Tick-Borne Encephalitis Virus and Its European Distribution in Ticks and Endothermic Mammals

Ecological and environmental factors affecting the risk of tick-borne encephalitis in Europe, 2017 to 2021

BackgroundTick-borne encephalitis (TBE) is a disease which can lead to severe neurological symptoms, caused by the TBE virus (TBEV). The natural transmission cycle occurs in foci and involves ticks as vectors and several key hosts that act as reservoirs and amplifiers of the infection spread. Recently, the incidence of TBE in Europe has been rising in both endemic and new regions.AimIn this study we want to provide comprehensive understanding of the main ecological and environmental factors that affect TBE spread across Europe.MethodsWe searched available literature on covariates linked with the circulation of TBEV in Europe. We then assessed the best predictors for TBE incidence in 11 European countries by means of statistical regression, using data on human infections provided by the European Surveillance System (TESSy), averaged between 2017 and 2021.ResultsWe retrieved data from 62 full-text articles and identified 31 different covariates associated with TBE occurrence. Finally, we selected eight variables from the best model, including factors linked to vegetation cover, climate, and the presence of tick hosts.DiscussionThe existing literature is heterogeneous, both in study design and covariate types. Here, we summarised and statistically validated the covariates affecting the variability of TBEV across Europe. The analysis of the factors enhancing disease emergence is a fundamental step towards the identification of potential hotspots of viral circulation. Hence, our results can support modelling efforts to estimate the risk of TBEV infections and help decision-makers implement surveillance and prevention campaigns.

The Consumption of Raw Goat Milk Resulted in TBE in Patients in Poland, 2022 "Case Report"

The alimentary route is the second most important route of tick-borne encephalitis infection. In Poland, the last TBE case due to the consumption of unpasteurized milk or dairy products of infected animals was recorded in 2017 as the fourth documented outbreak of TBEV infection in the country. In this study, two patients infected with TBEV through consumption of unpasteurized goat's milk from one source are described from a cluster of eight cases. In August and September 2022, a 63- and 67-year-old woman were hospitalized at the Infectious Diseases Clinic of the Institute of Rural Health (Lublin, Poland). The patients denied been recently bitten by a tick, and neither had been vaccinated against TBEV. The disease had a biphasic course. In the first case, the patient suffered from a fever, spine pain, and muscle weakness and paresis of the lower left limb. The second patient suffered from fever, vertigo, headaches, abdominal pain, and diarrhoea. The results of IgM and IgG antibodies were positive in both cases. After three weeks hospitalization, the patients were discharged in good condition. In one case, slight hearing impairment was observed. Vaccination and avoiding the consumption of unpasteurized milk remain the most effective ways to prevent tick-borne encephalitis.

Editorial for the Special Issue: “Tick-Borne Encephalitis”

Tick-borne encephalitis (TBE) is a disease caused by the tick-borne encephalitis virus (TBEV) [...]

Raccoons contraband - The metazoan parasite fauna of free-ranging raccoons in central Europe

The invasive raccoon (Procyon lotor) is an abundant carnivore and considered as an important potential vector of infectious diseases and parasites in Europe. Raccoons show a broad, opportunistic, omnivorous food spectrum. Food supply and habitat quality in urban areas are very attractive for the generalist raccoon. This inevitably leads to increased interaction with humans, domestic animals and livestock, making the raccoon a potentially suitable zoonosis vector. In its autochthonous range, especially in the Eastern and Midwestern United States, the raccoon has been studied very intensively since the beginning of the 20th century. Whereas, basic field biology and parasitology studies in Germany and Europe are lacking and have only been conducted sporadically, regionally and on small sample sizes. In the presented study 234 raccoons from central Germany were comprehensively examined for their metazoan parasite fauna. The present study shows for the first time an extremely diverse parasite fauna in raccoons outside their native range and proves their essential role as intermediate hosts and hosts for ecto- and endoparasites. A total of 23 different parasite species were identified, five of which are human pathogens, 14 of which are new for the parasite fauna of raccoons in Europe. The human pathogenic raccoon roundworm Baylisascaris procyonis is the most common parasite species in this study, with a prevalence of up to 95%. The digenetic trematode Plagiorchis muris, another human pathogenic parasite species, was detected for the first time in raccoons. The ongoing spread of invasive carnivores and the associated spread and transmission of their parasites and other pathogens increases the potential health risk of wild and farmed animals as well as humans. An increase in parasitic diseases in humans (e.g. raccoon roundworm) is to be expected, especially in urban areas, where raccoons are becoming more and more abundant.

