Results of HPA tick surveillance in Great Britain

Crimean-Congo Hemorrhagic Fever Virus: Progress in Vaccine Development

Crimean-Congo hemorrhagic fever virus (CCHFV), a member of the Nairoviridae family and Bunyavirales order, is transmitted to humans via tick bites or contact with the blood of infected animals. It can cause severe symptoms, including hemorrhagic fever, with a mortality rate between 5 to 30%. CCHFV is classified as a high-priority pathogen by the World Health Organization (WHO) due to its high fatality rate and the absence of effective medical countermeasures. CCHFV is endemic in several regions across the world, including Africa, Europe, the Middle East, and Asia, and has the potential for global spread. The emergence of the disease in new areas, as well as the presence of the tick vector in countries without reported cases, emphasizes the need for preventive measures to be taken. In the past, the lack of a suitable animal model susceptible to CCHFV infection has been a major obstacle in the development of vaccines and treatments. However, recent advances in biotechnology and the availability of suitable animal models have significantly expedited the development of vaccines against CCHF. These advancements have not only contributed to an enhanced understanding of the pathogenesis of CCHF but have also facilitated the evaluation of potential vaccine candidates. This review outlines the immune response to CCHFV and animal models utilized for the study of CCHFV and highlights the progress made in CCHFV vaccine studies. Despite remarkable advancements in vaccine development for CCHFV, it remains crucial to prioritize continued research, collaboration, and investment in this field.

A risk assessment of equine piroplasmosis entry, exposure and consequences in the UK

BACKGROUND

Equine piroplasmosis (EP) is currently not endemic in the UK, despite a lack of formal surveillance and the presence of carrier horses in the equine population. Pathogen establishment would have significant welfare and economic impacts on the national equine industry, but the disease is often overlooked by UK practitioners.

OBJECTIVES

To assess the risk of disease entry, exposure and consequences to the UK equine population.

STUDY DESIGN

Qualitative risk assessment.

METHODS

A qualitative risk assessment was constructed utilising the current World Organisation for Animal Health (OIE) published framework for importation risk assessment, assessing the key areas of disease entry, exposure and consequences to the UK equine population.

RESULTS

The overall risk of EP entry to the UK via importation of infected equidae with acute disease is very low but considered medium with subclinical carrier animals. Entry via importation of ticks or the importation of blood is considered very low. The risk of EP exposure to susceptible equidae in the UK is considered low by the infection routes of tick-bites, contaminated needles and contaminated blood, but very high via transplacental transfer. However, the consequences of EP endemic establishment are considered of high significance to the UK equine industry.

MAIN LIMITATIONS

A lack of available numerical data for events and variables in disease import risk meant a qualitative assessment was the most practical method for this scenario.

CONCLUSIONS

This risk assessment highlights that EP positive animals are able to enter and are currently present in the UK, and that conditions do exist that could allow forward transmission of the disease. It has highlighted a gap in existing policy where the UK falls behind OIE guidelines and has suggested steps to correct this discrepancy and improve national biosecurity.

Modelling the current and future temperature suitability of the UK for the vector Hyalomma marginatum (Acari: Ixodidae)

Hyalomma marginatum is the main vector of Crimean-Congo haemorrhagic fever virus (CCHFV) and spotted fever rickettsiae in Europe. The distribution of H. marginatum is currently restricted to parts of southern Europe, northern Africa and Asia, and one of the drivers limiting distribution is climate, particularly temperature. As temperatures rise with climate change, parts of northern Europe currently considered too cold for H. marginatum to be able to survive may become suitable, including the United Kingdom (UK), presenting a potential public health concern. Here we use a series of modelling methodologies to understand whether mean air temperatures across the UK during 2000-2019 were sufficient for H. marginatum nymphs to moult into adult stages and be able to overwinter in the UK if they were introduced on migratory birds. We then used UK-specific climate projections (UKCP18) to determine whether predicted temperatures would be sufficient to allow survival in future. We found that spring temperatures in parts of the UK during 2000-2019 were warm enough for predicted moulting to occur, but in all years except 2006, temperatures during September to December were too cold for overwintering to occur. Our analysis of the projections data suggests that whilst temperatures in the UK during September to December will increase in future, they are likely to remain below the threshold required for H. marginatum populations to become established.

