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Callaby H, Beard KR, Wakerley D, Lake MA, Osborne J, Brown K, Wand N, Warner J, Holding M, Davies NW, Proudfoot M, Semper A, Brooks T, Petridou C, Houlihan CF, Rampling T, Warrell CE, Gordon NC. Tick-borne encephalitis: from tick surveillance to the first confirmed human cases, the United Kingdom, 2015 to 2023. Euro Surveill 2025; 30:2400404. [PMID: 39916608 PMCID: PMC11803743 DOI: 10.2807/1560-7917.es.2025.30.5.2400404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 10/08/2024] [Indexed: 02/09/2025] Open
Abstract
BackgroundTick-borne encephalitis virus (TBEV) is a flavivirus spread by ticks and can cause tick-borne encephalitis (TBE) in humans. Previously, TBE has been reported in returning travellers in the United Kingdom (UK), but in 2019 and 2020, two probable cases of TBE acquired in the UK were identified.AimThe aim of this study was to investigate TBE cases in the UK between 2015 and 2023, describing the incidence, place and mode of acquisition and diagnostic process.MethodsA retrospective review of possible, probable and confirmed cases of TBE diagnosed by the Rare and Imported Pathogens Laboratory (RIPL) between January 2015 and December 2023 was performed. For cases identified in 2022 and 2023, clinical data were collected for enhanced surveillance using structured case record forms. Laboratory diagnosis is reviewed and described.ResultsWe identified 21 cases: three possible, seven probable and 11 confirmed cases. Of these, 12 were between January 2022 and December 2023: three possible, three probable and six confirmed cases. Two confirmed TBE cases had definite or highly probable acquisition in the UK, in June and August 2022, respectively. One of the possible cases had definite UK acquisition. Cases typically have a biphasic presentation, with encephalitis in the second phase.ConclusionClinicians should be aware of the possibility of TBE when the cause for encephalitis is not identified, even in the absence of travel to previously identified endemic regions.
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Affiliation(s)
- Helen Callaby
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- University of Aberdeen, Aberdeen, United Kingdom
| | - Kate R Beard
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- Hampshire Hospitals National Health Service (NHS) Foundation Trust, Hampshire, United Kingdom
| | - Dominic Wakerley
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- University College London Hospital, London, United Kingdom
| | - Mary Alexandra Lake
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- University College London Hospital, London, United Kingdom
| | - Jane Osborne
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
| | - Kevin Brown
- United Kingdom Health Security Agency (UKHSA) Virus Reference Department, Colindale, United Kingdom
| | - Nadina Wand
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Jenny Warner
- United Kingdom Health Security Agency (UKHSA) Diagnostics and Pathogen Characterisation Division, Porton Down, Salisbury, United Kingdom
| | - Maya Holding
- United Kingdom Health Security Agency (UKHSA) Diagnostics and Pathogen Characterisation Division, Porton Down, Salisbury, United Kingdom
| | - Nicholas Ws Davies
- Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom
| | | | - Amanda Semper
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
| | - Tim Brooks
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
| | - Christina Petridou
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- Hampshire Hospitals National Health Service (NHS) Foundation Trust, Hampshire, United Kingdom
| | - Catherine F Houlihan
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- University College London Hospital, London, United Kingdom
| | - Tommy Rampling
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- National Institute for Health and Care Research (NIHR) University College London Hospitals Biomedical Research Centre (BRC), London, United Kingdom
| | - Clare E Warrell
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- University College London Hospital, London, United Kingdom
| | - N Claire Gordon
- United Kingdom Health Security Agency (UKHSA) Rare and Imported Pathogens Laboratory, Porton Down, Salisbury, United Kingdom
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Angulo FJ, Halsby K, Davidson A, Ravikumar S, Pilz A, Stark JH, Moïsi JC. Publicly available surveillance data on tick-borne encephalitis in Europe, 2023. Ticks Tick Borne Dis 2024; 15:102388. [PMID: 39137541 DOI: 10.1016/j.ttbdis.2024.102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 07/15/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024]
Abstract
The European Centre for Disease Prevention and Control (ECDC) defines a case of tick-borne encephalitis (TBE) as an infection by the TBE virus (TBEV) with clinical manifestations of central nervous system inflammation (e.g., meningitis, encephalitis). To better understand the TBE surveillance landscape, online searches were conducted to determine if cases of TBE, TBEV infection, acute meningitis or encephalitis, or viral meningitis or encephalitis were subject to statutory reporting in European countries in 2023. In countries with statutory reporting, notification responsibility and available information on surveillance-reported cases were determined. The number of TBE cases reported to ECDC were compared with the number of cases recorded in national surveillance reports. Of 44 countries of the Europe Region of the United Nations, 37 (84 %) mandated statutory reporting of cases of TBE, TBEV infection, or acute/viral meningitis/encephalitis. Twenty-six (87 %) of 30 countries with identified surveillance reports recorded TBE cases in 2020-2023. Of these countries, 17 (65 %) required TBE reporting by clinicians and laboratories, 5 (19 %) by clinicians only, and 4 (15 %) by laboratories only. Twenty-four countries reported on TBE cases to ECDC in 2020; however, surveillance for TBE in Europe is heterogeneous. Standardization of TBE surveillance would enhance the understanding of TBE disease burden in Europe.