A Scoping Review of Species Distribution Modeling Methods for Tick Vectors

Background

Globally, tick-borne disease is a pervasive and worsening problem that impacts human and domestic animal health, livelihoods, and numerous economies. Species distribution models are useful tools to help address these issues, but many different modeling approaches and environmental data sources exist.

Objective

We conducted a scoping review that examined all available research employing species distribution models to predict occurrence and map tick species to understand the diversity of model strategies, environmental predictors, tick data sources, frequency of climate projects of tick ranges, and types of model validation methods.

Design

Following the PRISMA-ScR checklist, we searched scientific databases for eligible articles, their references, and explored related publications through a graphical tool (www.connectedpapers.com). Two independent reviewers performed article selection and characterization using a priori criteria.

Results

We describe data collected from 107 peer-reviewed articles that met our inclusion criteria. The literature reflects that tick species distributions have been modeled predominantly in North America and Europe and have mostly modeled the habitat suitability for Ixodes ricinus (n = 23; 21.5%). A wide range of bioclimatic databases and other environmental correlates were utilized among models, but the WorldClim database and its bioclimatic variables 1–19 appeared in 60 (56%) papers. The most frequently chosen modeling approach was MaxEnt, which also appeared in 60 (56%) of papers. Despite the importance of ensemble modeling to reduce bias, only 23 papers (21.5%) employed more than one algorithm, and just six (5.6%) used an ensemble approach that incorporated at least five different modeling methods for comparison. Area under the curve/receiver operating characteristic was the most frequently reported model validation method, utilized in nearly all (98.9%) included studies. Only 21% of papers used future climate scenarios to predict tick range expansion or contraction. Regardless of the representative concentration pathway, six of seven genera were expected to both expand and retract depending on location, while Ornithodoros was predicted to only expand beyond its current range.

Conclusion

Species distribution modeling techniques are useful and widely employed tools for predicting tick habitat suitability and range movement. However, the vast array of methods, data sources, and validation strategies within the SDM literature support the need for standardized protocols for species distribution and ecological niche modeling for tick vectors.

Unexpected TBEV Seropositivity in Serbian Patients Who Recovered from Viral Meningitis and Encephalitis

The tick-borne encephalitis virus (TBEV) causes a life-threatening disease named Tick-borne encephalitis (TBE). The clinical symptoms associated with TBE range from non-specific to severe inflammation of the central nervous system and are very similar to the clinical presentation of other viral meningitis/encephalitis. In consequence, TBE is often misclassified by clinical physicians, mainly in the non-identified high-risk areas where none or only a few TBE cases have been reported. Considering this situation, we hypothesized that among persons from northern Serbia who recovered from viral meningitis or encephalitis, there would be evidence of TBEV infection. To test this hypothesis, in this observational study, we evaluated the seroreactivity against TBEV antigens in patients from northern Serbia who were hospitalized due to viral meningitis and/or viral encephalitis of unknown etiology. Three cases of seroreactivity to TBEV antigens were discovered among convalescent patients who recovered from viral meningitis and/or encephalitis and accepted to participate in the study (n = 15). The clinical and laboratory findings of these patients overlap with that of seronegative convalescent patients. Although TBE has been a notifiable disease in Serbia since 2004, there is no active TBE surveillance program for the serologic or molecular screening of TBEV infection in humans in the country. This study highlights the necessity to increase the awareness of TBE among physicians and perform active and systematic screening of TBEV antibodies among patients with viral meningitis and/or encephalitis.