Ticks on the Run: A Mathematical Model of Crimean-Congo Haemorrhagic Fever (CCHF)-Key Factors for Transmission

Crimean-Congo haemorrhagic fever (CCHF) is a zoonotic disease caused by the Crimean-Congo hemorrhagic fever virus (CCHFV). Ticks of the genus Hyalomma are the main vectors and represent a reservoir for the virus. CCHF is maintained in nature in an endemic vertebrate-tick-vertebrate cycle. The disease is prevalent in wide geographical areas including Asia, Africa, South-Eastern Europe and the Middle East. It is of great importance for the public health given its occasionally high case/fatality ratio of CCHFV in humans. Climate change and the detection of possible CCHFV vectors in Central Europe suggest that the establishment of the transmission in Central Europe may be possible in future. We have developed a compartment-based nonlinear Ordinary Differential Equation (ODE) system to model the disease transmission cycle including blood sucking ticks, livestock and human. Sensitivity analysis of the basic reproduction number R0 shows that decreasing the tick survival time is an efficient method to control the disease. The model supports us in understanding the influence of different model parameters on the spread of CCHFV. Tick-to-tick transmission through co-feeding and the CCHFV circulation through transstadial and transovarial transmission are important factors to sustain the disease cycle. The proposed model dynamics are calibrated through an empirical multi-country analysis and multidimensional plot reveals that the disease-parameter sets of different countries burdened with CCHF are different. This information may help decision makers to select efficient control strategies.

The emerging tick-borne Crimean-Congo haemorrhagic fever virus: A narrative review

Crimean-Congo Haemorrhagic Fever (CCHF) is an increasingly relevant viral zoonosis caused by the negative-sense single-stranded (ss) RNA Crimean-Congo Haemorrhagic Fever Orthonairovirus (CCHFV) (Nairoviridae family, Bunyavirales order). The viral genome is divided into three segments (L-M-S) of distinct size and functions. The infection is generally mediated by a tick vector, in particular belonging to the Hyalomma genus, and the transmission follows a tick-vertebrate-tick ecologic cycle, with asymptomatic infected animals functioning as reservoirs and amplifiers for CCHFV. Human hosts could be infected primarily through infected ticks or by contact with infected hosts or their body fluids and tissues, also in a nosocomial way and in occupational contexts. Infected symptomatic patients generally manifest a nonspecific illness, which progresses across four stages, with possibly lethal outcomes. Disease outbreaks show a widespread geographic diffusion and a highly variable mortality rate, dramatically peaking in untreated patients. The lack of an adequate animal model and the elevated virus biological risk (only manageable under biosafety level 4 conditions) represent strongly limiting factors for a better characterization of the disease and for the development of specific therapies and vaccines. The present review discusses updated information on CCHFV-related disease, including details about the virus (taxonomy, structure, life cycle, transmission modalities) and considering CCHF pathogenesis, epidemiology and current strategies (diagnostic, therapeutic and preventive).

Distribution and prevalence of ticks and tick-borne disease on sheep and cattle farms in Great Britain

INTRODUCTION

The most abundant and widespread tick species in Great Britain, Ixodes ricinus, is responsible for the transmission of a range of pathogens that cause disease in livestock. Empirical data on tick distribution and prevalence are required to inform farm management strategies. However, such data are largely unavailable; previous surveys have been rare and are usually relatively localised.

METHODS

A retrospective questionnaire survey of farmers was used to assess the reported prevalence of ticks on livestock across Great Britain. Spatial scan statistics and kernel density maps were used to assess spatial clustering and identify areas of significantly elevated risk, independent of the underlying distribution of respondents. Logistic regression models were used to identify risk factors for tick presence.