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Affiliation(s)
- Frederick J Angulo
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, 500 Arcola Rd, Collegeville, PA 19426, USA.
| | - Kate Halsby
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, London, United Kingdom
| | - Alexander Davidson
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, New York, NY, USA
| | - Saiganesh Ravikumar
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, 500 Arcola Rd, Collegeville, PA 19426, USA; Department of Anesthesiology, Northwell Health, New Hyde Park, NY 11040, USA
| | - Andreas Pilz
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, Vienna, Austria
| | - James H Stark
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, Cambridge, MA, USA
| | - Jennifer C Moïsi
- Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, Paris, France
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Aregay A, Slunečko J, Korva M, Bogovic P, Resman Rus K, Knap N, Beicht J, Kubinski M, Saletti G, Avšič-Županc T, Steffen I, Strle F, Osterhaus ADME, Rimmelzwaan GF. Tick-borne encephalitis vaccine breakthrough infections induce aberrant T cell and antibody responses to non-structural proteins. NPJ Vaccines 2024; 9:141. [PMID: 39112523 PMCID: PMC11306791 DOI: 10.1038/s41541-024-00936-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/17/2024] [Indexed: 08/10/2024] Open
Abstract
Tick-borne encephalitis virus (TBEV) vaccine breakthrough (VBT) infections are not uncommon in endemic areas. The clinical and immunological outcomes have been poorly investigated. We assessed the magnitude and specificity of virus-specific antibody and T cell responses after TBE in previously vaccinated subjects and compared the results with those of unvaccinated TBE patients and study subjects that received vaccination without VBT infection. Symptomatic TBEV infection of unvaccinated study subjects induced virus-specific antibody responses to the E protein and non-structural protein 1 (NS1) as well as T cell responses to structural and other non-structural (NS) proteins. After VBT infections, significantly impaired NS1-specific antibody responses were observed, while the virus-specific T cell responses to the NS proteins were relatively strong. VBT infection caused predominantly moderate to severe disease during hospitalization. The level of TBEV EDIII- and NS1-specific antibodies in unvaccinated convalescent patients inversely correlated with TBE severity and neurological symptoms early after infection.
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Affiliation(s)
- Amare Aregay
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Jan Slunečko
- Institute for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Petra Bogovic
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katarina Resman Rus
- Institute for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Knap
- Institute for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jana Beicht
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Mareike Kubinski
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Giulietta Saletti
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Tatjana Avšič-Županc
- Institute for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Imke Steffen
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- Institute of Biochemistry, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Albert D M E Osterhaus
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Guus F Rimmelzwaan
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
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Ruzek D, Kaucka K. A brief tale of two pioneering moments: Europe's first discovery of Tick-Borne Encephalitis (TBE) virus beyond the Soviet Union and the largest alimentary TBE outbreak in history. Ticks Tick Borne Dis 2024; 15:102314. [PMID: 38290295 DOI: 10.1016/j.ttbdis.2024.102314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/05/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
The emergence of tick-borne encephalitis (TBE) in Europe marked several significant milestones. The discovery of TBE in Czechoslovakia in 1948, with Gallia and Krejčí simultaneously isolating the TBE virus (TBEV) from human samples for the first time in Europe outside the Soviet Union, was pivotal. Subsequent TBEV isolation from ticks suggested the viral transmission via this vector. In 1951, the outbreak in Rožňava in Slovakia (Czechoslovakia) revealed an unexpected mode of transmission, unpasteurized milk from a local dairy, challenging existing understanding. Investigations exposed illicit practices of mixing cow's milk with goat's milk for economic gains. Laboratory research confirmed the outbreak was caused by TBEV, which was substantiated by serological analyses. This was the first and largest documented alimentary TBE outbreak in history. In this review, we delve into both published sources and unpublished archival data, offering a comprehensive understanding of these historic accomplishments and shedding light on these pivotal moments.