Geo-Spatial Characteristics of 567 Places of Tick-Borne Encephalitis Infection in Southern Germany, 2018-2020

Tick-borne encephalitis (TBE) is a growing public health problem with increasing incidence and expanding risk areas. Improved prevention requires better understanding of the spatial distribution and ecological determinants of TBE transmission. However, a TBE risk map at sub-district level is still missing for Germany. We investigated the distribution and geo-spatial characteristics of 567 self-reported places of probable TBE infection (POI) from 359 cases notified in 2018-2020 in the study area of Bavaria and Baden-Wuerttemberg, compared to 41 confirmed TBE foci and 1701 random comparator places. We built an ecological niche model to interpolate TBE risk to the entire study area. POI were distributed heterogeneously at sub-district level, as predicted probabilities varied markedly across regions (range 0-93%). POI were spatially associated with abiotic, biotic, and anthropogenic geo-spatial characteristics, including summer precipitation, population density, and annual frost days. The model performed with 69% sensitivity and 63% specificity at an optimised probability threshold (0.28) and an area under the curve of 0.73. We observed high predictive probabilities in small-scale areas, consistent with the known circulation of the TBE virus in spatially restricted microfoci. Supported by further field work, our findings may help identify new TBE foci. Our fine-grained risk map could supplement targeted prevention in risk areas.

The evolving story of Borrelia burgdorferi sensu lato transmission in Europe

Beside mosquitoes, ticks are well-known vectors of different human pathogens. In the Northern Hemisphere, Lyme borreliosis (Eurasia, LB) or Lyme disease (North America, LD) is the most commonly occurring vector-borne infectious disease caused by bacteria of the genus Borrelia which are transmitted by hard ticks of the genus Ixodes. The reported incidence of LB in Europe is about 22.6 cases per 100,000 inhabitants annually with a broad range depending on the geographical area analyzed. However, the epidemiological data are largely incomplete, because LB is not notifiable in all European countries. Furthermore, not only differ reporting procedures between countries, there is also variation in case definitions and diagnostic procedures. Lyme borreliosis is caused by several species of the Borrelia (B.) burgdorferi sensu lato (s.l.) complex which are maintained in complex networks including ixodid ticks and different reservoir hosts. Vector and host influence each other and are affected by multiple factors including climate that have a major impact on their habitats and ecology. To classify factors that influence the risk of transmission of B. burgdorferi s.l. to their different vertebrate hosts as well as to humans, we briefly summarize the current knowledge about the pathogens including their astonishing ability to overcome various host immune responses, regarding the main vector in Europe Ixodes ricinus, and the disease caused by borreliae. The research shows, that a higher standardization of case definition, diagnostic procedures, and standardized, long-term surveillance systems across Europe is necessary to improve clinical and epidemiological data.

Maps of ticks (Acari: Argasidae, Ixodidae) for Austria and South Tyrol, Italy

A first compilation of georeferenced tick locations in Austria and South Tyrol, Italy, is presented here. This allows the tick fauna to be examined in the various climatic regions of the European Alps. The dataset comprises 424 tick locations of Austria and 48 tick locations of South Tyrol, which were digitized from literature and visualized in the form of geographical maps. The tick fauna of Austria includes two species of Argasidae in the genera Argas and Carios and 15 species of Ixodidae in the genera Dermacentor, Haemaphysalis, and Ixodes, altogether 17 tick species. In addition, two species of Ixodidae in the genera Hyalomma (each spring imported by migratory birds) and Rhipicephalus (occasionally imported by dogs returning from abroad with their owners) are included in the tick atlas. Of these, the georeferenced locations of 18 tick species are depicted in maps. The occurrence of the one remaining tick species, Ixodes inopinatus, is given at the level of the federal states. The first Austrian distribution map of the long-legged bat tick Ixodes vespertilionis, which was reported from 21 caves, deserves special mention. The most common and widespread tick species is Ixodes ricinus, with records in all nine federal states of Austria, followed by Ixodes canisuga, Ixodes hexagonus, and I. vespertilionis in six federal states each. Haemaphysalis concinna and Dermacentor reticulatus are only endemic in the eastern plains, while Dermacentor marginatus only occurs in the west, in the Tyrolean Alpine valleys. Eight tick species were reported from South Tyrol, Italy. There, the most frequently flagged tick from the vegetation is also I. ricinus, while D. marginatus and Haemaphysalis punctata are often collected from sheep. The locations are shown together with those from North and East Tyrol on a separate Tyrol map. The tick atlas in Austria and South Tyrol as well as the underlying digital dataset in the supplement contribute to the closing of data gaps in global distribution maps of ticks and improve the data basis for new species distribution models.

