement<\/td>\nRecommended immunization schedule of persons of a certain age against TBE is introduced from April 1, 2019 as a part of National Immunization Program. Primary series of two or three doses followed by booster after one to three years is recommended.
There is no reimbursement. Immunization is to be paid out of pocket.<\/td>\n<\/tr>\n
Vaccine uptake by age group\/ risk group\/ general population<\/td>\nActive immunization is recommended as measure of protection of population in endemic areas and for professionally exposed as well as those exposed during recreational activities in endemic areas.
There are no information available on vaccine uptake.<\/td>\n<\/tr>\n
Name, address\/website of TBE National Reference Center<\/td>\nNo information available<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>
\n\n\n\n
\n
\n

Figure 1:<\/span> Burden of TBE in Serbia6-13<\/sup><\/a><\/h3>\n<\/div>\n
\"\"<\/a><\/figure>
<\/div>\n
Source data \n\n\n\n\t\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t
Year<\/th>Number of Cases<\/th>Incidence \/ 10 5<\/sup><\/th>\n<\/tr>\n<\/thead>\n
2004<\/td>1<\/td>0.01<\/td>\n<\/tr>\n
2005<\/td>6<\/td>0.08<\/td>\n<\/tr>\n
2006<\/td>1<\/td>0.01<\/td>\n<\/tr>\n
2012<\/td>4<\/td>0.06<\/td>\n<\/tr>\n
2015<\/td>4<\/td>0.06<\/td>\n<\/tr>\n
2016<\/td>1<\/td>0.01<\/td>\n<\/tr>\n
2017<\/td>5<\/td>0.07<\/td>\n<\/tr>\n
2018<\/td>13<\/td>0.19<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/a><\/div>\n<\/div>
\n\n\n\n
\n
\n

Figure 2:<\/span> Age and gender distribution of TBE in Serbia6-10<\/sup><\/a><\/h3>\n<\/div>\n
\"\"<\/a><\/figure>
<\/div>\n
Source data \n\n\n\n\t\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t
Age groups (years)<\/th>Males<\/th>Females<\/th>All<\/th>\n<\/tr>\n<\/thead>\n
0-9<\/td>3<\/td>1<\/td>4<\/td>\n<\/tr>\n
10-19<\/td>1<\/td>1<\/td>2<\/td>\n<\/tr>\n
20-29<\/td>3<\/td>1<\/td>4<\/td>\n<\/tr>\n
30-39<\/td>2<\/td>0<\/td>2<\/td>\n<\/tr>\n
40-49<\/td>4<\/td>1<\/td>5<\/td>\n<\/tr>\n
50-59<\/td>4<\/td>0<\/td>4<\/td>\n<\/tr>\n
60-69<\/td>8<\/td>6<\/td>14<\/td>\n<\/tr>\n
>70<\/td>0<\/td>0<\/td>0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/a><\/div>\n<\/div>
\n\n\n\n
\n
\n

Figure 3:<\/span> TBEV-isolation and TBE cases in Serbia4,<\/sup><\/a>11<\/sup><\/a><\/h3>\n<\/div>\n
\"\"<\/a><\/figure>
<\/div>\n<\/div>\n\n\n\n

Contact:<\/h3>\n\n\n\n

Vladimir.petrovic@izjzy.org.rs<\/a><\/p>\n\n\n\n

Citation:<\/strong><\/h3>\n\n\n\n

Petrovi\u0107 V, Ristanovi\u0107 E, Potkonjak A. TBE in Serbia<\/em>. Chapter 12b. In: Dobler G, Erber W, Br\u00f6ker M, Schmitt HJ, eds. The TBE Book<\/em>. 6th ed. Singapore: Global Health Press;2023. doi:10.33442\/26613980_12b28-6<\/p>\n\n\n\n

References <\/h3>\n\n\n\n
    \n
  1. <\/a>Vesenjak-Zmijanac J, Bedjani\u010d M, Rus S, Kmet J. Virus meningo-encephalitis in Slovenia: 3. Isolation of the causative agent. Bulletin of the World Health Organization<\/em>. 1955;12(4):513-20.<\/li>\n\n\n\n
  2. <\/a>Likar M, Kmet J. Virus meningoencephalitis in Slovenia: 4.Isolation of the virus from the ticks Ixodes ricinus. Bulletin of the World Health Organization<\/em>. 1956;15(1-2):275-9.<\/li>\n\n\n\n
  3. <\/a>Bor\u0111o\u0161ki M, Stojkovi\u0107 L, Polak D, et al. Etiologija i epidemiologija akutnih virusnih oboljenja nervnog sistema. Srpski arhiv za celokupno lekarstvo<\/em>. 1969;97(5):531- 47.<\/li>\n\n\n\n
  4. <\/a>Bordjoski M, Gligic A, Boskovic R. Arbovirus infections in Serbia. Vojnosanitetski pregled<\/em>. 1972;29(4):173-5.<\/li>\n\n\n\n
  5. <\/a>Amicizia D, Domnich A, Panatto D, et al. Epidemiology of tick- borne encephalitis (TBE) in Europe and its prevention by available vaccines. Hum Vaccin Immunother<\/em>. 2013;9(5):1163- 71.<\/li>\n\n\n\n
  6. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2004, Belgrade, Serbia. Accessed January 9, 2016. Available at: http:\/\/www.batut.org.rs\/index.php? category_id=140<\/a><\/li>\n\n\n\n
  7. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2005, Belgrade, Serbia. Accessed January 9, 2016. Available at: http:\/\/www.batut.org.rs\/index.php? category_id=140<\/a><\/li>\n\n\n\n