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Affiliation(s)
- Daniel Ruzek
- Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic; Laboratory of Emerging Viral Diseases, Veterinary Research Institute, Brno, Czech Republic.
| | - Kristyna Kaucka
- Masaryk Institute and Archives of the Czech Academy of Sciences, Prague, Czech Republic
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Arsevska E, Hengl T, Singleton DA, Noble PJM, Caminade C, Eneanya OA, Jones PH, Medlock JM, Hansford KM, Bonannella C, Radford AD. Risk factors for tick attachment in companion animals in Great Britain: a spatiotemporal analysis covering 2014-2021. Parasit Vectors 2024; 17:29. [PMID: 38254168 PMCID: PMC10804489 DOI: 10.1186/s13071-023-06094-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Ticks are an important driver of veterinary health care, causing irritation and sometimes infection to their hosts. We explored epidemiological and geo-referenced data from > 7 million electronic health records (EHRs) from cats and dogs collected by the Small Animal Veterinary Surveillance Network (SAVSNET) in Great Britain (GB) between 2014 and 2021 to assess the factors affecting tick attachment in an individual and at a spatiotemporal level. METHODS EHRs in which ticks were mentioned were identified by text mining; domain experts confirmed those with ticks on the animal. Tick presence/absence records were overlaid with a spatiotemporal series of climate, environment, anthropogenic and host distribution factors to produce a spatiotemporal regression matrix. An ensemble machine learning spatiotemporal model was used to fine-tune hyperparameters for Random Forest, Gradient-boosted Trees and Generalized Linear Model regression algorithms, which were then used to produce a final ensemble meta-learner to predict the probability of tick attachment across GB at a monthly interval and averaged long-term through 2014-2021 at a spatial resolution of 1 km. Individual host factors associated with tick attachment were also assessed by conditional logistic regression on a matched case-control dataset. RESULTS In total, 11,741 consultations were identified in which a tick was recorded. The frequency of tick records was low (0.16% EHRs), suggesting an underestimation of risk. That said, increased odds for tick attachment in cats and dogs were associated with younger adult ages, longer coat length, crossbreeds and unclassified breeds. In cats, males and entire animals had significantly increased odds of recorded tick attachment. The key variables controlling the spatiotemporal risk for tick attachment were climatic (precipitation and temperature) and vegetation type (Enhanced Vegetation Index). Suitable areas for tick attachment were predicted across GB, especially in forests and grassland areas, mainly during summer, particularly in June. CONCLUSIONS Our results can inform targeted health messages to owners and veterinary practitioners, identifying those animals, seasons and areas of higher risk for tick attachment and allowing for more tailored prophylaxis to reduce tick burden, inappropriate parasiticide treatment and potentially TBDs in companion animals and humans. Sentinel networks like SAVSNET represent a novel complementary data source to improve our understanding of tick attachment risk for companion animals and as a proxy of risk to humans.
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Affiliation(s)
- Elena Arsevska
- Unit for Animals, Health, Territories, Risks and Ecosystems (UMR ASTRE), French Agricultural Research Centre for International Development (CIRAD), 34980, Montferrier-sur-Lez, France.
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, Neston, UK.
| | - Tomislav Hengl
- OpenGeoHub Foundation, 6708 PW, Wageningen, The Netherlands
| | - David A Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, Neston, UK
| | - Peter-John M Noble
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, Neston, UK
| | - Cyril Caminade
- Earth System Physics Department, Abdus Salam International Centre for Theoretical Physics (ICTP), 34151, Trieste, Italy
| | - Obiora A Eneanya
- Health Programs, The Carter Center, 30307, Atlanta, Georgia, USA
| | - Philip H Jones
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, Neston, UK
| | - Jolyon M Medlock
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, SP4 0JG, Salisbury, UK
- NIHR Health Protection Research Unit in Environmental Change and Health, WC1E 7HT, London, UK
| | - Kayleigh M Hansford
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, SP4 0JG, Salisbury, UK
- NIHR Health Protection Research Unit in Environmental Change and Health, WC1E 7HT, London, UK
| | - Carmelo Bonannella
- OpenGeoHub Foundation, 6708 PW, Wageningen, The Netherlands
- Laboratory of Geo-information Science and Remote Sensing, Wageningen University & Research, 6708 PB, Wageningen, The Netherlands
| | - Alan D Radford
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, Neston, UK
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Schelling J, Einmahl S, Torgler R, Larsen CS. Evidence for a 10-year TBE vaccine booster interval: an evaluation of current data. Expert Rev Vaccines 2024; 23:226-236. [PMID: 38288983 DOI: 10.1080/14760584.2024.2311359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/24/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION Tick-borne encephalitis (TBE) is rapidly spreading to new areas in many parts of Europe. While vaccination remains the most effective method of protection against the disease, vaccine uptake is low in many endemic countries. AREAS COVERED We conducted a literature search of the MEDLINE database to identify articles published from 2018 to 2023 that evaluated the immunogenicity and effectiveness of TBE vaccines, particularly Encepur, when booster doses were administered up to 10 years apart. We searched PubMed with the MeSH terms 'Encephalitis, Tick-Borne/prevention and control' and 'Vaccination' for articles published in the English language. EXPERT OPINION Long-term immunogenicity data for Encepur and real-world data on vaccine effectiveness and breakthrough infections following the two European TBE vaccines, Encepur and FSME-Immun, have shown that extending the booster interval from 3-5 years to 10 years does not negatively impact protection against TBE, regardless of age. Such extension not only streamlines the vaccination schedules but may also increase vaccine uptake and compliance among those living in endemic regions.
