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.

Tick-borne encephalitis (TBE) is an emerging vector-borne disease in Europe, but its epidemiology remains poorly defined in Serbia. In orthoflavivirus-endemic settings, diagnostic challenges may contribute to underrecognition of TBE, particularly among patients with suspected West Nile virus (WNV) infection. We conducted a multicenter retrospective study including patients hospitalized between 2018 and 2023 with suspected WNV neuroinvasive disease or viral encephalitis of unknown etiology. Serum samples were tested for TBEV-neutralizing antibodies using a microneutralization assay. Among 79 patients, TBEV-neutralizing antibodies were detected in four (5.1%). Most reactive cases occurred in patients initially classified as having suspected WNV-associated meningoencephalitis, while TBE had not been considered in the differential diagnosis at admission. These findings suggest that TBE may be underrecognized in Serbia and highlight the importance of confirmatory testing in orthoflavivirus-endemic settings. Strengthening clinical awareness and surveillance will be essential to better define the burden of TBE and inform prevention strategies.

Background: Toxocara canis and Toxocara cati are zoonotic nematodes of dogs and cats that maintain a human infection risk through environmental contamination with highly resistant eggs. Data on toxocariasis in North Macedonia are limited, and ocular toxocariasis (OT) remains a clinically important but easily overlooked manifestation of human infection. Methods: This retrospective assessment combined coprological data from dogs and cats with a complementary clinical description of a human case of OT. Routine fecal samples from dogs and cats from January 2018 to March 2026 were morphologically examined. The human case of OT was a 13-year-old boy with unilateral ocular disease. Results: Of 465 samples, Toxocara spp. eggs were detected in 14, corresponding to an overall detection of 3.0%. Detection was 3.0% in dogs (11/371) and 3.2% in cats (3/94), with no significant difference between species. The human clinical component involved unilateral visual loss, strabismus, and posterior segment inflammatory changes. Conclusions: Dogs and cats in North Macedonia showed sporadic Toxocara spp. egg shedding, supporting ongoing zoonotic exposure potential. The clinically confirmed OT case complements the animal data and underscores the need for improved awareness among clinicians and veterinarians, as well as strengthened preventive measures aimed at reducing environmental contamination and zoonotic exposure.