  8. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2006, Belgrade, Serbia. Accessed January 9, 2016. Available at: http:\/\/www.batut.org.rs\/index.php? category_id=140<\/a><\/li>\n\n\n\n
  9. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2012, Belgrade, Serbia. Accessed January 9, 2016. Available at: http:\/\/www.batut.org.rs\/index.php? category_id=140<\/a><\/li>\n\n\n\n
  10. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2015, Belgrade, Serbia. Accessed January 9, 2016. Available at: http:\/\/www.batut.org.rs\/index.php? category_id=140<\/a><\/li>\n\n\n\n
  11. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2016, Belgrade, Serbia. Accessed January 28, 2020. Available at: http:\/\/www.batut.org.rs\/download\/izvestaji\/zarazneBolestiGodisnjiIzvestaj2016.pdf<\/li>\n\n\n\n
  12. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2017, Belgrade, Serbia. Accessed January 28, 2020. Available at: http:\/\/www.batut.org.rs\/download\/izvestaji\/Godisnji%20izvestaj%20zarazne%20bolesti%202017.pdf<\/li>\n\n\n\n
  13. <\/a>Institute of Public Health of Serbia. Report on infectious disease in Serbia for 2018, Belgrade, Serbia. Accessed January 28, 2020. Available at: http:\/\/www.batut.org.rs\/download\/izvestaji\/GodisnjiIzvestajOZaraznimBolestima2018.pdf<\/li>\n\n\n\n
  14. <\/a>Potkonjak A, Petrovi\u0107 T, Ristanovi\u0107 E, Lali\u0107 I, Vra\u010dar V, Savi\u0107 S, Turkulov V, \u010canak G, Milo\u0161evi\u0107 V, Vidanovi\u0107 D and others. Molecular Detection and Serological Evidence of Tick-Borne Encephalitis Virus in Serbia. Vector Borne Zoonotic Dis<\/em>. 2017;17(12):813-820.<\/li>\n\n\n\n
  15. <\/a>\u017divojinovi\u0107 M, Stoki\u0107 Nikoli\u0107 S, Dobrosavljevi\u0107 I, Lazi\u0107 M., Radoji\u010di\u0107 S., Stojanovi\u0107 M, Veljovi\u0107 Lj, Mili\u0107evi\u0107 V. Tick-Borne encephalitis in Serbia. Proceedings of 28. Serbian Veterinarians’ Conference. 2017; Zlatibor, Serbia:109-113 (In Serbian)<\/li>\n<\/ol>\n<\/span>","protected":false},"excerpt":{"rendered":"

    TBE in Serbia Vladimir Petrovi\u0107, Elizabeta Ristanovi\u0107 and Aleksandar Potkonjak E-CDC risk status: endemic (no new data available as of May 2023) History and current situation Tick-borne encephalitis virus (TBEV) was first isolated in the former Yugoslavia in 1953 from the blood of infected human patients in Slovenia.1 The virus was isolated from ticks in 1954, also in Slovenia.2 Thereafter a number of tick-borne encephalitis (TBE) foci were registered in the western part of the country, while in the Republic of Serbia such foci were not registered. In the period following 1969, no new infections with TBEV could be confirmed in the Republic of Serbia through the routine serological testing of samples from more than 1,000 patients with clinical signs of meningitis and encephalitis, as conducted in laboratories of the Institute of Immunobiology and Virology \u201cTorlak\u201d in Belgrade.3 In the period from 1962 to 1969, a total of 1,726 serum samples collected from healthy individuals in the Republic of Serbia were tested by hemagglutination inhibition for the presence of antibodies to TBEV and 1.1%\u201352.6% were positive. The highest percentage of seropositive persons was registered in the region of Sand\u017eak-Ra\u0161ka (Novi Pazar and its surroundings: 52.6%) in the province of Kosovo (37.8%) and in Western Serbia (19.4%). In the area of Banat in the Province Vojvodina antibodies were found in 8.4% of tested sera, while in the territory of Belgrade city the seropositivity rate was 7.3%. In Eastern Serbia (Zaje\u010dar and surroundings) \u2013 3.6% samples were seroreactive, 2.0% in Central Serbia and 1.1% in the Srem area in Vojvodina. These results clearly document – along with the isolation of the TBEV (Western subtype) from ixodid ticks from the area of Pe\u0161ter, Sand\u017eak-Ra\u0161ka in 1972 \u2013 the existence of TBEV-hot spots, i.e. active foci of tick-borne encephalitis in the Republic of Serbia.4 Overview of TBE in Serbia In the Republic of Serbia, TBE is subject to mandatory reporting under the 2004 law for protecting the population from