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Affiliation(s)
- Jörg Schelling
- Department of Medicine IV, LMU University Hospital, LMU Munich, University of Munich, Munich, Germany
| | - Suzanne Einmahl
- Department of Medical Strategy, Bavarian Nordic AG, Zug, Switzerland
| | - Ralph Torgler
- Department of Medical Strategy, Bavarian Nordic AG, Zug, Switzerland
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Ackermann-Gäumann R, Brêchet A, Smetana J, Salát J, Lienhard R, Croxatto A, Polcarová P, Chlíbek R, Růžek D. Vaccination against tick-borne encephalitis elicits a detectable NS1 IgG antibody response. J Virol Methods 2023; 322:114831. [PMID: 37838083 DOI: 10.1016/j.jviromet.2023.114831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023]
Abstract
Vaccine-induced protection against tick-borne encephalitis virus (TBEV) is mediated by antibodies to the viral particle/envelope protein. The detection of non-structural protein 1 (NS1) specific antibodies has been suggested as a marker indicative of natural infections. However, recent work has shown that TBEV vaccines contain traces of NS1, and immunization of mice induced low amounts of NS1-specific antibodies. In this study, we investigated if vaccination induces TBEV NS1-specific antibodies in humans. Healthy army members (n = 898) were asked to fill in a questionnaire relating to flavivirus vaccination or infection, and blood samples were collected. In addition, samples of 71 suspected acute TBE cases were included. All samples were screened for the presence of TBEV NS1-specific IgG antibodies using an in-house developed ELISA. Antibodies were quantified as percent positivity in reference to a positive control. For qualitative evaluation, cut-off for positivity was defined based on the mean OD of the lower 95% of the vaccinated individuals + 3 SD. We found significantly higher NS1-specific IgG antibody titers (i.e., quantitative evaluation) in individuals having received 2, 3, or 4 or more vaccine doses than in non-vaccinated individuals. Similarly, the percentage of individuals with a positive test result (i.e., qualitative evaluation) was higher in individuals vaccinated against tick-borne encephalitis than in unvaccinated study participants. Although NS1-specific IgG titers remained at a relatively low level when compared to TBE patients, a clear distinction was not always possible. Establishing a clear cut-off point in detection systems is critical for NS1-specific antibodies to serve as a marker for distinguishing the immune response after vaccination and infection.
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Affiliation(s)
- Rahel Ackermann-Gäumann
- Microbiologie, ADMED Analyses et Diagnostics Médicaux, La Chaux-de-Fonds, Switzerland; Swiss National Reference Center for Tick-Transmitted Diseases, Switzerland.
| | - Arthur Brêchet
- Microbiologie, ADMED Analyses et Diagnostics Médicaux, La Chaux-de-Fonds, Switzerland
| | - Jan Smetana
- Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Jiři Salát
- Laboratory of Emerging Viral Infections, Veterinary Research Institute, Brno, Czech Republic; Laboratory of Arbovirology, Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic; Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Reto Lienhard
- Microbiologie, ADMED Analyses et Diagnostics Médicaux, La Chaux-de-Fonds, Switzerland; Swiss National Reference Center for Tick-Transmitted Diseases, Switzerland
| | - Antony Croxatto
- Microbiologie, ADMED Analyses et Diagnostics Médicaux, La Chaux-de-Fonds, Switzerland; Swiss National Reference Center for Tick-Transmitted Diseases, Switzerland
| | - Petra Polcarová
- Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Roman Chlíbek
- Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Daniel Růžek
- Laboratory of Emerging Viral Infections, Veterinary Research Institute, Brno, Czech Republic; Laboratory of Arbovirology, Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic; Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
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8
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Kelly J, Koch O. Human granulocytic anaplasmosis in a Scottish traveller returning from Canada. Travel Med Infect Dis 2023; 56:102675. [PMID: 38036160 DOI: 10.1016/j.tmaid.2023.102675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023]
Affiliation(s)
- John Kelly
- Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK.