RESULTS

Tick infection risk to livestock is shown to be spatially aggregated, with areas of significantly elevated risk in north Wales, northwest England and western Scotland. Overall, the prevalence of farms reporting tick presence was 13% for sheep farms and 6% for cattle farms, but in "hot spot" clusters prevalence ranged between 48-100%. The prevalence of farms reporting tick-borne disease overall was 6% for sheep and 2% for cattle, but on farms reporting ticks, prevalence was 44% and 33% for sheep and cattle farms, respectively. Upland farming, larger flock sizes, region and the presence of sheep on cattle farms were all significant risk factors for tick presence.

CONCLUSIONS

These data have important implications for assessing both the risk of tick-borne disease in livestock and optimising approaches to disease management. In particular, the study highlights the need for effective livestock tick control in upland regions and the southwest, and provides evidence for the importance of sheep as tick maintenance hosts.

Assessing the role of migratory birds in the introduction of ticks and tick-borne pathogens from African countries: An Italian experience

The continuous flow of billions of birds between Africa and Europe creates an "ecological bridge" between physically remote areas. Migratory birds fly south from their breeding grounds during late summer/fall and fly back in spring. These movements regulate the spread of internal and external parasites, as well as pathogens of potential public health concern. The aim of the present study was to investigate the possible introduction of exotic tick species and tick-borne pathogens into Europe via migratory birds. At the bird observatory of Ventotene island (Italy), 443 feeding ticks were collected from 249 birds captured and ringed during their northbound migration in spring 2013. Each tick was identified by morphological and molecular methods and then tested for bacterial and viral pathogens: Borrelia burgdorferi s.l., Rickettsia spp., Ehrlichia ruminantium and Coxiella burnetii, Crimean Congo haemorrhagic fever virus (CCHFV) and Flavivirus. Morphological and molecular identification confirmed Hyalomma rufipes as the most abundant species among the collected arthropods (366/443; 82.6%) followed by Hyalomma marginatum (10/433; 2.3%). Rickettsia aeschlimannii was identified in 158 ticks, while one engorged Amblyomma variegatum nymph was infected with Rickettsia africae. The other bacteria were not detected in any specimen. Among viruses, RNA belonging to West Nile virus and other Flavivirus were detected whereas all ticks were negative for CCHFV RNA. These results confirm how migratory birds play a role in carrying Rickettsia-infected ticks, as well as viruses of zoonotic importance, from Africa into Europe. To what extent tick species are capable of establishing a permanent population once introduced in naïve areas, is far from defined and deserve further investigation.

Hyalomma rufipes on an untraveled horse: Is this the first evidence of Hyalomma nymphs successfully moulting in the United Kingdom?

During September 2018, a tick was submitted to Public Health England's Tick Surveillance Scheme for identification. The tick was sent from a veterinarian who removed it from a horse in Dorset, England, with no history of overseas travel. The tick was identified as a male Hyalomma rufipes using morphological and molecular methods and then tested for a range of tick-borne pathogens including; Alkhurma virus, Anaplasma, Babesia, Bhanja virus, Crimean-Congo Haemorrhagic fever virus, Rickettsia and Theileria. The tick tested positive for Rickettsia aeschlimannii, a spotted fever group rickettsia linked to a number of human cases in Africa and Europe. This is the first time H. rufipes has been reported in the United Kingdom (UK), and the lack of travel by the horse (or any in-contact horses) suggests that this could also be the first evidence of successful moulting of a Hyalomma nymph in the UK. It is postulated that the tick was imported into the UK on a migratory bird as an engorged nymph which was able to complete its moult to the adult stage and find a host. This highlights that passive tick surveillance remains an important method for the detection of unusual species that may present a threat to public health in the UK. Horses are important hosts of Hyalomma sp. adults in their native range, therefore, further surveillance studies should be conducted to check horses for ticks in the months following spring bird migration; when imported nymphs may have had time to drop off their avian host and moult to adults. The potential human and animal health risks of such events occurring more regularly are discussed.

