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. 2023 Oct;28(42):2300121.
doi: 10.2807/1560-7917.ES.2023.28.42.2300121.

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

Francesca Dagostin  1 , Valentina Tagliapietra  1 , Giovanni Marini  1 , Claudia Cataldo  2 , Maria Bellenghi  2 , Scilla Pizzarelli  3 , Rosaria Rosanna Cammarano  3 , William Wint  4 , Neil S Alexander  4 , Markus Neteler  5 , Julia Haas  5 , Timothée Dub  6 , Luca Busani  2 , Annapaola Rizzoli  1
Affiliations

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

Francesca Dagostin et al. Euro Surveill. 2023 Oct.

Abstract

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.

Keywords: Covariates; Europe; Incidence; Modelling; Tick-Borne Encephalitis; Vector-Borne Diseases.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Main characteristics of included studies on factors affecting the risk of tick-borne encephalitis, EU/EEA, 2000–2021 (n = 62)
Figure 2
Figure 2
Mean tick-borne encephalitis incidence in the 380 NUTS regions selected for analysis, EU/EEA, 2017–2021
Figure 3
Figure 3
Best model conditional predictions of factors affecting the risk of tick-borne encephalitis, EU/EEA, 2000–2021
See this image and copyright information in PMC

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