| | - Oliver Koch
- Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK
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9
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Svoboda P, Haviernik J, Bednar P, Matkovic M, Cervantes Rincón T, Keeffe J, Palus M, Salat J, Agudelo M, Nussenzweig MC, Cavalli A, Robbiani DF, Ruzek D. A combination of two resistance mechanisms is critical for tick-borne encephalitis virus escape from a broadly neutralizing human antibody. Cell Rep 2023; 42:113149. [PMID: 37715951 PMCID: PMC10591882 DOI: 10.1016/j.celrep.2023.113149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/26/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023] Open
Abstract
Tick-borne encephalitis virus (TBEV) is a flavivirus that causes human neuroinfections and represents a growing health problem. The human monoclonal antibody T025 targets envelope protein domain III (EDIII) of TBEV and related tick-borne flaviviruses, potently neutralizing TBEV in vitro and in preclinical models, representing a promising candidate for clinical development. We demonstrate that TBEV escape in the presence of T025 or T028 (another EDIII-targeting human monoclonal antibody) results in virus variants of reduced pathogenicity, characterized by distinct sets of amino acid changes in EDII and EDIII that are jointly needed to confer resistance. EDIII substitution K311N impairs formation of a salt bridge critical for T025-epitope interaction. EDII substitution E230K is not on the T025 epitope but likely induces quaternary rearrangements of the virus surface because of repulsion of positively charged residues on the adjacent EDI. A combination of T025 and T028 prevents virus escape and improves neutralization.
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Affiliation(s)
- Pavel Svoboda
- Veterinary Research Institute, Brno, Czech Republic; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic; Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic; Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
| | - Jan Haviernik
- Veterinary Research Institute, Brno, Czech Republic; Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Petr Bednar
- Veterinary Research Institute, Brno, Czech Republic; Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic; Faculty of Science, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Milos Matkovic
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Tomás Cervantes Rincón
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland
| | | | - Martin Palus
- Veterinary Research Institute, Brno, Czech Republic; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic
| | - Jiri Salat
- Veterinary Research Institute, Brno, Czech Republic; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic
| | - Marianna Agudelo
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY, USA
| | - Michel C Nussenzweig
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY, USA; Howard Hughes Medical Institute, New York, NY, USA
| | - Andrea Cavalli
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Davide F Robbiani
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland.
| | - Daniel Ruzek
- Veterinary Research Institute, Brno, Czech Republic; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic; Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic; Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi City, Japan.
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10
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Chiffi G, Grandgirard D, Leib SL, Chrdle A, Růžek D. Tick-borne encephalitis: A comprehensive review of the epidemiology, virology, and clinical picture. Rev Med Virol 2023; 33:e2470. [PMID: 37392370 DOI: 10.1002/rmv.2470] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 07/03/2023]
Abstract
Tick-borne encephalitis virus (TBEV) is a flavivirus commonly found in at least 27 European and Asian countries. It is an emerging public health problem, with steadily increasing case numbers over recent decades. Tick-borne encephalitis virus affects between 10,000 and 15,000 patients annually. Infection occurs through the bite of an infected tick and, much less commonly, through infected milk consumption or aerosols. The TBEV genome comprises a positive-sense single-stranded RNA molecule of ∼11 kilobases. The open reading frame is > 10,000 bases long, flanked by untranslated regions (UTR), and encodes a polyprotein that is co- and post-transcriptionally processed into three structural and seven non-structural proteins. Tick-borne encephalitis virus infection results in encephalitis, often with a characteristic biphasic disease course. After a short incubation time, the viraemic phase is characterised by non-specific influenza-like symptoms. After an asymptomatic period of 2-7 days, more than half of patients show progression to a neurological phase, usually characterised by central and, rarely, peripheral nervous system symptoms. Mortality is low-around 1% of confirmed cases, depending on the viral subtype. After acute tick-borne encephalitis (TBE), a minority of patients experience long-term neurological deficits. Additionally, 40%-50% of patients develop a post-encephalitic syndrome, which significantly impairs daily activities and quality of life. Although TBEV has been described for several decades, no specific treatment exists. Much remains unknown regarding the objective assessment of long-lasting sequelae. Additional research is needed to better understand, prevent, and treat TBE. In this review, we aim to provide a comprehensive overview of the epidemiology, virology, and clinical picture of TBE.
