@article{nokeyn,

title = {Tick-borne pathogen diversity and clinical impact of tick-infestation in Serbia and North Macedonia},

author = {Jakimovski D and Banović P and Mateska S and Stavrova M and Stamenkovska A and Bosilkovski M and Mijatović D and Bogdan I and Simin V and Lis K and Diaz-Sanchez AA and Obregon D and Moutailler S and Foucault-Simonin A and Zając Z and Griffith N and Cabezas-Cruz A},

url = {https://www.pasterovzavod.rs/wp-content/uploads/2026/04/2026-Tick-bornepathogendiversityandclinicalimpactoftick-infestationinSerbiaandNorthMacedonia.pdf},

doi = {https://doi.org/10.1016/j.ttbdis.2026.102626},

year  = {2026},

date = {2026-03-17},

journal = {Ticks Tick Borne Dis. 2026 Mar 17;17(3):102626.},

abstract = {A B S T R A C T

Ticks and tick-borne pathogens (TBPs) pose an expanding health threat across Europe, yet few studies link tick infection data directly to human clinical outcomes. We conducted a prospective, cross-border “One Health” study in Serbia and North Macedonia to assess the prevalence, diversity, and potential transmission of TBPs from ticks to humans. A total of 133 tick-infested patients were enrolled at two healthcare centers (112 in Skopje, 26 in Novi Sad), and 135 ticks were collected from these individuals, alongside paired blood and serum samples.

Overall, TBP DNA was detected in 66.6 % of ticks, with Rickettsia helvetica (25.9 %) and Rickettsia monacensis (12.5 %) were most common. Mixed infections occurred in 15 % of ticks, with up to three pathogens cooccurring.

Other detected TBPs included Borrelia afzelii, Borrelia garinii, Borrelia lusitaniae, Anaplasma phagocytophilum, Babesia microti, and Babesia divergens. Four patients (3 %) had detectable pathogen DNA in blood, primarily Rickettsia spp. and Anaplasma spp., yet remained asymptomatic. Most common clinical outcome during the observation period was local hypersensitivity reaction (21.1 %), while α-Gal sensitization was detected in two cases. Phylogenetic analysis revealed Balkan Rickettsia and Borrelia strains were mostly identical to Western and Central European lineages, with a notable exception: a Bo. garinii strain from North Macedonia clustered with strains from Russia and China, indicating possible long-distance introduction. The present study demonstrates that human exposure to multiple TBPs is common and while asymptomatic bloodstream infections do occur, local hypersensitivity reactions are much more common.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokeyi,

title = {Probable Lyme carditis in pacemaker candidates with atrioventricular block: Preliminary results from northern Serbia},

author = {Gazibara D and Simin V and Bogdan I and Milovančev A and Redžek A and Kovačević D and Banović P},

url = {https://www.pasterovzavod.rs/wp-content/uploads/2026/04/Probable-Lyme-carditis-in-pacemaker-candidates-with-atrioventricular.pdf},

doi = {https://doi.org/10.1016/j.ijid.2026.108488},

year  = {2026},

date = {2026-02-12},

urldate = {2026-02-12},

journal = {Int J Infect Dis. 2026 Apr;165:108488.},

abstract = {a b s t r a c t 

Objectives: This study aimed to estimate the proportion of patients with newly diagnosed cardiac conduc- tion disorders requiring pacemaker implantation who have serological findings consistent with probable Lyme carditis in endemic northern Serbia. Methods: Adults presenting with new conduction disorders and scheduled for permanent pacing were enrolled and provided serum at baseline and 4-week follow-up. Anti- Borrelia immunoglobulin (Ig)G was assessed using a two-tier algorithm (enzyme-linked immunosorbent assay screening, immunoblot confir- mation). Probable Lyme carditis was defined as IgG seroconversion or stable/rising titers; no Lyme carditis was defined as persistent seronegativity or declining titers. Results: Of 80 enrolled patients, 74 completed follow-up (92.5%; mean age 71.6 years; 68.9% male). Third- degree atrioventricular block was most frequent (56.8%). Probable Lyme carditis was identified in eight of 74 (10.8%) patients. Of 14 patients who were enzyme-linked immunosorbent assay–reactive/borderline, six (42.9%) were immunoblot-negative. Seropositive patients were older (age 76.3 vs 71.1 years); titers were higher in men at 4 weeks. IgG positivity was associated with suspected Lyme carditis (relative risk 6.8 at baseline; 16.2 at 4 weeks). No participant reported a recent tick bite or erythema migrans. Conclusion: Approximately one in 10 pacemaker candidates showed serological patterns compatible with probable Lyme carditis. Incorporating two-tier paired serology into evaluation of high-grade conduction disorders in endemic settings may improve etiologic diagnosis and inform management.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokeyj,

