Multiple transmissions of tick-borne encephalitis virus between Japan and Russia

Tick-borne encephalitis (TBE) is a zoonotic disease causing meningitis, encephalitis, and meningoencephalitis. Tick-borne encephalitis virus (TBEV) is an etiological agent of TBE. From an analysis of five distinct sequences of Japanese TBEV, it has been proposed that Japanese TBEV was transmitted from Russia to Japan on just a single occasion 260-430 years ago. Here thirteen distinct nucleotide sequences encoding the entire region of the envelope protein for Japanese TBEV were analyzed. It is shown, from the phylogenetic analysis, that Japanese TBEV belongs to the Far Eastern subtype, which is known to be highly pathogenic. Japanese TBEV was divided into three groups, and TBEV was inferred to have been transmitted between Japan and Russia at least three times, which were estimated to have occurred several hundred years ago. These results indicate that TBEV has not only been endemic but also transmitted multiple times to Japan.

Tick-Borne Encephalitis Virus in Clethrionomys glareolus in the Czech Republic

A total of 474 specimens from 157 rodents caught at the military training area of Boletice in the south of the Czech Republic from May to November 1999 were screened for TBEV by nested PCR. TBEV-specific RNA was amplified from lung, kidney, and spleen derived from one Clethrionomys glareolus in the first RT-PCR round. Sequence analysis revealed a 100% identity to the TBEV strain Neudoerfl. TBEV presence in the sample was confirmed by mouse brain passage of backup samples and cell culture. The results support the observation that hantaviruses and TBEV transmission can occur sympatrically in the same rodent population.

[Epidemiology of TBE]

In the period between 1974 and 2003, the incidence of TBE increased appreciably in most European countries. Numerous factors, including climatic changes, biological (ecological) and non-biological factors, have an influence on the epidemiology of TBE. In addition, a greater awareness and better understanding (of the problem), improvements in diagnosis, an increase in travel, political and associated major social changes have had an impact on epidemiological data banks. We shall succeed in turning back the rising tide only by achieving further progress in the field of risk analysis, and redoubling our efforts in the area of active immunisation.

Tick-borne Encephalitis – a European Health Challenge Conference report of the 8th meeting of the International Scientific Working Group on Tick-borne Encephalitis (ISW TBE)

The annual 2006 meeting of the International Scientific Working Group on Tick-borne Encephalitis (ISW TBE) raised the topic "Tick-borne Encephalitis--a European Health Challenge". TBE incidence has more or less increased in all European countries with a TBE risk in the last years (excepting Austria). Additionally, TBE has become an international public health problem because of increasing mobility of people travelling to risk areas. TBE vaccination should be recommended when people travel to endemic regions and come into contact with nature, regardless of the duration of the stay. As no clear recommendations for travellers exist, it will be one of the major future challenges of the ISW TBE to increase problem awareness outside endemic regions and create general recommendations, which are valid for at least all European countries.

Sacred cows and sympathetic squirrels: the importance of biological diversity to human health

Dobson and colleagues describe how some host species act to reduce the risk of transmission of virulent zoonotic pathogens to humans.