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Affiliation(s)
- Gabriele Chiffi
- Department for BioMedical Research, University of Bern, Bern, Switzerland
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Denis Grandgirard
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Stephen L Leib
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Aleš Chrdle
- Department of Infectious Diseases, Hospital Ceske Budejovice, Ceske Budejovice, Czech Republic
- Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
- Royal Liverpool University Hospital, Liverpool, UK
| | - Daniel Růžek
- Veterinary Research Institute, Emerging Viral Diseases, Brno, Czech Republic
- Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
- Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice, Czech Republic
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11
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Marini G, Tagliapietra V, Cristofolini F, Cristofori A, Dagostin F, Zuccali MG, Molinaro S, Gottardini E, Rizzoli A. Correlation between airborne pollen data and the risk of tick-borne encephalitis in northern Italy. Sci Rep 2023; 13:8262. [PMID: 37217780 DOI: 10.1038/s41598-023-35478-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/18/2023] [Indexed: 05/24/2023] Open
Abstract
Tick-borne encephalitis (TBE) is caused by a flavivirus that infects animals including humans. In Europe, the TBE virus circulates enzootically in natural foci among ticks and rodent hosts. The abundance of ticks depends on the abundance of rodent hosts, which in turn depends on the availability of food resources, such as tree seeds. Trees can exhibit large inter-annual fluctuations in seed production (masting), which influences the abundance of rodents the following year, and the abundance of nymphal ticks two years later. Thus, the biology of this system predicts a 2-year time lag between masting and the incidence of tick-borne diseases such as TBE. As airborne pollen abundance is related to masting, we investigated whether inter-annual variation in pollen load could be directly correlated with inter-annual variation in the incidence of TBE in human populations with a 2-year time lag. We focused our study on the province of Trento (northern Italy), where 206 TBE cases were notified between 1992 and 2020. We tested the relationship between TBE incidence and pollen load collected from 1989 to 2020 for 7 different tree species common in our study area. Through univariate analysis we found that the pollen quantities recorded two years prior for two tree species, hop-hornbeam (Ostrya carpinifolia) and downy oak (Quercus pubescens), were positively correlated with TBE emergence (R2 = 0.2) while a multivariate model with both tree species better explained the variation in annual TBE incidence (R2 = 0.34). To the best of our knowledge, this is the first attempt at quantifying the correlation between pollen quantities and the incidence of TBE in human populations. As pollen loads are collected by widespread aerobiological networks using standardized procedures, our study could be easily replicated to test their potential as early warning system for TBE and other tick-borne diseases.
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Affiliation(s)
- Giovanni Marini
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele All'Adige, TN, Italy.
| | - Valentina Tagliapietra
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele All'Adige, TN, Italy
| | - Fabiana Cristofolini
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele All'Adige, TN, Italy
| | - Antonella Cristofori
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele All'Adige, TN, Italy
| | - Francesca Dagostin
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele All'Adige, TN, Italy
| | | | | | - Elena Gottardini
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele All'Adige, TN, Italy
| | - Annapaola Rizzoli
- Research and Innovation Centre, Fondazione Edmund Mach, San Michele All'Adige, TN, Italy
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12
