https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(09)60935-1.pdf

Managing the health effects of climate change

Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 31[Suppl 1]:1-14). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment. Tables list the doses and durations of antimicrobial therapy recommended for treatment and prevention of Lyme disease and provide a partial list of therapies to be avoided. A definition of post-Lyme disease syndrome is proposed.

/pdf/the-clinical-assessment-treatment-and-prevention-of-lyme-xajvcef2ye.pdf

The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America

Ticks and tick-borne diseases affect animal and human health worldwide and are the cause of significant economic losses. Approximately 10% of the currently known 867 tick species act as vectors of a broad range of pathogens of domestic animals and humans and are also responsible for damage directly due to their feeding behaviour. The most important tick species and the effects they cause are listed. The impact on the global economy is considered to be high and although some estimates are given, there is a lack of reliable data. The impact of ticks and tick-borne diseases on animal production and public health and their control are discussed.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/2CCD9EAD34FA5E2FB3CD37DAAFFF7F56/S0031182004005967a.pdf/div-class-title-the-global-importance-of-ticks-div.pdf

The global importance of ticks.

Ticks are currently considered to be second only to mosquitoes as vectors of human infectious diseases in the world. Each tick species has preferred environmental conditions and biotopes that determine the geographic distribution of the ticks and, consequently, the risk areas for tickborne diseases. This is particularly the case when ticks are vectors and reservoirs of the pathogens. Since the identification of Borrelia burgdorferi as the agent of Lyme disease in 1982, 15 ixodid-borne bacterial pathogens have been described throughout the world, including 8 rickettsiae, 3 ehrlichiae, and 4 species of the Borrelia burgdorferi complex. This article reviews and illustrate various aspects of the biology of ticks and the tickborne bacterial diseases (rickettsioses, ehrlichioses, Lyme disease, relapsing fever borrelioses, tularemia, Q fever), particularly those regarded as emerging diseases. Methods are described for the detection and isolation of bacteria from ticks and advice is given on how tick bites may be prevented and how clinicians should deal with patients who have been bitten by ticks.

/pdf/ticks-and-tickborne-bacterial-diseases-in-humans-an-emerging-2zzolyaitq.pdf

Ticks and tickborne bacterial diseases in humans: an emerging infectious threat

Many factors are involved in determining the latitudinal and altitudinal spread of the important tick vector Ixodes ricinus (Acari: Ixodidae) in Europe, as well as in changes in the distribution within its prior endemic zones. This paper builds on published literature and unpublished expert opinion from the VBORNET network with the aim of reviewing the evidence for these changes in Europe and discusses the many climatic, ecological, landscape and anthropogenic drivers. These can be divided into those directly related to climatic change, contributing to an expansion in the tick’s geographic range at extremes of altitude in central Europe, and at extremes of latitude in Scandinavia; those related to changes in the distribution of tick hosts, particularly roe deer and other cervids; other ecological changes such as habitat connectivity and changes in land management; and finally, anthropogenically induced changes. These factors are strongly interlinked and often not well quantified. Although a change in climate plays an important role in certain geographic regions, for much of Europe it is non-climatic factors that are becoming increasingly important. How we manage habitats on a landscape scale, and the changes in the distribution and abundance of tick hosts are important considerations during our assessment and management of the public health risks associated with ticks and tick-borne disease issues in 21st century Europe. Better understanding and mapping of the spread of I. ricinus (and changes in its abundance) is, however, essential to assess the risk of the spread of infections transmitted by this vector species. Enhanced tick surveillance with harmonized approaches for comparison of data enabling the follow-up of trends at EU level will improve the messages on risk related to tick-borne diseases to policy makers, other stake holders and to the general public.

/pdf/driving-forces-for-changes-in-geographical-distribution-of-1aaezoaq4a.pdf

Driving forces for changes in geographical distribution of Ixodes ricinus ticks in Europe

Zoonotic tick-borne diseases are an increasing health burden in Europe and there is speculation that this is partly due to climate change affecting vector biology and disease transmission. Data on the vector tick Ixodes ricinus suggest that an extension of its northern and altitude range has been accompanied by an increased prevalence of tick-borne encephalitis. Climate change may also be partly responsible for the change in distribution of Dermacentor reticulatus. Increased winter activity of  I. ricinus is probably due to warmer winters and a retrospective study suggests that hotter summers will change the dynamics and pattern of seasonal activity, resulting in the bulk of the tick population becoming active in the latter part of the year. Climate suitability models predict that eight important tick species are likely to establish more northern permanent populations in a climate-warming scenario. However, the complex ecology and epidemiology of such tick-borne diseases as Lyme borreliosis and tick-borne encephalitis make it difficult to implicate climate change as the main cause of their increasing prevalence. Climate change models are required that take account of the dynamic biological processes involved in vector abundance and pathogen transmission in order to predict future tick-borne disease scenarios.

/pdf/effects-of-climate-change-on-ticks-and-tick-borne-diseases-41afewrp4q.pdf

Effects of climate change on ticks and tick-borne diseases in europe.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1469-0691.2010.03175.x

Lyme borreliosis: Clinical case definitions for diagnosis and management in Europe

Existing knowledge on reservoir hosts of Borrelia burgdorferi sensu lato was collated and reviewed and several species, particularly birds, were identified as reservoir competent. At the present time, 9 small mammals, 7 medium-sized mammals and 16 bird species, including passerines, sea birds and pheasants, appear to be capable of transmitting spirochaetes to ticks and thus of participating in the natural circulation of B. burgdorferi s.l. in Europe. The house mouse, Mus musculus is strongly suspected of reservoir competence and many other small rodent species, particularly in eastern Europe and Russia, have been implicated. Ungulates are not thought to play a major role as reservoir hosts, though co-feeding transmission may permit some tick infection. The criteria for establishment of reservoir status are outlined and a method for identification of host blood meals of previous instars of unfed ticks, developed in a participant laboratory, is briefly described.

European reservoir hosts of Borrelia burgdorferi sensu lato.

The EU Concerted Action on Risk Assessment in Lyme Borreliosis (EUCALB) has consulted other clinicians and scientists in Europe to produce case definitions of the principal manifestations of European Lyme borreliosis. These case definitions will not only be helpful in supporting its own research interests, but are also intended to assist other clinicians in appropriate management and to support further studies aimed at determining the full clinical spectrum of the disease. The case definitions were achieved after a series of meetings organised by EUCALB with other expert clinicians and scientists from twelve European countries. The definitions and the diagnostic criteria presented thus represent the consensus reached at these meetings. The proposed case definitions consider skin, nervous system, cardiac and musculoskeletal presentations and the role of laboratory investigation in supporting diagnosis.

J.S. Gray

Papers

Effects of climate change on ticks and tick-borne diseases in europe.

Lyme borreliosis: Clinical case definitions for diagnosis and management in Europe

European reservoir hosts of Borrelia burgdorferi sensu lato.

European Union Concerted Action on Risk Assessment in Lyme Borreliosis: clinical case definitions for Lyme borreliosis.

Lyme borreliosis: biology, epidemiology and control.