An antivector vaccine protects against a lethal vector-borne pathogen

Vaccines that target blood-feeding disease vectors, such as mosquitoes and ticks, have the potential to protect against the many diseases caused by vector-borne pathogens. We tested the ability of an anti-tick vaccine derived from a tick cement protein (64TRP) of Rhipicephalus appendiculatus to protect mice against tick-borne encephalitis virus (TBEV) transmitted by infected Ixodes ricinus ticks. The vaccine has a “dual action” in immunized animals: when infested with ticks, the inflammatory and immune responses first disrupt the skin feeding site, resulting in impaired blood feeding, and then specific anti-64TRP antibodies cross-react with midgut antigenic epitopes, causing rupture of the tick midgut and death of engorged ticks. Three parameters were measured: “transmission,” number of uninfected nymphal ticks that became infected when cofeeding with an infected adult female tick; “support,” number of mice supporting virus transmission from the infected tick to cofeeding uninfected nymphs; and “survival,” number of mice that survived infection by tick bite and subsequent challenge by intraperitoneal inoculation of a lethal dose of TBEV. We show that one dose of the 64TRP vaccine protects mice against lethal challenge by infected ticks; control animals developed a fatal viral encephalitis. The protective effect of the 64TRP vaccine was comparable to that of a single dose of a commercial TBEV vaccine, while the transmission-blocking effect of 64TRP was better than that of the antiviral vaccine in reducing the number of animals supporting virus transmission. By contrast, the commercial antitick vaccine (TickGARD) that targets only the tick's midgut showed transmission-blocking activity but was not protective. The 64TRP vaccine demonstrates the potential to control vector-borne disease by interfering with pathogen transmission, apparently by mediating a local cutaneous inflammatory immune response at the tick-feeding site.

Blood-sucking vectors such as mosquitoes and ticks transmit hundreds of micro-organisms that cause diseases like malaria and Lyme disease. Controlling so many diseases is an enormous challenge. A new idea is to make vaccines against the vectors rather than against all the individual disease agents they carry. The authors examined this hypothesis using a vaccine prepared from tick cement. This cement is secreted by ticks to help them attach to a human or animal to feed. A mouse model was used in which mice were infested with ticks infected with tick-borne encephalitis virus (TBEV), the most important vector-borne virus in Europe and northern Asia. The control mice developed fatal encephalitis and died about a week after being bitten by the infected tick. By contrast, the tick cement vaccine gave protection similar to the level seen in mice immunized with a single shot of the commercial TBEV vaccine for humans. However, a commercial tick vaccine used to control cattle ticks did not protect the mice. The authors' tick cement vaccine appeared to work by causing a cellular immune response in the skin where ticks were feeding. These results show that it is feasible to produce a vaccine against a tick that protects against the disease agent it transmits.

[Increasing prevalence of early summer meningoencephalitis in Europe]

The importance of TBE has increased considerably since the mid 70 s in the whole of Europe and Far East. The number of registered clinical cases has risen and risk areas have expanded. For this development a number of factors are responsible ( i. e. global warming, ecological, political, social changes). Because of the high quality and immunogenicity of TBE vaccines available for children and adults TBE should not have to be considered any longer as a problem, subject to the fact that every person at risk has been vaccinated. An important prerequisite for a scientifically based vaccine application are the constant surveillance of TBE risk areas and an actual data base. Epidemiological data with respect to the expansion of risk areas and its level of risk are available covering most European countries with TBE risk and can be made available for medical purposes when travelling.

Attempt to detect evidence for tick-borne encephalitis virus in ticks and mammalian wildlife in The Netherlands

To investigate if tick-borne encephalitis virus (TBEV) is present in mammalian wildlife species or ticks in The Netherlands, serum samples and ticks were tested for TBEV antibodies and TBEV RNA, respectively. Serum samples were collected from wild boar (666), deer (13), fox (399), and rodents (90), and were tested for TBEV antibodies, using ELISA, and SN test or HI test. Over a period of 4 years, a total of 906 ticks was collected from seven regions in The Netherlands. In four different regions, this was done on a monthly basis and during four consecutive summers. All ticks were tested for TBEV RNA by RT-PCR. TBEV antibody was detected by ELISA in two (0.5%) sera of foxes and 49 (7%) sera of wild boar, but not confirmed by HI or SNT. TBEV RNA was not detected in any of 906 ticks. It was concluded that there is no real evidence for a TBEV reservoir in ticks or wildlife in The Netherlands.