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Saegerman C, Humblet MF, Leandri M, Gonzalez G, Heyman P, Sprong H, L’Hostis M, Moutailler S, Bonnet SI, Haddad N, Boulanger N, Leib SL, Hoch T, Thiry E, Bournez L, Kerlik J, Velay A, Jore S, Jourdain E, Gilot-Fromont E, Brugger K, Geller J, Studahl M, Knap N, Avšič-Županc T, Růžek D, Zomer TP, Bødker R, Berger TFH, Martin-Latil S, De Regge N, Raffetin A, Lacour SA, Klein M, Lernout T, Quillery E, Hubálek Z, Ruiz-Fons F, Estrada-Peña A, Fravalo P, Kooh P, Etore F, Gossner CM, Purse B. First Expert Elicitation of Knowledge on Possible Drivers of Observed Increasing Human Cases of Tick-Borne Encephalitis in Europe. Viruses 2023; 15:v15030791. [PMID: 36992499 PMCID: PMC10054665 DOI: 10.3390/v15030791] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/11/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Tick-borne encephalitis (TBE) is a viral disease endemic in Eurasia. The virus is mainly transmitted to humans via ticks and occasionally via the consumption of unpasteurized milk products. The European Centre for Disease Prevention and Control reported an increase in TBE incidence over the past years in Europe as well as the emergence of the disease in new areas. To better understand this phenomenon, we investigated the drivers of TBE emergence and increase in incidence in humans through an expert knowledge elicitation. We listed 59 possible drivers grouped in eight domains and elicited forty European experts to: (i) allocate a score per driver, (ii) weight this score within each domain, and (iii) weight the different domains and attribute an uncertainty level per domain. An overall weighted score per driver was calculated, and drivers with comparable scores were grouped into three terminal nodes using a regression tree analysis. The drivers with the highest scores were: (i) changes in human behavior/activities; (ii) changes in eating habits or consumer demand; (iii) changes in the landscape; (iv) influence of humidity on the survival and transmission of the pathogen; (v) difficulty to control reservoir(s) and/or vector(s); (vi) influence of temperature on virus survival and transmission; (vii) number of wildlife compartments/groups acting as reservoirs or amplifying hosts; (viii) increase of autochthonous wild mammals; and (ix) number of tick species vectors and their distribution. Our results support researchers in prioritizing studies targeting the most relevant drivers of emergence and increasing TBE incidence.
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Affiliation(s)
- Claude Saegerman
- Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, 4000 Liege, Belgium
- Correspondence:
| | - Marie-France Humblet
- Department for Occupational Protection and Hygiene, Unit Biosafety, Biosecurity and Environmental Licences, University of Liege, 4000 Liege, Belgium
| | - Marc Leandri
- UMI SOURCE, Université Paris-Saclay—UVSQ, 78000 Versailles, France
| | - Gaëlle Gonzalez
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | | | - Hein Sprong
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 MA Bilthoven, The Netherlands
| | - Monique L’Hostis
- Ecole Nationale Vétérinaire Agroalimentaire et de l’Alimentation Nantes-Atlantique, Oniris, 44307 Nantes, France
| | - Sara Moutailler
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Sarah I. Bonnet
- UMR 2000 Institut Pasteur-CNRS-Université Paris-Cité, Ecology and Emergence of Arthropod-borne Pathogens, 75015 Paris, France
- Animal Health Department, INRAE, 37380 Nouzilly, France
| | - Nadia Haddad
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Nathalie Boulanger
- UR7290: VBP: Borrelia Group, France and French Reference Centre on Lyme Borreliosis, CHRU, Unversity of Strasbourg, 67000 Strasbourg, France
| | - Stephen L. Leib
- Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
| | | | - Etienne Thiry
- Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, 4000 Liege, Belgium
| | - Laure Bournez
- ANSES, Nancy Laboratory for Rabies and Wildlife, 54220 Malzéville, France
| | - Jana Kerlik
- Department of Epidemiology, Regional Authority of Public Health in Banská Bystrica, 497556 Banská Bystrica, Slovakia
| | - Aurélie Velay
- Unité Mixte de Recherché Immunorhumathologie Moléculaire (UMR IRM_S) 1109, Université de Strasbourg, INSERM, 67000 Strasbourg, France
| | - Solveig Jore
- Zoonotic, Water and Foodborne Infections, The Norwegian Institute for Public Health (NIPH), 0213 Oslo, Norway
| | - Elsa Jourdain
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, Route de Theix, 63122 Saint-Genès-Champanelle, France
| | | | - Katharina Brugger
- Competence Center Climate and Health, Austrian National Institute of Public Health, 1010 Vienna, Austria
| | - Julia Geller
- Department of Virology and Immunology, National Institute for Health Development, 11619 Tallinn, Estonia
| | - Marie Studahl
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, 41685 Gothenburg, Sweden
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, 1000 Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, 1000 Ljubljana, Slovenia
| | - Daniel Růžek
- Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, 37005 Ceske Budejovice, Czech Republic
- Department of Experimental Biology, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, 62100 Brno, Czech Republic
| | - Tizza P. Zomer