Crimean-Congo hemorrhagic fever and expansion from endemic regions

Crimean-Congo hemorrhagic fever (CCHF) is a virus-mediated hemorrhagic disease that occurs over a wide geographic region. In recent years, a variety of active and passive surveillance networks have improved our knowledge of areas with existing circulation of Crimean-Congo hemorrhagic fever virus (CCHFV), the etiologic agent of CCHF. These investigations aid in better defining the distribution of the virus. Expansion of a virus into new areas can occur through a variety of means, including introduction of infected humans, vectors, or animals. Here, these potential contributors to expansion of CCHFV into neighboring countries and geographically distant locations are reviewed, and the likelihood and possible implications of these events, based on known characteristics of the virus and its natural maintenance and transmission cycles are explored. Furthermore, this report discusses limitations in the currently described distribution of CCHFV, and the challenges in assessing viral circulation identified in a new region as geographic expansion of the virus.

Assessment of the Public Health Threats Posed by Vector-Borne Disease in the United Kingdom (UK)

In recent years, the known distribution of vector-borne diseases in Europe has changed, with much new information also available now on the status of vectors in the United Kingdom (UK). For example, in 2016, the UK reported their first detection of the non-native mosquito Aedes albopictus, which is a known vector for dengue and chikungunya virus. In 2010, Culex modestus, a principal mosquito vector for West Nile virus was detected in large numbers in the Thames estuary. For tick-borne diseases, data on the changing distribution of the Lyme borreliosis tick vector, Ixodes ricinus, has recently been published, at a time when there has been an increase in the numbers of reported human cases of Lyme disease. This paper brings together the latest surveillance data and pertinent research on vector-borne disease in the UK, and its relevance to public health. It highlights the need for continued vector surveillance systems to monitor our native mosquito and tick fauna, as well as the need to expand surveillance for invasive species. It illustrates the importance of maintaining surveillance capacity that is sufficient to ensure accurate and timely disease risk assessment to help mitigate the UK's changing emerging infectious disease risks, especially in a time of climatic and environmental change and increasing global connectivity.

Potential risk posed by the importation of ticks into the UK on animals: records from the Tick Surveillance Scheme

In order to monitor important tick vectors in the UK, Public Health England's Tick Surveillance Scheme (TSS) receives specimens from across the country for identification. In recent years, an increasing number of these specimens have been removed from animals with a recent history of travel outside the UK. This paper presents all data collated by the TSS on ticks entering the country on recently travelled or imported animals since surveillance commenced in 2005. Ten different tick species representing six different genera were identified, entering the UK from 15 different countries. Key themes appear to be emerging from the last 10 years of data, including canine travel from Cyprus and Spain being associated with Rhipicephalus sanguineus importation, and canine travel from France being associated with the importation of multiple tick species and canine illness. In addition, more unusual importation routes have been uncovered, such as the importation of Hyalomma lusitanicum on a dog. Some companion animal owners may not be fully aware of the risks associated with ticks, and may not seek advice from a veterinarian before travel or importing a pet. Promoting awareness of ticks and tickborne disease risk during and after travel or animal importation is needed and veterinarians play an importation role in disseminating this information to their clients.

Distribution of the tick Dermacentor reticulatus in the United Kingdom

The recent implication of Dermacentor reticulatus (Ixodida: Ixodidae) in the transmission of canine babesiosis in the U.K. has highlighted the lack of accurate published data on its distribution in this country. This paper aims to collate and appraise historical data for D. reticulatus, to supplement such data with more recent surveillance data and to report on field sampling conducted during 2009-2016. These updated data facilitate better understanding of the current distribution of this tick in the U.K., which will better inform disease risk assessments. There appear to be four known regions of the U.K. in which D. reticulatus currently occurs, including western Wales, North and South Devon, and Essex. The majority of foci are located in coastal sand dunes and maritime grasslands, including grazing marsh. However, more recently the tick has been detected in urban greenspace in Essex. The emergence of this tick as a vector of babesiosis in the U.K. and its recent apparent spread in Essex into urban greenspace highlight the need for continued surveillance and for further research into its status as a vector of human and veterinary pathogens.