The basic reproductive number of tick–borne encephalitis virus

Tick-borne encephalitis virus (TBEV) is reciprocally transmitted between Ixodes ricinus ticks and small mammals. Recently, transmission between co-feeding ticks has been postulated as an epidemiological by important mechanism of perpetuating the agent. To empirically examine the question whether the "traditional" mode of transmission is sufficient to maintain enzootic TBEV transmission, the basic reproductive number R(0) of TBEV could be estimated under this model for sites in which TBEV is enzootic. I propose an empirical estimator of R(0) for TBEV which is based on longitudinal stage-specific local tick infestation densities assessed by live trapping of small mammals. A Gibbs sampler-based 95%-credibility interval is presented. When applied to published field data from TBEV enzootic sites sub-critical R(0) estimates are obtained for both sites. I discuss potential shortcomings of this method and possible implications of these findings on the discussion of supplemental mechanisms of transmission.

Short report: duration of tick attachment required for transmission of powassan virus by deer ticks

Infected deer ticks (Ixodes scapularis) were allowed to attach to naive mice for variable lengths of time to determine the duration of tick attachment required for Powassan (POW) virus transmission to occur. Viral load in engorged larvae detaching from viremic mice and in resulting nymphs was also monitored. Ninety percent of larval ticks acquired POW virus from mice that had been intraperitoneally inoculated with 10(5) plaque-forming units (PFU). Engorged larvae contained approximately 10 PFU. Transstadial transmission efficiency was 22%, resulting in approximately 20% infection in nymphs that had fed as larvae on viremic mice. Titer increased approximately 100-fold during molting. Nymphal deer ticks efficiently transmitted POW virus to naive mice after as few as 15 minutes of attachment, suggesting that unlike Borrelia burgdorferi, Babesia microti, and Anaplasma phagocytophilum, no grace period exists between tick attachment and POW virus transmission.

Experimental transmission of Karshi and Langat (tick-borne encephalitis virus complex) viruses by Ornithodoros ticks (Acari: Argasidae)

Selected species of mosquitoes and Ornithodoros ticks were evaluated for their potential to transmit Karshi and Langat (tick-borne encephalitis virus complex) viruses in the laboratory. Although there was no evidence of replication of Karshi virus in either of the two mosquito species tested [Ochlerotatus taeniorhynchus (Wiedemann) or Culex pipiens (L.)], Karshi virus replicated in and was transmitted by all three species of Ornithodoros ticks tested (Ornithodoros parkeri Cooley, Ornithodoros sonrai Sautet & Witkowski, and Ornithodoros tartakovskyi Olenev). When inoculated with Karshi virus, 90% of Ornithodoros ticks (44/49) transmitted this virus by bite to suckling mice, and transmission continued to occur for at least 1 yr, the longest extrinsic incubation tested. After feeding on a suckling mouse with a viremia of approximately 10(5) suckling mouse subcutaneous lethal dose. units of Karshi virus per milliliter of blood, all three species of Ornithodoros tested became infected with and transmitted Karshi virus both trans-stadially and horizontally by bite to suckling mice. In addition, female O. tartakovskyi transmitted Karshi virus vertically to their progeny. In a continuation of a previous study, O. sonrai, orally exposed to Langat virus, were able to transmit this virus after >3 yr, the longest interval tested. Therefore, Ornithodoros spp. should be considered as potential vectors and as possible long-term maintenance hosts for Karshi virus and other members of the tick-borne encephalitis virus complex.

Ticks need not bite their red grouse hosts to infect them with louping ill virus

For pathogens transmitted by biting vectors, one of the fundamental assumptions is often that vector bites are the sole or main route of host infection. Here, we demonstrate experimentally a transmission route whereby hosts (red grouse, Lagopus lagopus scoticus) became infected with a member of the tick-borne encephalitis virus complex, louping ill virus, after eating the infected tick vector. Furthermore, we estimated from field observations that this mode of infection could account for 73-98% of all virus infections in wild red grouse in their first season. This has potential implications for the understanding of other biting vector-borne pathogens where hosts may ingest vectors through foraging or grooming.