title = {Dominance of Ixodes ricinus and Emergence of Hyalomma marginatum Among Ticks Removed from Humans in Serbia and North Macedonia (2022–2024)},

author = {Radevska, A.M and Mateska, S and Stamenkovska, A and Najdovska, M and Stevanoska, S and Simin, V and Bogdan, I and Mijatović, D and Jakimovski, D and Banović, P},

url = {https://www.pasterovzavod.rs/wp-content/uploads/2026/04/Dominance-of-Ixodes-ricinus-and-Emergence-of-Hyalomma.pdf},

doi = {https://doi.org/10.3390/parasitologia6010006},

year  = {2026},

date = {2026-01-15},

urldate = {2026-01-15},

journal = {Parasitologia 2026, 6, 6.},

abstract = {Abstract

Tick-borne diseases are rising across Europe, yet human-biting tick data from the central Balkans remain limited. We analysed ticks removed from patients seeking care after tick bites at centers in Skopje (North Macedonia) and Novi Sad (Serbia) between January 2022 and December 2024, recording species, developmental stage, month of removal, and anatomical attachment site. A total of 1641 ticks were collected (North Macedonia, n = 157; Serbia, n = 1484) and identified morphologically. Six tick species were detected in North Macedonia and eight in Serbia. Ixodes ricinus was dominant in both countries, comprising ~69% of ticks in North Macedonia and >90% in Serbia, while Hyalomma marginatum was found in North Macedonia. Adult females predominated among ticks in North Macedonia (75.8%), whereas nymphs were most frequent among ticks in Serbia (55.6%); between-center comparisons of developmental stage should be interpreted cautiously given the marked sampling imbalance. In both settings, collections peaked in May–June (~64% of annual ticks), indicating highest bite pressure in late spring/early summer. Attachment sites were most commonly the torso and lower extremities, with significant between-country differences and species-/stage-specific patterns most evident in Serbia. These data refine the epidemiology of human tick exposure in two Balkan countries and support targeted seasonal prevention messaging and strengthened regional surveillance.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokeyl,

title = {Differential Exposure to Borrelia spp. and Spotted Fever Group Rickettsia in Serbia and North Macedonia: A Comparative Study},

author = {Jakimovski, D and Mateska, S and Najdovska, M and Stamenkovska, A and Pavleva, V and Bosilkovski, M and Mijatović, D and Simin, V and Bogdan, I and Grujić, J and et al.},

doi = {https://doi.org/10.3390/pathogens14080814},

year  = {2025},

date = {2025-08-15},

urldate = {2025-08-15},

journal = {Pathogens 2025, 14, 814.},

abstract = {Abstract

Several diseases caused by tick-borne pathogens, including Lyme borreliosis (LB) and spotted fever group rickettsioses, are endemic in the Balkan Peninsula, positioned between Central Europe and the Middle East. This cross-sectional study aimed to assess serological exposure to Borrelia spp. and spotted fever group Rickettsiae (SFGR) among individuals with recent tick bites and healthy controls in two Balkan countries—Serbia and North Macedonia. Serum samples from 223 participants were tested for anti-Borrelia and anti-SFGR IgG antibodies. SFGR exposure was significantly higher in tick-exposed individuals from Skopje (North Macedonia) compared to those from Novi Sad (Serbia) (30.9% vs. 8.0%; p = 0.003). In contrast, anti-Borrelia IgG was more frequently detected in Novi Sad, though differences did not reach statistical significance. The findings support a north-to-south gradient in Borrelia exposure and a reverse trend for SFGR, consistent with earlier studies and regional tick infection data. Given the high SFGR exposure and limited clinical reporting in North Macedonia, the results highlight the likelihood that tick-borne rickettsioses remain under-recognized. Additionally, Borrelia exposure in North Macedonia warrants further investigation. These findings emphasize the need for enhanced tick-borne disease surveillance, identification of endemic zones, and improved diagnostic and public health infrastructure in both countries.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokeyf,

