An Overview of Tick-Borne Encephalitis Epidemiology in Endemic Regions of Continental Croatia, 2017–2023

Vilibic-Cavlek, Tatjana; Krcmar, Stjepan; Bogdanic, Maja; Tomljenovic, Morana; Barbic, Ljubo; Roncevic, Dobrica; Sabadi, Dario; Vucelja, Marko; Santini, Marija; Hunjak, Blazenka; Stevanovic, Vladimir; Boljfetic, Marko; Bjedov, Linda; Masovic, Viktor; Potocnik-Hunjadi, Tanja; Lakoseljac, Danijela; Al-Mufleh, Mahmoud; Savic, Vladimir

doi:10.3390/microorganisms12020386

Cited by 3 publications

(1 citation statement)

References 47 publications

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“…In Croatia, flavivirus infections are regularly reported in the continental counties. TBE is considered endemic in northwestern and eastern regions with 84 autochthonous cases reported from 2017 to 2023 [9]. WNV infections occur sporadically or as smaller (2012,2022,2023) and larger (2013,2018) outbreaks.…”

Section: Introductionmentioning

confidence: 99%

Proinflammatory Chemokine Levels in Cerebrospinal Fluid of Patients with Neuroinvasive Flavivirus Infections

Zidovec-Lepej,

Bodulić,

Bogdanic

et al. 2024

Microorganisms

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Tick-borne encephalitis virus (TBEV) and West Nile virus (WNV) are the most important neuroinvasive arboviruses detected in Europe. In this study, we analyzed cerebrospinal fluid (CSF) concentrations of 12 proinflammatory chemokines (CCL2, CCL3, CCL4, CCL11, CCL17, CCL20, CXCL1, CXCL5, CXCL8, CXCL9, CXCL10, and CXCL11) in 77 patients with neuroinvasive diseases (NIDs). Flavivirus infection was confirmed in 62 patients (TBEV and WNV in 31 patients each), while in 15 patients the etiology of NID was not determined (NDE). Similar patterns of high-level expression of chemokines regulating monocyte/macrophage responses (CCL2), neutrophil recruitment (CXCL1 and CXCL8), and interferon-inducible chemoattractants for leukocytes (CXCL10 and CXCL11) have been observed in WNV and TBEV groups. None of the tested chemokines significantly differed between patients with TBEV or WNV. Concentrations of CCL17, CCL20, CXCL5, CXCL10, and CXCL11 were significantly lower in both WNV and TBEV groups compared to NID NDE patients. The logistic regression model showed that CSF concentrations of CXCL11, CXCL5, and CXCL10 could potentially be used for the classification of patients into the WNV or TBEV group versus groups with other NIDs. This study identified, for the first time, similar patterns of CSF chemokine expression in WNV and TBEV infections, suggesting common immunopathogenic mechanisms in neuroinvasive flavivirus infections that should be further evaluated.

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Section: Introductionmentioning

confidence: 99%

Proinflammatory Chemokine Levels in Cerebrospinal Fluid of Patients with Neuroinvasive Flavivirus Infections

Zidovec-Lepej,

Bodulić,

Bogdanic

et al. 2024

Microorganisms

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TBE In Croatia

Vilibić-Čavlek,

Bogdanić,

Savić

et al. 2024

Tick-Borne Encephalitis - The Book

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In Croatia, TBE was reported for the first time in 1953 near Križevci (Stara Ves, northwestern region).1 In addition to this first focus, several continental foci (Bjelovar, Pakrac, Koprivnica, Karlovac, Varaždin) have been recorded since 1961. Moreover, TBEV antibodies were detected in residents of the Croatian littoral near the islands of Zadar, Pula, and Brac.2 In 1991, TBEV emerged in the mountainous area of Gorski Kotar.3 The disease is also endemic in northwestern and eastern regions between the Sava and Drava rivers. Endemicity is highest in northwestern counties, with average incidence rates ranging from 3.61 to 6.78 per 100,000 inhabitants.4,5 In 2015 and 2019, two TBE clusters after consumption of raw goat milk were observed.6,7

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Global Seroprevalence of Tick-Borne Encephalitis Antibodies in Humans, 1956–2022: A Literature Review and Meta-Analysis

Kelly,

Zhang,

Dobler

et al. 2024

Vaccines

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Despite the availability of tick-borne encephalitis (TBE) vaccines, the incidence of TBE is increasing. To understand the historical patterns of infection, we conducted a global meta-analysis of studies before December 2023 reporting human antibody prevalence against TBEV (TBE virus) among general or high-risk population groups stratified by country, collection year, serological method, and vaccination status. Pooled data were compared within groups over time by random-effects modeling. In total, 2403 articles were retrieved; 130 articles published since 1959 were included. Data were extracted from 96 general populations (117,620 participants) and 71 high-risk populations (53,986 participants) across 33 countries. Germany had the most population groups (21), and Poland had the most participants (44,688). Seven serological methods were used; conventional IgG/IgM ELISAs were the most common (44%). Four studies (1.7%) used NS1-ELISA serology. Between 1956–1991 and 1992–2022, anti-TBEV seroprevalence remained at ~2.75% across all population groups from “high-risk” areas (p = 0.458) but decreased within general populations (1.7% to 1%; p = 0.001) and high-risk populations (5.1% to 1.3%; p < 0.001), possibly due to differences in the study methodologies between periods. This global summary explores how serological methods can be used to assess TBE vaccination coverage and potential exposure to TBEV or measure TBE burden and highlights the need for standardized methodology when conducting TBE seroprevalence studies to compare across populations.

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An Overview of Tick-Borne Encephalitis Epidemiology in Endemic Regions of Continental Croatia, 2017–2023

Cited by 3 publications

References 47 publications

Proinflammatory Chemokine Levels in Cerebrospinal Fluid of Patients with Neuroinvasive Flavivirus Infections

Proinflammatory Chemokine Levels in Cerebrospinal Fluid of Patients with Neuroinvasive Flavivirus Infections

TBE In Croatia

Global Seroprevalence of Tick-Borne Encephalitis Antibodies in Humans, 1956–2022: A Literature Review and Meta-Analysis

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