Publication details

A Retrospective Sero-Surveillance Study for Antibodies Against Tick-Borne Encephalitis Virus in Norway

Authors

LAMSAL Alaka PAULSEN Katrine Mork DIEKMANN Maria Juul HUNGNES Olav ALFSNES Kristian QUIST-PAULSEN Else RŮŽEK Daniel SALAT Jiri STRAKOVA Petra KROGFELT Karen Angeliki SOLENG Arnulf VIKSE Rose ANDREASSEN Ashild K.

Year of publication 2025
Type Article in Periodical
Magazine / Source Viruses
MU Faculty or unit

Faculty of Science

Citation
web https://www.mdpi.com/1999-4915/17/3/291
Doi https://doi.org/10.3390/v17030291
Keywords tick-borne encephalitis virus; TBEV prevalence; Norway; central nervous system infections; seroprevalence study
Description Tick-borne encephalitis virus (TBEV) is an emerging pathogen that initially causes flu-like symptoms and can progress to central nervous system (CNS) infections. Tick-borne encephalitis (TBE) is an endemic disease in southern coastal counties with regular human cases, while the causative agent, TBEV, is prevalent in ticks in most of the coastal regions of Norway. This study was aimed to understand TBEV infection status across Norway including both TBE endemic and non-endemic areas. For this, we analyzed a total of 1940 residual serum samples from 19 counties of Norway (as of 2016). The samples were initially screened by ELISA, followed by virus neutralization tests for TBEV confirmation. We found a similar TBEV seroprevalence of 1.7% in TBE endemic and 1.6% in non-endemic areas. Since TBE cases are only reported from endemic regions, our findings suggest a potential subclinical or asymptomatic infection and underdiagnosis in non-endemic areas. Notably, only 43% of the ELISA-positive samples were confirmed by virus neutralization tests indicating that not all ELISA positives are true TBEV infections. Additionally, 137 samples of patients presenting with symptoms of CNS infections from a non-endemic area were included. Of these samples, 11 ELISA-positive samples were analyzed for cross-reactivity among flaviviruses. Cross-reactivity was detected with Dengue virus, West Nile Virus, and non-specific reactions. This underscores the importance of using multiple diagnostic tests to confirm TBEV infections. None of the patients with CNS infection was found to be TBE positive, and in the whole cohort, we found a low TBEV seroprevalence of 0.7%.

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