Rhipicephalus sanguineus importation into the UK: surveillance, risk, public health awareness and One Health response

As part of Public Health England's assessment of vectorborne disease risk to public health in the UK, tick specimens are regularly submitted by veterinarians for identification via the Tick Surveillance Scheme. Recently, a number of these specimens have been identified as the brown dog tick, Rhipicephalus sanguineus This species is non-endemic to the UK and presents a risk to both human and animal health due to its role in the transmission of various tickborne pathogens. Although current climatic conditions in the UK are unlikely to permit the survival of this species outdoors, indoor infestations can occur and this can present a risk of disease transmission within an infested property. This paper documents 40 importation events involving R sanguineus on recently travelled or imported dogs into the UK since 2012. It also provides details of the response following these detections in line with the One Health concept. With the increasing number of dogs travelling or being imported, it is likely that importation and infestation events in the UK will continue and may result in pathogen transmission. It is therefore important to raise awareness of this risk and share lessons learned to improve our prevention and response strategies to this emerging issue.

Canine babesiosis and tick activity monitored using companion animal electronic health records in the UK

Recent publications highlighting autochthonous Babesia canis infection in dogs from Essex that have not travelled outside the UK are a powerful reminder of the potential for pathogen emergence in new populations. Here the authors use electronic health data collected from two diagnostic laboratories and a network of 392 veterinary premises to describe canine Babesia cases and levels of Babesia concern from January 2015 to March 2016, and the activity of ticks during December 2015–March 2016. In most areas of the UK, Babesia diagnosis in this population was rare and sporadic. In addition, there was a clear focus of Babesia cases in the affected area in Essex. Until February 2016, analysis of health records indicated only sporadic interest in Babesia largely in animals coming from overseas. Following media coverage in March 2016, there was a spike in owner concern that was geographically dispersed beyond the at-risk area. Tick activity (identified as ticks being removed from animals in veterinary consultations) was consistent but low during the period preceding the infections (<5 ticks/10,000 consultations), but increased in March. This highlights the use of electronic health data to describe rapidly evolving risk and concern that follows the emergence of a pathogen.

Tick pests and vectors (Acari: Ixodoidea) in European towns: Introduction, persistence and management

Ticks have always been a part of fauna in and around human settlements, and their significance changed concurrently with the enlargement of settlements and their transformation into towns. The increased rate of urbanization during the last decades has created a new reality for tick existence. Two groups of ticks are of major concern for modern towns: those living under natural conditions of urban surroundings and those well-adapted to urban conditions. During the process of urbanization, encroachment into forested and uncultivated areas as well as protection of existing green spaces create opportunities for ticks living in nature to also exist under urban and suburban conditions. Conditions of modern urban and especially suburban environment in developed European countries adequately meet tick requirements. Tick species having an advantage in urban areas are those that can use one and the same host at all parasitic stages, can starve for a prolonged time, can use either urban pests or domesticated animals as hosts, and can live in man-made buildings. The ticks of the Argas reflexus group (Argasidae) and the brown dog tick Rhipicephalus sanguineus (Ixodidae) comply with practically all conditions necessary for successful survival in urban areas. The ability of ticks to transmit numerous human and animal pathogens and the presence of many reservoir hosts in urban and suburban areas create persistent danger for human populations and domestic animals. Impact on urban ticks should be directed against the two major requirements of tick existence: reducing populations of potential tick hosts (feral pigeons, stray dogs and cats, and urban rodents), and changing other environmental conditions to make them less suitable for ticks. It is especially important that urban inhabitants be properly informed about the danger posed by ticks, the sites of possible tick attacks, and basic self-protection techniques.

Spotted fever group rickettsiae in Dermacentor reticulatus and Haemaphysalis punctata ticks in the UK

Background

Spotted fever group (SFG) rickettsiae have recently been identified for the first time in UK ticks. This included the findings of Rickettsia helvetica in Ixodes ricinus and Rickettsia raoultii in Dermacentor reticulatus. This paper further investigates the occurrence of SFG rickettsiae in additional geographically distinct populations of D. reticulatus, and for the first time, investigates the occurrence of SFG rickettsiae in UK populations of Haemaphysalis punctata ticks.

Methods

Questing D. reticulatus and H. punctata were collected at a number of sites in England and Wales. DNA from questing ticks was extracted by alkaline lysis and detection of rickettsiae DNA was performed, in addition to detection of A. phagocytophilum, N. mikurensis, C. burnetii and B. burgdorferi sensu lato.