title = {Prevalencija tvrdih krpelja koji infestiraju ljude u Južnobačkom okrugu: povezanost starosne dobi i lokalizacije infestacije sa razvojnim stadijumima krpelja},

author = {Stevanoska S and Simin V and Bogdan I and Gazibara D and Mijatović D and Stojšić A and Banović P},

url = {https://www.pasterovzavod.rs/wp-content/uploads/2026/04/Prevalencija-tvrdih-krpelja-koji-infestiraju.pdf},

doi = {https://doi.org/10.5937/pomc22-5502},

year  = {2025},

date = {2025-08-11},

urldate = {2025-08-11},

journal = {PONS Med J. 2025;22(1):3–8.},

abstract = {APSTRAKT

Cilj. 

Cilj istraživanja je bio utvrditi prevalenciju različitih vrsta krpelja koje infestiraju ljude, korelaciju između starosti pacijenata sa delom tela koji je bio zahvaćen infestacijom, kao i broj infestacija ljudi u periodu 1.1.2023 - 31.12.2023.

Metode. 

U istraživanje su bili uključeni pacijenti sa mestom prebivališta u Južnobačkom okrugu, a koji su se javili u Pasterov zavod sa već uklonjenim ili pričvršćenim krpeljom. Pacijenti su na osnovu starosti bili podeljeni u 8 starosnih kategorija: 1-10 godina, 11-20 godina, 21-30 godina, 31-40 godina, 41-50 godina, 51-60 godina, 61-70 godina i 71-80 godina. Istraživanje je uključivalo asocijacije starosnih kategorija u odnosu na zahvaćene delove tela (glava i vrat, gornji ekstremitet, donji ekstremitet, torzo i genitalni region), broj uklonjenih krpelja, kao i razvojne stadijume krpelja (adult, nimfa, larva).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokeym,

title = {One health investigation following a cluster of Crimean-Congo haemorrhagic fever, North Macedonia, July to November 2023},

author = {Jakimovski D and Banović P and Spasovska K and Rangelov G and Cvetanovska M and Cana F and Simin V and Bogdan I and Mijatović D and Cvetkovikj A and Djadjovski I and Christova I and Meletis E and Kostoulas P and Zana B and Lanszki Z and Görföl T and Tauber Z and Kemenesi G},

url = {https://www.pasterovzavod.rs/wp-content/uploads/2026/04/One-health-investigation-following-a-cluster-of.pdf},

doi = {https://doi.org/10.2807/1560-7917.ES.2025.30.4.2400286},

year  = {2025},

date = {2025-01-30},

urldate = {2025-01-30},

journal = {Euro Surveill. 2025 Jan;30(4):2400286.},

abstract = {Background: Crimean–Congo haemorrhagic fever (CCHF) is a severe illness characterised by fever, bleeding and high case-fatality rates. The disease is caused by CCHF virus (CCHFV), transmitted by ticks

and infectious body fluids and tissues. Aim: After CCHF was diagnosed in three persons in 2023, we aimed to investigate the presence of antibodies against CCHFV in healthcare workers (HCW), sheep and goats, and of CCHFV in ticks, in an area in North Macedonia and characterise virus strains. Methods: In 2023, we collected blood samples from HCWs involved in treating CCHF patients and sera and ticks from sheep and goats in the village in North Macedonia where the index case resided. The blood samples were analysed by ELISA. Ticks were tested for presence of CCHFV, and the virus from a CCHF case was sequenced. 

Results: Samples from four of 52 HCWs and 10 of 17 small ruminants had antibodies against CCHFV. The virus was not detected from any of the 24 Rhipicephalus bursa ticks.

The virus strain from the index case clustered with regional strains within the Europe-1 lineage (genotype V) group and was closest to strains from Kosovo‡.

Conclusion: This report shows CCHFV is endemic in North Macedonia. Raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus is important. Healthcare workers need to be aware of the disease. Early detection, robust diagnostic methods, surveillance and collaborative efforts are necessary to prevent and control CCHF in the affected regions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}