Banović Pavle, Obregón Dasiel, Mijatović Dragana, Simin Verica, Stankov Srdjan, Budakov-Obradović Zorana, Bujandrić Nevenka, Grujić Jasmina, Sević Siniša, Turkulov Vesna, Díaz-Sánchez Adrian Alberto, Cabezas-Cruz Alejandro
Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia.
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Pathogens. 2021 Mar 5;10(3):301. doi: 10.3390/pathogens10030301.
Tick-borne encephalitis (TBE), caused by the TBE virus (TBEV), is a life-threatening disease with clinical symptoms ranging from non-specific to severe inflammation of the central nervous system. Despite TBE is a notifiable disease in Serbia since 2004, there is no active TBE surveillance program for the serologic or molecular screening of TBEV infection in humans in the country. This prospective cohort study aimed to assess the TBEV exposure among tick-infested individuals in Serbia during the year 2020. A total of 113 individuals exposed to tick bites were recruited for the study and screened for anti-TBEV antibodies using a commercial indirect fluorescent antibody test (IFA) test. Blood samples from 50 healthy donors not exposed to tick bites were included as a control group. Most of the enrolled patients reported infestations with one tick, being the most frequent tick found in the participants. The TBEV seroprevalence was higher (13.27%, 15 total 113) in tick-infested individuals than in healthy donors (4%, 2 total 50), although the difference was not significant. Notably, male individuals exposed to tick bites showed five times higher relative risk (RR) of being TBEV-seropositive than healthy donors of the same gender (RR= 5.1, CI = 1.6-19; = 0.007). None of the seropositive individuals developed clinical manifestations of TBE, but the first clinical-stage of Lyme borreliosis (i.e., erythema migrans) was detected in seven of them. Potential TBEV foci were identified in rural areas, mostly in proximity or within the Fruška Gora mountain. We conclude that the Serbian population is at high risk of TBEV exposure. Further epidemiological studies should focus on potential TBEV foci identified in this study. The implementation of active surveillance for TBEV might contribute to evaluating the potential negative impact of TBE in Serbia.
蜱传脑炎（TBE）由蜱传脑炎病毒（TBEV）引起，是一种危及生命的疾病，临床症状从非特异性到严重的中枢神经系统炎症不等。尽管自2004年以来TBE在塞尔维亚属于应报告疾病，但该国没有针对人类TBEV感染进行血清学或分子筛查的活跃TBE监测计划。这项前瞻性队列研究旨在评估2020年塞尔维亚蜱虫叮咬人群中的TBEV暴露情况。共有113名暴露于蜱虫叮咬的个体被招募参加该研究，并使用商业间接荧光抗体试验（IFA）检测抗TBEV抗体。50名未暴露于蜱虫叮咬的健康供者的血样作为对照组。大多数登记患者报告被一只蜱虫叮咬，这是参与者中最常见的蜱虫。蜱虫叮咬个体中的TBEV血清阳性率（13.27%，113人中15人）高于健康供者（4%，50人中2人），尽管差异不显著。值得注意的是，暴露于蜱虫叮咬的男性个体TBEV血清阳性的相对风险比同性别健康供者高五倍（相对风险RR = 5.1，可信区间CI = 1.6 - 19；P = 0.007）。没有血清阳性个体出现TBE的临床表现，但其中7人检测到莱姆病的第一临床阶段（即游走性红斑）。在农村地区发现了潜在的TBEV疫源地，大多靠近弗鲁什卡·戈拉山或在其范围内。我们得出结论，塞尔维亚人群面临TBEV暴露的高风险。进一步的流行病学研究应关注本研究中确定的潜在TBEV疫源地。实施TBEV的主动监测可能有助于评估TBE在塞尔维亚的潜在负面影响。