Results

This paper builds on previous findings to include the detection of spotted fever Rickettsia which showed the highest homology to Rickettsia massiliae in Haemaphysalis punctata, as well as R. helvetica in D. reticulatus. The occurrence of SFG rickettsiae in D. reticulatus in the UK appears to be confined only to Welsh and Essex populations, with no evidence so far from Devon. Similarly, the occurrence of SFG rickettsiae in H. punctata appears confined to one of two farms known to be infested with this tick in North Kent, with no evidence so far from the Sussex populations. Anaplasma phagocytophilum, Neoehrlichia mikurensis, Coxiella burnetii and Borrelia burgdorferi sensu lato DNA was not detected in any of the ticks.

Conclusion

These two tick species are highly restricted in their distribution in England and Wales, but where they do occur they can be abundant. Following detection of these SFG rickettsiae in additional UK tick species, as well as I. ricinus, research should now be directed towards clarifying firstly the geographic distribution of SFG rickettsiae in UK ticks, and secondly to assess the prevalence rates in ticks, wild and domesticated animals and humans to identify the drivers for disease transmission and their public health significance.

Prevalence, distribution and risk associated with tick infestation of dogs in Great Britain

Current concerns over the potential impacts of climate change and the increased movement between countries of people and companion animals on the distribution of ectoparasites, highlight the need for accurate understanding of existing prevalence patterns. Without these future changes will not be detected. Here, the distribution and prevalence of tick infestations of domestic dogs in Great Britain were examined. A total of 173 veterinary practices were recruited to monitor tick attachment to dogs in their local areas between March and October 2009. Practices selected five dogs at random each week from those brought to the surgery and undertook a thorough, standardized examination for ticks. Each veterinary practice participated for 3 months before being replaced. Any ticks identified were collected and a sample sent to the investigators for identification, along with a clinical history of the dog. A total of 3534 dogs were examined; 810 dogs were found to be carrying at least one tick. Ixodes ricinus (Linnaeus) (Acari: Ixodidae) was identified in 72.1% of cases, Ixodes hexagonus Leach in 21.7% and Ixodes canisuga Johnston in 5.6% of cases. Five samples of Dermacentor reticulatus (Fabricius) (Acari: Ixodidae) were also found, adding to the growing evidence that an established population of D. reticulatus now exists in south-eastern England. Almost all the ticks found were adults. Overall, 19.2% of the veterinary practices reported no tick detections, 50% reported that ≥14.9% of the dogs seen were infested and 14.6% reported that >50% of the dogs inspected carried ticks. The estimated incidence of tick attachment was 0.013 per day in March (lowest) and 0.096 per day in June (highest). A number of risk factors affected the likelihood of tick attachment on dogs. Gundog, terrier and pastoral breed groups were more likely to carry ticks, as were non-neutered dogs. Dogs with shorter hair were less likely to have ticks, and dogs were most likely to carry a tick in June. This study is of value because, unusually, it presents the results of a randomized sample of dogs and gives a prevalence which is higher than those previously recorded in Great Britain.

First detection of spotted fever group rickettsiae inIxodes ricinusandDermacentor reticulatusticks in the UK

A preliminary study was conducted to determine the presence of spotted fever rickettsiae in two species of British tick (Ixodes ricinusandDermacentor reticulatus). The 16S rRNA gene ofRickettsiaspp. was detected in 39/401 (9·7%) of ticks tested, including 22/338 (6·5%)I. ricinusand 17/63 (27%)D. reticulatus. Some positiveI. ricinussamples showed 100% homology withRickettsia helvetica(10/22), and most positiveD. reticulatusshowed 100% homology withR. raoultii(13/17). Five otherRickettsiaspp. were detected exhibiting 96–99% homology. Ticks positive for rickettsiae were collected from various hosts and from vegetation from eight counties across Great Britain. The distribution ofR. helveticain various engorged and unfed stages ofI. ricinussuggests thatR. helveticais widespread.R. raoultiiwas found in questing adultD. reticulatusin Wales and England. This is the first evidence of potentially pathogenic spotted fever rickettsiae in British ticks.