- Lyme Center Apeldoorn, Gelre Hospital, 7300 DS Apeldoorn, The Netherlands
| | - René Bødker
- Animal Welfare and Disease Control, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg, Denmark
| | - Thomas F. H. Berger
- Agroscope, Risk Evaluation and Risk Mitigation, Schwarzenburgstrasse, 3003 Bern-Liebefeld, Switzerland
| | - Sandra Martin-Latil
- Laboratory for Food Safety, ANSES, University of Paris-EST, 94700 Maisons-Alfort, France
| | - Nick De Regge
- Operational Direction Infectious Diseases in Animals, Unit of Exotic and Vector-borne Diseases, Sciensano, 1180 Brussels, Belgium
| | - Alice Raffetin
- Reference Centre for Tick-Borne Diseases, Paris and Northern Region, Department of Infectious Diseases, General Hospital of Villeneuve-Saint-Georges, 94100 Villeneuve-Saint-Georges, France
| | - Sandrine A. Lacour
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Matthias Klein
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, LMU München, Marchioninistraße 15, 81377 München, Germany
| | - Tinne Lernout
- Scientific Directorate of Epidemiology and Public Health, Sciensano, 1180 Brussels, Belgium
| | - Elsa Quillery
- ANSES, Risk Assessment Department, 94700 Maisons-Alfort, France
| | - Zdeněk Hubálek
- Institute of Vertebrate Biology, Czech Academy of Sciences, Květná 8, 60365 Brno, Czech Republic
| | - Francisco Ruiz-Fons
- Health & Biotechnology (SaBio) Group, Instituto de Investigación en Recursos Cinegéticos (IREC), CSIC-UCLM-JCCM, 13071 Ciudad Real, Spain
| | - Agustín Estrada-Peña
- Deptartment of Animal Health, Faculty of Veterinary Medicine, 50013 Zaragoza, Spain
| | - Philippe Fravalo
- Pôle Agroalimentaire, Conservatoire National des Arts et Métiers (Cnam), 75003 Paris, France
| | - Pauline Kooh
- ANSES, Risk Assessment Department, 94700 Maisons-Alfort, France
| | - Florence Etore
- ANSES, Risk Assessment Department, 94700 Maisons-Alfort, France
| | - Céline M. Gossner
- European Centre for Disease Prevention and Control (ECDC), 17183 Solna, Sweden
| | - Bethan Purse
- UK Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Oxfordshire OX10 8BB, UK
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Hansford KM, Gandy SL, Gillingham EL, McGinley L, Cull B, Johnston C, Catton M, Medlock JM. Mapping and monitoring tick (Acari, Ixodida) distribution, seasonality, and host associations in the United Kingdom between 2017 and 2020. MEDICAL AND VETERINARY ENTOMOLOGY 2023; 37:152-163. [PMID: 36309852 PMCID: PMC10092223 DOI: 10.1111/mve.12621] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Tick-borne disease risk is intrinsically linked to the distribution of tick vector species. To assess risk and anticipate disease emergence, an understanding of tick distribution, host associations, and seasonality is needed. This can be achieved, to some extent, using passive surveillance supported by engagement with the public, animal health, and public health experts. The Tick Surveillance Scheme (TSS) collects data and maps tick distribution across the United Kingdom (UK). Between 2017 and 2020, 3720 tick records were received and 39 tick species were detected. Most records were acquired in the UK, with a subset associated with recent overseas travel. The dominant UK acquired species was Ixodes ricinus (Ixodida: Ixodidae, Linnaeus), the main vector of Lyme borreliosis. Records peaked during May and June, highlighting a key risk period for tick bites. Other key UK species were detected, including Dermacentor reticulatus (Ixodida: Ixodidae, Fabricius) and Haemaphysalis punctata (Ixodida: Ixodidae, Canestrini & Fanzago) as well as several rarer species that may present novel tick-borne disease risk to humans and other animals. Updated tick distribution maps highlight areas in the UK where tick exposure has occurred. There is evidence of increasing human tick exposure over time, including during the COVID-19 pandemic, but seasonal patterns remain unchanged.
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Affiliation(s)
| | - Sara L. Gandy
- Medical Entomology & Zoonoses EcologyUK Health Security AgencyPorton DownUK
| | - Emma L. Gillingham
- Medical Entomology & Zoonoses EcologyUK Health Security AgencyPorton DownUK
| | - Liz McGinley
- Medical Entomology & Zoonoses EcologyUK Health Security AgencyPorton DownUK
| | - Benjamin Cull
- Medical Entomology & Zoonoses EcologyUK Health Security AgencyPorton DownUK
| | - Colin Johnston
- Medical Entomology & Zoonoses EcologyUK Health Security AgencyPorton DownUK
| | - Matthew Catton
- Medical Entomology & Zoonoses EcologyUK Health Security AgencyPorton DownUK
| | - Jolyon M. Medlock
- Medical Entomology & Zoonoses EcologyUK Health Security AgencyPorton DownUK
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