New and Confirmed Foci of Tick-Borne Encephalitis Virus (TBEV) in Northern Germany Determined by TBEV Detection in Ticks

Tick-borne encephalitis (TBE) is a tick-transmitted, virus-induced neurological disease with potentially fatal outcomes in humans and animals. Virus transmission takes places in so-called tick-borne encephalitis virus (TBEV) microfoci, which constitute small areas of sustained virus circulation. In southern Germany, TBEV has been endemic for decades; however, a northward expansion of risk areas, based on disease incidence in the human population, has been observed in recent years. The present study investigated TBEV occurrence in questing ticks at eight locations in the federal state of Lower Saxony, northwestern Germany, chosen due to reported associations with human TBE cases (N = 4) or previous virus detection (N = 4). A total of 20,056 ticks were collected in 2020 and 2021 and tested for TBEV RNA in pools of ten nymphs or five adults by quantitative reverse transcription-PCR (RT-qPCR). Positive results were confirmed by RT amplification of the viral E gene. In total, 18 pools from five different sampling locations were positive for TBEV RNA. One previously unknown transmission focus was detected, while ongoing virus circulation was confirmed at the four further locations. Phylogenetic analysis showed that two different virus strains with different origins circulate in the locations identified as natural foci.

Incidence and occurrence of tick-borne encephalitis and neuroborreliosis in Germany

Given the nationwide distribution of the vector, Ixodes ricinus, both neuroborreliosis and tick-borne encephalitis (TBE) might be expected to occur throughout Germany. However, cases of neuroborreliosis and TBE have so far only been reported in certain German states and counties. The aim of this survey therefore was to investigate the possible occurrence of TBE in regions not designated as known risk areas and the spread and incidence of neuroborreliosis throughout Germany. Data were collected by means of a questionnaire which was sent to 305 neurological clinics in Germany. Only twenty-two of them (7.2%) participated in a prospective, and 52 (17%) in a retrospective survey, therefore the significance of the study is limited. Cases of TBE were detected in five counties (Barnim, Dessau-Roßlau, Western Pomerania-Ruegen, Saarbruecken, Uckermark) that were not known so far as areas of risk according to the definition of the German Robert-Koch-Institute (RKI). The median incidence of TBE in various counties was 1.24 cases with a range from 0.19 to 20 cases per 100,000 inhabitants/year. Illnesses from neuroborreliosis were reported from all 61 counties, where clinics participated in the study. The incidence here varied between 0.19 and 23.4 cases with a median of 3.0 cases per 100,000 inhabitants/year. In areas where both diseases occurred, their incidence differed greatly from each other. The survey shows the occurrence of TBE in several counties in eastern Germany that are not defined as risk areas by the RKI and an incidence of neuroborreliosis in Germany that is significantly higher than reported to the public health authorities.