Tick surveillance in Great Britain

The ability for public/veterinary health agencies to assess the risks posed by tick-borne pathogens is reliant on an understanding of the main tick vector species. Crucially, the status, distribution, and changing trends in tick distribution and abundance are implicit requirements of any risk assessment; however, this is contingent on the quality of tick distribution data. Since 2005 the Health Protection Agency has promoted an enhanced tick surveillance program. Through engagement with a variety of public and veterinary health agencies and practitioners (e.g., clinicians and veterinarians), wildlife groups (deer society, zoos, animal refuge centers, and academics), and amateur entomologists, >4000 ticks from 900 separate records across Great Britain have been submitted, representing 14 tick species (Ixodes ricinus, Ixodes hexagonus, Ixodes acuminatus, Ixodes arboricola, Ixodes canisuga, Ixodes frontalis, Ixodes lividus, Ixodes trianguliceps, Ixodes ventalloi, Carios vespertilionis, Dermacentor reticulatus, Haemaphysalis punctata, Hyalomma marginatum, and Amblyomma species). The majority of ticks submitted were I. ricinus (81%), followed by I. hexagonus (10%) and I. frontalis (2.5%). Predominant host groups include companion animals (411 records), humans (198 records), wild birds (111 records), and large wild mammals (88 records), with records also from small/medium wild mammals, livestock, the environment and domestic/aviary birds. The scheme has elucidated the detection of two nonnative tick species, the expansion of previously geographically restricted D. reticulatus and produced ground data on the spread of I. ricinus in southwest England. It has also provided a forum for submission of ticks from the concerned public and particularly those infected with Lyme borreliosis, thus raising awareness among public health agencies of the increased peri-urban tick problem in Britain. Our results demonstrate that it is possible to run a cost-effective nationwide surveillance program to successfully monitor endemic tick species, identify subtle changes in their distribution, and detect the arrival and presence of exotic species.

Ecological approaches to informing public health policy and risk assessments on emerging vector-borne zoonoses

Pathogens associated with vector-borne zoonoses occur in enzootic cycles within nature. They are driven by a combination of vertebrate host and invertebrate vector population dynamics, which in turn respond to changes in environmental stimuli. Human involvement in these cycles, and hence the occurrence of human disease, is often to act as incidental host. From a public health perspective our ability to better predict human outbreaks of these diseases and prepare intervention and mitigation strategies relies on understanding the natural cycle of pathogen transmission. This requires consideration of, for example, invertebrate and vertebrate ecology and biology, climatology, land use and habitat change. Collectively, these can be referred to as medical entomology and medical ecology. This article reviews the importance for inclusion of such disciplines when assessing the public health risk from vector-borne zoonoses and summarizes the possible future challenges and driving forces for changes in vector status and vector-borne zoonoses emergence, with a particular focus on a UK and European context.

The feasibility of developing a risk assessment for the impact of climate change on the emergence of Crimean-Congo haemorrhagic fever in livestock in Europe: a review

Crimean-Congo haemorrhagic fever virus (CCHFV) is one of the most widespread of all medically important arboviruses with ticks of the Hyalomma spp. serving as the main vectors. Infection of livestock by CCHFV serves as a route of exposure to humans, as a reservoir of disease and as a route of importation. This study discusses the pathways and data requirements for a qualitative risk assessment for the emergence of CCHFV in livestock in Europe. A risk map approach is proposed based on layers that include the potential routes of release (e.g. by migrating birds carrying infected ticks) together with the main components for exposure, namely the distributions of the tick vectors, the small vertebrate host reservoirs and the livestock. A layer on landscape fragmentation serves as a surrogate for proximity of livestock to the tick cycle. Although the impact of climate change on the emergence of CCHF is not clear, comparing the distribution of risk factors in each layer currently with those predicted in the 2080s with climate change can be used to speculate how potential high-risk areas may shift. According to the risk pathway, transstadial and/or transovarial transmission in the tick vector are crucial for CCHFV spread. Vector competence and tick vector switching, however, remain critical factors for CCHFV colonization of new regions in Europe. The species of migratory bird is also an important consideration in the release assessment with greater abundance and biodiversity of ground-dwelling birds in southern Europe than in northern Europe.