TICK-BORNE ENCEPHALITIS DIAGNOSIS IN PATIENTS WITH INFLAMMATORY CHANGES IN THE CEREBROSPINAL-FLUID IN A REGION WITH VERY-LOW PREVALENCE

Tick-borne encephalitis (TBE)-IgG antibodies are used tor the serologi c detection of antigen contact caused by TEE infection or immunization , In the present study, enzyme-linked immune sorbent assay (ELISA) res ults from a group of patients with inflammatory changes in the cerebro spinal fluid (CSF) were re-examined using Western blot technology The result of the TBE-IgG-ELISA was positive in 47 of the 904 sera samples tested, Retesting the sera with a Western blot confirmed this result in only 31.8 %. of the positive cases, In 134 of the 904 sera, the ELI SA result was borderline, In 5.5 % of these sera, the Western blot rea cted specifically. The remaining 723 sera samples tested negative with the ELISA. Of these sera, 15 were selected randomly and retested with the Western blot; none of them tested positive, The high number of fa lse positive ELISA results can be explained by the highly selected gro up of patients and the low prevalence of TEE in the region studied, In patients with meningitis or encephalitis with positive ELISA results and uncharacteristic clinical symptoms, the treating physician should consider the possibility of nonspecific reactions involving inflammato ry mediators or crossreactivity with other flaviviruses, The ELISA-med iated diagnosis of TEE should therefore be verified by means of the pa tient's history and clinical symptoms, as well as further serologic te sts including the Western blot, the hemagglutination test and the neut ralization test.