infectious diseases. In that year, a single case of TBE disease was recorded by the Institute of Public Health of Serbia, followed by 6 cases in 2005 and 1 case in 2006.5 In 2012, the Institute of Public Health of Serbia reported a total of 4 cases of TBE, while in 2013 and 2014, no cases of the disease were registered. In 2015, in central Serbia 4 cases of disease were registered; all cases were males and more than 45 years old.6\u201310 In the last three years, 19 new cases of TBE disease were officially reported to the Institute of Public Health of Serbia. In 2016, in central Serbia (Belgrade region) 1 case of TBE disease was registered (male, age distribution group 40\u201349 years) and 5 cases of TBE were registered in 2017 (all cases in central Serbia (Belgrade region-3 cases and Podunavlje District-2 cases). All cases were males and more than 20 years old. The largest number of TBE cases (13) was registered in 2018 in central Serbia (Belgrade region: 4 cases; Podunavlje District: 4 cases). Six of these cases were males and 7 cases were females, 1 in the 20\u201329 years age group, 3 cases in the 40\u201349 years group, 1 case in the 50\u201359 year group and 8 cases were older than 60 years.11\u201313 From January 1, 2014 until October 31, 2015, serum samples from 200 animals (40 dogs, 20 horses, 40 wild boars, 40 cattle, 40 roe deer, and 20 goats) were collected. All serum samples were tested using commercial all-species ELISA kits (Progen Biotechnik, Germany). Anti-TBEV IgG antibodies were found in 7 dogs (17.5%), 1 horse (5%), 5 wild boars (12.5%), 1 cow (2.5%), and 1 roe deer (2.5%). None of the goats tested were positive for anti-TBEV IgG antibodies.11 At the same time, PCR and sequencing confirmed the presence of the Western subtype of TBEV (TBEV-EU) in Ixodes ricinus ticks, detected in 1 of the 50 (2.0%) I. ricinus ticks in Vojvodina province (Fru\u0161ka Gora mountain) and in 30 of the 450 (6.6%) I. ricinus ticks in the vicinity of Belgrade (Manastirska \u0161uma, Rakovica).14 In 2017, 1 case of TBE disease in horses with acute neurological symptoms was PCR confirmed in Branicevo District.15 Serbia is “endemic” as several human cases have been reported with seasonal recurrences and the presence of TBEV in I. ricinus ticks and\/or animals. Table 1: Virus, vector, transmission of TBE in Serbia Viral subtypes, distribution Presence of Western subtype of TBEV was detected in the regions of Vojvodina province, Belgrade, and Pe\u0161ter4,14 Reservoir animals Seropositive species of animals: dogs, horses, wild boars, cattle, and roe deer14 Infected tick species (%) I. ricinus; 2% and 6.6% at the two different localities14 Dairy product transmission Not documented Table 2: TBE reporting and vaccine prevention in Serbia Mandatory TBE reporting Since 2004, under the Law on Protection of Population from Infectious Diseases Other TBE-surveillance Since January 2020, surveillance according to the EU Clinical Case Definition is introduced in all hospitals in Autonomous Province of Vojvodina, as a part of Special Public Health Program. Program is based on software application for Case Definition detection in all departments for infectious diseases. Special clinical features No information available Available vaccines No information available Vaccination recommendations and reimbursement Recommended immunization schedule of persons of a certain age against TBE is introduced from April 1, 2019 as a part of National Immunization Program. Primary series of two or three doses followed by booster after one to three years is recommended.There is no reimbursement. Immunization is to be paid out of pocket. Vaccine uptake by age group\/ risk group\/ general population Active immunization is recommended as measure of protection of population in endemic areas and for professionally exposed as well as those exposed during recreational activities in endemic areas.There are no information available on vaccine uptake. Name, address\/website of TBE National Reference Center No information available Figure 1: Burden of TBE in Serbia6-13 Source data Figure 2: Age and gender distribution of TBE in Serbia6-10 Source data Figure 3: TBEV-isolation and TBE cases<\/p>\n","protected":false},"author":3,"featured_media":12837,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[37],"tags":[],"coauthors":[65],"class_list":["post-4235","post","type-post","status-publish","format-standard","has-post-thumbnail","category-tbe-countries-serbia"],"yoast_head":"\nSerbia - TBE Book<\/title>\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\/tbe12b28\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Serbia - TBE Book\" \/>\n<meta property=\"og:description\" content=\"TBE in Serbia Vladimir Petrovi\u0107, Elizabeta Ristanovi\u0107 and Aleksandar Potkonjak E-CDC risk status: endemic (no new data available as of May 2023) History and current situation Tick-borne encephalitis virus (TBEV) was first isolated in the former Yugoslavia in 1953 from the blood of infected human patients in Slovenia.1 The virus was isolated from ticks in 1954, also in Slovenia.2 Thereafter a number of tick-borne encephalitis (TBE) foci were registered in the western part of the country, while in the Republic of Serbia such foci were not registered. In the period following 1969, no new infections with TBEV could be confirmed in the Republic of Serbia through the routine serological testing of samples from more than 1,000 patients with clinical signs of meningitis and encephalitis, as conducted in laboratories of the Institute of Immunobiology and Virology \u201cTorlak\u201d in Belgrade.3 In the period from 1962 to 1969, a total of 1,726 serum samples collected from healthy individuals in the Republic of Serbia were tested by hemagglutination inhibition for the presence of antibodies to TBEV and 1.1%\u201352.6% were positive. The highest percentage of seropositive persons was registered in the region of Sand\u017eak-Ra\u0161ka (Novi Pazar and its surroundings: 52.6%) in the province of Kosovo (37.8%) and in Western Serbia (19.4%). In the area of Banat in the Province Vojvodina antibodies were found in 8.4% of tested sera, while in the territory of Belgrade city the seropositivity rate was 7.3%. In Eastern Serbia (Zaje\u010dar and surroundings) \u2013 3.6% samples were seroreactive, 2.0% in Central Serbia and 1.1% in the Srem area in Vojvodina. These results clearly document – along with the isolation of the TBEV (Western subtype) from ixodid ticks from the area of Pe\u0161ter, Sand\u017eak-Ra\u0161ka in 1972 \u2013 the existence of TBEV-hot spots, i.e. active foci of tick-borne encephalitis in the Republic of Serbia.4 Overview of TBE in Serbia In the Republic of Serbia, TBE is subject to mandatory reporting under the 2004 law for protecting the population from infectious diseases. In that year, a single case of TBE disease was recorded by the Institute of Public Health of Serbia, followed by 6 cases in 2005 and 1 case in 2006.5 In 2012, the Institute of Public Health of Serbia reported a total of 4 cases of TBE, while in 2013 and 2014, no cases of the disease were registered. In 2015, in central Serbia 4 cases of disease were registered; all cases were males and more than 45 years old.6\u201310 In the last three years, 19 new cases of TBE disease were officially reported to the Institute of Public Health of Serbia. In 2016, in central Serbia (Belgrade region) 1 case of TBE disease was registered (male, age distribution group 40\u201349 years) and 5 cases of TBE were registered in 2017 (all cases in central Serbia (Belgrade region-3 cases and Podunavlje District-2 cases). All cases were males and more than 20 years old. The largest number of TBE cases (13) was registered in 2018 in central Serbia (Belgrade region: 4 cases; Podunavlje District: 4 cases). Six of these cases were males and 7 cases were females, 1 in the 20\u201329 years age group, 3 cases in the 40\u201349 years group, 1 case in the 50\u201359 year group and 8 cases were older than 60 years.11\u201313 From January 1, 2014 until October 31, 2015, serum samples from 200 animals (40 dogs, 20 horses, 40 wild boars, 40 cattle, 40 roe deer, and 20 goats) were collected. All serum samples