Publication details

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

Authors	SAEGERMAN Claude HUMBLET Marie-France LEANDRI Marc GONZALEZ Gaëlle HEYMAN Paul SPRONG Hein L’HOSTIS Monique MOUTAILLER Sara BONNET Sarah I. HADDAD Nadia BOULANGER Nathalie LEIB Stephen L. HOCH Thierry THIRY Etienne BOURNEZ Laure KERLIK Jana VELAY Aurélie JORE Solveig JOURDAIN Elsa GILOT-FROMONT Emmanuelle BRUGGER Katharina GELLER Julia STUDAHL Marie KNAP Nataša AVŠIČ-ŽUPANC Tatjana RŮŽEK Daniel ZOMER Tizza P. BODKER René BERGER Thomas F. H. MARTIN-LATIL Sandra DE REGGE Nick RAFFETIN Alice LACOUR Sandrine A. KLEIN Matthias LERNOUT Tinne QUILLERY Elsa HUBÁLEK Zdeněk RUIZ-FONS Francisco ESTRADA-PENA Agustín FRAVALO Philippe KOOH Pauline ETORE Florence GOSSNER Céline M. PURSE Bethan
Year of publication	2023
Type	Article in Periodical
Magazine / Source	Viruses
MU Faculty or unit	Faculty of Science
Citation
Web	https://www.mdpi.com/1999-4915/15/3/791
Doi	http://dx.doi.org/10.3390/v15030791
Keywords	tick-borne encephalitis (TBE); flavivirus; TBEV; genus Ixodes; Dermacentor reticulatus; drivers; expert elicitation; ticks; multi-criteria decision analysis (MCDA); clustering analysis; sensitivity analysis; uncertainty
Description	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.