[Ixodes ricinus, transmitted diseases and reservoirs]

The tick Ixodes ricinus has been recorded in most Italian regions especially in thermo-mesophilous woods and shrubby habitats where the relative humidity allow the tick to complete its 3 year developmental cycle, as predicted for the European climatic ranges. This tick acts both as vector and reservoir for a series of wildlife zoonotic pathogens, especially the agents of Lyme diseases, Tick borne encephalitis and Human Granulocytic Ehrlichiosis, which are emerging in most of Europe. To assess the spatial distribution of these pathogens and the infection risk for humans and animals within the territory of the Province of Trento, we carried out a long term study using a combination of eco-epidemiological surveys and mathematical modelling. An extensive tick collection with a GIS based habitat suitability analysis allowed us to identify the areas where tick occurs at various density. To identify the areas with higher infection risk, we estimated the values of R0 for Borrelia burgdorferi s.l., TBE virus and Anaplasma phagocytophila under different ecological conditions. We assessed the infection prevalence in the vector and in the wildlife reservoir species that play a central role in the persistence of these infections, ie the small mammals A. flavicollis and C. glareolus. We also considered the double effect of roe deer (Capreolus capreolus) which act as reservoir for A. phagocytophila but is an incompetent host for B. burgdorferi and TBE virus, thus reducing the infection prevalence in ticks of these last two pathogens. Infection prevalence with B. burgdorferi and A. phagocytophila in the vector was assessed by PCR screening 1212 I. ricinus nymphs collected by dragging in six main study areas during 2002. The mean infection prevalence recorded was 1.32% for B. burgdorferi s.l. and 9.84% for A. phagocytophila. Infection prevalence in nymphs with TBE virus, as assessed in a previous study was 0.03%. Infection prevalence in rodents was assessed by screening (with ELISA and PCR) tissues and blood samples collected from 367 rodent individuals trapped extensively during 2002 within 6 main study areas. A. flavicollis (N=238) was found to be infected with all three pathogens investigated, with infection prevalence ranging from 3.3% for TBE virus to 11.7% for A. phagocytophila, and 16.6% with B. burgdorferi s.l. C. glareolus (N=108) showed an infection prevalence of 6.5% with A. phagocytophila and 12.7% with B. burgdorferi s.l., while no individuals were infected with TBE virus. We also screened 98 spleen samples collected from roe deer with PCR, resulting in a mean prevalence of infection with A. phagocytophila of 19.8%. Using a deterministic model we explored the condition for diseases persistence under different rodent and roe deer densities. R0 values resulted largely above 1 for B. burgdorferi s.l. in the vast majority of the areas classified as suitable for I. ricinus occurrence in Trentino, while the condition for TBE persistence appeared to be more restricted by a combination of climatic condition and host densities.

Problems in the study and prophylaxis of mixed infections transmitted by ixodid ticks

The spread of mixed infections with natural focality transmitted by ixodid ticks is a normal phenomenon attributable to trends in the relationships of different pathogens in the vector organism and ecosystem as a whole. Any disease developing as a result of tick bite should be regarded as a potentially mixed infection. Clinically, tick-borne mixed infections proceed more severely than the corresponding diseases caused by a single agent. The residual course of the disease may sometimes be accounted for by the persistence of two or even several pathogens. This implies the necessity of a comprehensive approach to the study, diagnosis, treatment, management and prophylaxis of infections belonging to this group.

Tick-borne encephalitis and the impact of vaccination

TBE virus is endemic in many parts of Europe and Northern Asia, and in these regions it causes more than 10,000 severe cases of central nervous system disease in humans each year. The virus is primarily transmitted to humans when infected ticks take a blood meal, but infections due to the consumption of unpasteurized milk, primarily from goats, occur in certain regions. Based on genetic analyses, three closely related subtypes can be distinguished and are designated European, Siberian, and Far Eastern subtype according to their primary geographic distribution. Consistent with their close antigenic relationships, immunization studies in animals have revealed a high degree of cross-protection between virus strains belonging to different subtypes. The commercially available vaccines in Europe consist of highly purified inactivated whole TBE virus. Austria is the country with the highest coverage of TBE vaccination (86% of the total population) and this has led to a dramatic reduction in the annual number of clinical cases and proves under field conditions that vaccination is an effective means for the prophylaxis of TBE.