were tested using commercial all-species ELISA kits (Progen Biotechnik, Germany). Anti-TBEV IgG antibodies were found in 7 dogs (17.5%), 1 horse (5%), 5 wild boars (12.5%), 1 cow (2.5%), and 1 roe deer (2.5%). None of the goats tested were positive for anti-TBEV IgG antibodies.11 At the same time, PCR and sequencing confirmed the presence of the Western subtype of TBEV (TBEV-EU) in Ixodes ricinus ticks, detected in 1 of the 50 (2.0%) I. ricinus ticks in Vojvodina province (Fru\u0161ka Gora mountain) and in 30 of the 450 (6.6%) I. ricinus ticks in the vicinity of Belgrade (Manastirska \u0161uma, Rakovica).14 In 2017, 1 case of TBE disease in horses with acute neurological symptoms was PCR confirmed in Branicevo District.15 Serbia is “endemic” as several human cases have been reported with seasonal recurrences and the presence of TBEV in I. ricinus ticks and\/or animals. Table 1: Virus, vector, transmission of TBE in Serbia Viral subtypes, distribution Presence of Western subtype of TBEV was detected in the regions of Vojvodina province, Belgrade, and Pe\u0161ter4,14 Reservoir animals Seropositive species of animals: dogs, horses, wild boars, cattle, and roe deer14 Infected tick species (%) I. ricinus; 2% and 6.6% at the two different localities14 Dairy product transmission Not documented Table 2: TBE reporting and vaccine prevention in Serbia Mandatory TBE reporting Since 2004, under the Law on Protection of Population from Infectious Diseases Other TBE-surveillance Since January 2020, surveillance according to the EU Clinical Case Definition is introduced in all hospitals in Autonomous Province of Vojvodina, as a part of Special Public Health Program. Program is based on software application for Case Definition detection in all departments for infectious diseases. Special clinical features No information available Available vaccines No information available Vaccination recommendations and reimbursement Recommended immunization schedule of persons of a certain age against TBE is introduced from April 1, 2019 as a part of National Immunization Program. Primary series of two or three doses followed by booster after one to three years is recommended.There is no reimbursement. Immunization is to be paid out of pocket. Vaccine uptake by age group\/ risk group\/ general population Active immunization is recommended as measure of protection of population in endemic areas and for professionally exposed as well as those exposed during recreational activities in endemic areas.There are no information available on vaccine uptake. Name, address\/website of TBE National Reference Center No information available Figure 1: Burden of TBE in Serbia6-13 Source data Figure 2: Age and gender distribution of TBE in Serbia6-10 Source data Figure 3: TBEV-isolation and TBE cases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/tbenews.com\/tbe\/tbe12b28\/\" \/>\n<meta property=\"og:site_name\" content=\"TBE Book\" \/>\n<meta property=\"article:published_time\" content=\"2017-07-24T07:42:28+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-12T08:44:50+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/07\/Serbia.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1180\" \/>\n\t<meta property=\"og:image:height\" content=\"250\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Administrator admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Administrator admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/tbe12b28\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/tbe12b28\\\/\"},\"author\":{\"name\":\"Administrator admin\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/#\\\/schema\\\/person\\\/dd436937ad52c89f92315a6488c1d2c7\"},\"headline\":\"Serbia\",\"datePublished\":\"2017-07-24T07:42:28+00:00\",\"dateModified\":\"2023-05-12T08:44:50+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/tbe12b28\\\/\"},\"wordCount\":1383,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/tbe12b28\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/wp-content\\\/uploads\\\/2017\\\/07\\\/Serbia.jpg\",\"articleSection\":[\"Serbia\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/tbenews.com\\\/tbe\\\/tbe12b28\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/tbe12b28\\\/\",\"url\":\"https:\\\/\\\/tbenews.com\\\/tbe\\\/tbe12b28\\\/\",\"name\":\"Serbia - 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TBE Book","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/tbenews.com\/tbe\/tbe12b28\/","og_locale":"en_US","og_type":"article","og_title":"Serbia - TBE Book","og_description":"TBE in Serbia Vladimir Petrovi\u0107, Elizabeta Ristanovi\u0107 and Aleksandar Potkonjak E-CDC risk status: endemic (no new data available as of May 2023) History and current situation Tick-borne encephalitis virus (TBEV) was first isolated in the former Yugoslavia in 1953 from the blood of infected human patients in Slovenia.1 The virus was isolated from ticks in 1954, also in Slovenia.2 Thereafter a number of tick-borne encephalitis (TBE) foci were registered in the western part of the country, while in the Republic of Serbia such foci were not registered. In the period following 1969, no new infections with TBEV could be confirmed in the Republic of Serbia through the routine serological testing of samples from more than 1,000 patients with clinical signs of meningitis and encephalitis, as conducted in laboratories of the Institute of Immunobiology and Virology \u201cTorlak\u201d in Belgrade.3 In the period from 1962 to 1969, a total of 1,726 serum samples collected from healthy individuals in the Republic of Serbia were tested by hemagglutination inhibition for the presence of antibodies to TBEV and 1.1%\u201352.6% were positive. The highest percentage of seropositive persons was registered in the region of Sand\u017eak-Ra\u0161ka (Novi Pazar and its surroundings: 52.6%) in the province of Kosovo (37.8%) and in Western Serbia (19.4%). In the area of Banat in the Province Vojvodina antibodies were found in 8.4% of tested sera, while in the territory of Belgrade city the seropositivity rate was 7.3%. In Eastern Serbia (Zaje\u010dar and surroundings) \u2013 3.6% samples were seroreactive, 2.0% in Central Serbia and 1.1% in the Srem area in Vojvodina. These results clearly document – along with the isolation of the TBEV (Western subtype) from ixodid ticks from the area of Pe\u0161ter, Sand\u017eak-Ra\u0161ka in 1972 \u2013 the existence of TBEV-hot spots, i.e. active foci of tick-borne encephalitis in the Republic of Serbia.4 Overview of TBE in Serbia In the Republic of Serbia, TBE is subject to mandatory reporting under the 2004 law for protecting the population from infectious diseases. In that year, a single case of TBE disease was recorded by the Institute of Public Health of Serbia, followed by 6 cases in 2005 and 1 case in 2006.5 In 2012, the Institute of Public Health of Serbia reported a total of 4 cases of TBE, while in 2013 and 2014, no cases of the disease were registered. In 2015, in central Serbia 4 cases of disease were registered; all cases were males and more than 45 years old.6\u201310 In the last three years, 19 new cases of TBE disease were officially reported to the Institute of Public Health of Serbia. In 2016, in central Serbia (Belgrade region) 1 case of TBE disease was registered (male, age distribution group 40\u201349 years) and 5 cases of TBE were registered in 2017 (all cases in central Serbia (Belgrade region-3 cases and Podunavlje District-2 cases). All cases were males and more than 20 years old. The largest number of TBE cases (13) was registered in 2018 in central Serbia (Belgrade region: 4 cases; Podunavlje District: 4 cases). Six of these cases were males and 7 cases were females, 1 in the 20\u201329 years age group, 3 cases in the 40\u201349 years group, 1 case in the 50\u201359 year group and 8 cases were older than 60 years.11\u201313 From January 1, 2014 until October 31, 2015, serum samples from 200 animals (40 dogs, 20 horses, 40 wild boars, 40 cattle, 40 roe deer, and 20 goats) were collected. All serum samples were tested using commercial all-species ELISA kits (Progen Biotechnik, Germany). Anti-TBEV IgG antibodies were found in 7 dogs (17.5%), 1 horse (5%), 5 wild boars (12.5%), 1 cow (2.5%), and 1 roe deer (2.5%). None of the goats tested were positive for anti-TBEV IgG antibodies.11 At the same time, PCR and sequencing confirmed the presence of the Western subtype of TBEV (TBEV-EU) in Ixodes ricinus ticks, detected in 1 of the 50 (2.0%) I. ricinus ticks in Vojvodina province (Fru\u0161ka Gora mountain) and in 30 of the 450 (6.6%) I. ricinus ticks in the vicinity of Belgrade (Manastirska \u0161uma, Rakovica).14 In 2017, 1 case of TBE disease in horses with acute neurological symptoms was PCR confirmed in Branicevo District.15 Serbia is “endemic” as several human cases have been reported with seasonal recurrences and the presence of TBEV in I. ricinus ticks and\/or animals. Table 1: Virus, vector, transmission of TBE in Serbia Viral subtypes, distribution Presence of Western subtype of TBEV was detected in the regions of Vojvodina province, Belgrade, and Pe\u0161ter4,14 Reservoir animals Seropositive species of animals: dogs, horses, wild boars, cattle, and roe deer14 Infected tick species (%) I. ricinus; 2% and 6.6% at the two different localities14 Dairy product transmission Not documented Table 2: TBE reporting and vaccine prevention in Serbia Mandatory TBE reporting Since 2004, under the Law on Protection of Population from Infectious Diseases Other TBE-surveillance Since January 2020, surveillance according to the EU Clinical Case Definition is introduced in all hospitals in Autonomous Province of Vojvodina, as a part of Special Public Health Program. Program is based on software application for Case Definition detection in all departments for infectious diseases. Special clinical features No information available Available vaccines No information available Vaccination recommendations and reimbursement Recommended immunization schedule of persons of a certain age against TBE is introduced from April 1, 2019 as a part of National Immunization Program. Primary series of two or three doses followed by booster after one to three years is recommended.There is no reimbursement. Immunization is to be paid out of pocket. Vaccine uptake by age group\/ risk group\/ general population Active immunization is recommended as measure of protection of population in endemic areas and for professionally exposed as well as those exposed during recreational activities in endemic areas.There are no information available on vaccine uptake. Name, address\/website of TBE National Reference Center No information available Figure 1: Burden of TBE in Serbia6-13 Source data Figure 2: Age and gender distribution of TBE in Serbia6-10 Source data Figure 3: TBEV-isolation and TBE cases","og_url":"https:\/\/tbenews.com\/tbe\/tbe12b28\/","og_site_name":"TBE Book","article_published_time":"2017-07-24T07:42:28+00:00","article_modified_time":"2023-05-12T08:44:50+00:00","og_image":[{"width":1180,"height":250,"url":"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/07\/Serbia.jpg","type":"image\/jpeg"}],"author":"Administrator admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Administrator admin","Est. reading time":"8 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/tbenews.com\/tbe\/tbe12b28\/#article","isPartOf":{"@id":"https:\/\/tbenews.com\/tbe\/tbe12b28\/"},"author":{"name":"Administrator admin","@id":"https:\/\/tbenews.com\/tbe\/#\/schema\/person\/dd436937ad52c89f92315a6488c1d2c7"},"headline":"Serbia","datePublished":"2017-07-24T07:42:28+00:00","dateModified":"2023-05-12T08:44:50+00:00","mainEntityOfPage":{"@id":"https:\/\/tbenews.com\/tbe\/tbe12b28\/"},"wordCount":1383,"commentCount":0,"publisher":{"@id":"https:\/\/tbenews.com\/tbe\/#organization"},"image":{"@id":"https:\/\/tbenews.com\/tbe\/tbe12b28\/#primaryimage"},"thumbnailUrl":"https:\/\/tbenews.com\/tbe\/wp-content\/uploads\/2017\/07\/Serbia.jpg","articleSection":["Serbia"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/tbenews.com\/tbe\/tbe12b28\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/tbenews.com\/tbe\/tbe12b28\/","url":"https:\/\/tbenews.com\/tbe\/tbe12b28\/","name":"Serbia - 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