Diagnosis of tick-borne encephalitis

Area of Science:

• Neuroscience
• Virology
• Immunology

Background:

• Tick-borne encephalitis (TBE) presents with non-specific clinical features, necessitating laboratory confirmation for accurate diagnosis.
• Early diagnosis is crucial for patient management and understanding disease progression.

Purpose of the Study:

• To outline the laboratory methods for diagnosing TBE.
• To discuss the interpretation of serological tests for TBE virus infection and immunity.

Main Methods:

• Enzyme-linked immuno-sorbent assay (ELISA) for detecting specific IgM and IgG serum antibodies.
• Reverse-transcriptase polymerase chain reaction (RT-PCR) for detecting viral nucleic acid in blood or cerebrospinal fluid.
• Neutralization assays to assess immunity in cases of potential flavivirus cross-reactivity.

Main Results:

• IgM and IgG antibodies detected by ELISA are highly reliable for TBE diagnosis upon hospitalization.
• Specific antibodies in cerebrospinal fluid are detectable in most patients by day 10 of illness.
• Virus isolation or RT-PCR is most effective during the initial viremic phase before seroconversion.

Conclusions:

• ELISA is the gold standard for TBE diagnosis and immunity testing.
• RT-PCR is valuable for early diagnosis and in fatal cases.
• Neutralization assays are essential to differentiate TBE immunity from other flavivirus infections.