TY - JOUR

T1 - First Expert Elicitation of Knowledge on Possible Drivers of Observed Increasing Human Cases of Tick-Borne Encephalitis in Europe

AU - Saegerman, Claude

AU - Humblet, Marie France

AU - Leandri, Marc

AU - Gonzalez, Gaëlle

AU - Heyman, Paul

AU - Sprong, Hein

AU - L'Hostis, Monique

AU - Moutailler, Sara

AU - Bonnet, Sarah I.

AU - Haddad, Nadia

AU - Boulanger, Nathalie

AU - Leib, Stephen L.

AU - Hoch, Thierry

AU - Thiry, Etienne

AU - Bournez, Laure

AU - Kerlik, Jana

AU - Velay, Aurélie

AU - Jore, Solveig

AU - Jourdain, Elsa

AU - Gilot-Fromont, Emmanuelle

AU - Brugger, Katharina

AU - Geller, Julia

AU - Studahl, Marie

AU - Knap, Nataša

AU - Avšič-Županc, Tatjana

AU - Růžek, Daniel

AU - Zomer, Tizza P.

AU - Bødker, René

AU - Berger, Thomas F.H.

AU - Martin-Latil, Sandra

AU - De Regge, Nick

AU - Raffetin, Alice

AU - Lacour, Sandrine A.

AU - Klein, Matthias

AU - Lernout, Tinne

AU - Quillery, Elsa

AU - Hubálek, Zdeněk

AU - Ruiz-Fons, Francisco

AU - Estrada-Peña, Agustín

AU - Fravalo, Philippe

AU - Kooh, Pauline

AU - Etore, Florence

AU - Gossner, Céline M.

AU - Purse, Bethan

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - clustering analysis

KW - Dermacentor reticulatus

KW - drivers

KW - expert elicitation

KW - flavivirus

KW - genus Ixodes

KW - multi-criteria decision analysis (MCDA)

KW - sensitivity analysis

KW - TBEV

KW - tick-borne encephalitis (TBE)

KW - ticks

KW - uncertainty

U2 - 10.3390/v15030791

DO - 10.3390/v15030791

M3 - Journal article

C2 - 36992499

AN - SCOPUS:85151218082

VL - 15

JO - Viruses

JF - Viruses

SN - 1999-4915

IS - 3

M1 - 791

ER -