Evolution and dispersal of encephalitic flaviviruses

There are two major groups of encephalitic flaviviruses, those that infect and are transmitted by ticks, particularly Ixodes spp. and those that infect and are transmitted by mosquitoes, particularly Culex spp. The tick-borne encephalitic flaviviruses exhibit evolutionary characteristics that are largely determined by the protracted life cycle of the tick, its habitat and the prevailing climatic conditions. These viruses appear to have evolved gradually from non-encephalitic viruses that radiated eastwards and north eastwards out of Africa into Asia and the southern islands, then northwards to far east Asia and finally westwards across Eurasia to western Europe, during the past two to four thousand years. Only one of these recognized species has found its way to North America viz. Powassan virus. In contrast, the evolution of the recognized mosquito-borne encephalitic flaviviruses reflects the wide range of mosquito species that they infect. They emerged out of Africa relatively recently and at roughly the same time, i.e., probably during the past few centuries. Although many of these mosquito-borne viruses are geographically widely dispersed, with the exception of West Nile virus, they are found either in the Old World or the New World, never in both, and we are now beginning to understand the reasons. Phylogenetic trees will be used here to describe the evolution, epidemiology and dispersal characteristics of these viruses, taking into account the importance of virus persistence and recombination.

Empirical evidence for key hosts in persistence of a tick-borne disease

An important epidemiological consequence of aggregated host-parasite associations occurs when parasites are vectors of pathogens. Those hosts that attract many vectors will tend to be the focus of transmission. But to what extent, and can we identify characteristics of these key hosts? We investigated these questions with respect to the host-tick relationship of the yellow-necked mouse, Apodemus flavicollis, a critical host in the maintenance of the zoonotic disease, tick-borne encephalitis. Transmission of the virus occurs when ticks feed in a 'co-feeding' aggregation. Thus, the number and frequency of co-feeding groups provides an estimate of the potential rate of virus transmission. We recorded the spatio-temporal variations in co-feeding on a population of rodents in conjunction with recording individual host characteristics. Using Lorenz curves, we revealed conformation of tick-borne encephalitis transmission potential to the 20/80 Rule, where the 20% of hosts most infested with ticks were accountable for 80% of transmission potential. Hosts in the transmission cohort were identified as the sexually mature males of high body mass. Therefore control efforts targeted at this group would substantially reduce transmission potential compared to non-targeted control of the population, which resulted in a linear reduction in transmission potential. Focusing on the 'wrong' functional group would have little impact upon transmission potential until a considerable proportion of the population had been subject to control. However, individuals can change their functional status over time making it difficult to predict the contribution of these individuals to future transmission.

[Impact of global climate changes on arboviruses transmitted to humans by mosquitoes and ticks]

Global warming [+0.5-0.6 degree C during the second half of the 20th century] seems a reality although climatologists did not reach a common agreement on its actual origin, and this phenomenon may still increase along the 21st century [+1.5 to 6 degrees C]. Epidemiologists are anxious at the eventual effects of the resulting climate change on the evolution of arbovirus infections transmitted to human beings by hematophagous vectors such as mosquitoes and ticks. Analysis of the literature devoted to this problem did not lead to precise conclusions and the mathematical models used seems insufficient for they take into account mainly the climatic factors and not enough the human ones. Examples of dengue, european tick-borne encephalitis and other arbovirus infections are discussed. Peculiar attention is devoted to the eventual effects of climatic changes on the hibernation process in some small mammals and the timing of bird's migrations, involved in enzootic cycles of arboviruses. It is likely that arbovirus diseases may locally extend, both in latitude and altitude, leading to outbreaks, but regressions may also occur.