Bulk Milk Tank Samples Are Suitable to Assess Circulation of Tick-Borne Encephalitis Virus in High Endemic Areas

A reliable surveillance strategy of tick-borne encephalitis virus (TBEV) is necessary to ensure adequate disease control measures. However, current approaches assessing geographical TBEV circulation are ineffective or have significant limitations. In this study we investigated a total of 1363 goat and 312 sheep bulk tank milk samples for the presence of TBEV. Samples were collected from systematically selected farms in Lithuania every 4–5 days from April to November in 2018 and 2019. To validate results, we additionally tested 2685 questing ticks collected in the vicinity of milk collection sites. We found 4.25% (95% CI 3.25–5.47) and 4.48% (95% CI 2.47–7.41) goat and sheep milk samples to be positive for TBEV, respectively. Furthermore, geographical distribution of TBEV in milk samples coincided with the known TBE endemic zone and was correlated with incidence of TBE in humans in 2019. When sampling time coincides, TBEV detection in milk samples is as good a method as via flagged ticks, however bulk milk samples can be easier to obtain more frequently and regularly than tick samples. The minimal infectious rate (MIR) in ticks was 0.34% (CI 95% 0.15–0.64). Therefore, our results confirm that testing milk serves as a valuable tool to investigate the spatial distribution of TBEV at higher resolution and lower cost.

Ticks on the turf: investigating the presence of ixodid ticks on and around football fields in Germany

Ixodes ricinus is the most abundant tick species and an important vector of pathogens in Germany and in large parts of Europe. A few other ixodid tick species, e.g., Dermacentor reticulatus, may also be of eco-epidemiological relevance. As ticks are not only found in natural but also in suburban areas (parks, gardens), the present study investigated whether ticks occur on and near football grounds thus posing a potential risk to players and visitors. Thirty-two football grounds from all 16 German federal states were selected, mainly situated adjacent to a green area (forest, park). Ticks were collected by the conventional flagging method in spring 2018, and nymphs and adults were counted and morphologically determined. Altogether 807 nymphal and adult ticks were collected from 29 football grounds: 714 I. ricinus, 64 Ixodes inopinatus, 2 Ixodes frontalis, 24 Ixodes sp. ticks, and 3 D. reticulatus. Ixodes inopinatus was found in 13 out of 16 German states. Three ticks were even found on the turf of two football fields. It can be concluded that ticks occur quite frequently and sometimes in high abundance near football grounds situated close or adjacent to a forest or a park.

Vectors of disease at the northern distribution limit of the genus Dermacentor in Eurasia: D. reticulatus and D. silvarum

The two ixodid tick species Dermacentor reticulatus (Fabricius) and Dermacentor silvarum Olenev occur at the northern distribution limit of the genus Dermacentor in Eurasia, within the belt of [Formula: see text] latitude. Whilst the distribution area of D. reticulatus extends from the Atlantic coast of Portugal to Western Siberia, that of D. silvarum extends from Western Siberia to the Pacific coast. In Western Siberia, the distribution areas of the two Dermacentor species overlap. Although the two tick species are important vectors of disease, detailed information concerning the entire distribution area, climate adaptation, and proven vector competence is still missing. A dataset was compiled, resulting in 2188 georeferenced D. reticulatus and 522 D. silvarum locations. Up-to-date maps depicting the geographical distribution and climate adaptation of the two Dermacentor species are presented. To investigate the climate adaptation of the two tick species, the georeferenced locations were superimposed on a high-resolution map of the Köppen-Geiger climate classification. The frequency distribution of D. reticulatus under different climates shows two major peaks related to the following climates: warm temperate with precipitation all year round (57%) and boreal with precipitation all year round (40%). The frequency distribution of D. silvarum shows also two major peaks related to boreal climates with precipitation all year round (30%) and boreal winter dry climates (60%). Dermacentor silvarum seems to be rather flexible concerning summer temperatures, which can range from cool to hot. In climates with cool summers D. reticulatus does not occur, it prefers warm and to a lesser extent hot summers. Lists are given in this paper for cases of proven vector competence for various agents of both Dermacentor species. For the first time, the entire distribution areas of D. reticulatus and D. silvarum were mapped using georeferenced data. Their climate adaptations were quantified by Köppen profiles.