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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Determinants of tick-borne encephalitis in counties of southern Germany, 2001-2008</title><author><name sortKey="Kiffner, Christian" sort="Kiffner, Christian" uniqKey="Kiffner C" first="Christian" last="Kiffner">Christian Kiffner</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Zucchini, Walter" sort="Zucchini, Walter" uniqKey="Zucchini W" first="Walter" last="Zucchini">Walter Zucchini</name><affiliation><nlm:aff id="I2">Institute for Statistics and Econometrics, Georg-August-University Göttingen, Platz der Göttinger Sieben 5, 37073 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Schomaker, Philipp" sort="Schomaker, Philipp" uniqKey="Schomaker P" first="Philipp" last="Schomaker">Philipp Schomaker</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Vor, Torsten" sort="Vor, Torsten" uniqKey="Vor T" first="Torsten" last="Vor">Torsten Vor</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Hagedorn, Peter" sort="Hagedorn, Peter" uniqKey="Hagedorn P" first="Peter" last="Hagedorn">Peter Hagedorn</name><affiliation><nlm:aff id="I3">Centre for Biological Safety, Robert Koch-Institut, Nordufer 20, 13353 Berlin, Germany</nlm:aff></affiliation></author><author><name sortKey="Niedrig, Matthias" sort="Niedrig, Matthias" uniqKey="Niedrig M" first="Matthias" last="Niedrig">Matthias Niedrig</name><affiliation><nlm:aff id="I3">Centre for Biological Safety, Robert Koch-Institut, Nordufer 20, 13353 Berlin, Germany</nlm:aff></affiliation></author><author><name sortKey="Ruhe, Ferdinand" sort="Ruhe, Ferdinand" uniqKey="Ruhe F" first="Ferdinand" last="Rühe">Ferdinand Rühe</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20707897</idno><idno type="pmc">2928184</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928184</idno><idno type="RBID">PMC:2928184</idno><idno type="doi">10.1186/1476-072X-9-42</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">000064</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000064</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Determinants of tick-borne encephalitis in counties of southern Germany, 2001-2008</title><author><name sortKey="Kiffner, Christian" sort="Kiffner, Christian" uniqKey="Kiffner C" first="Christian" last="Kiffner">Christian Kiffner</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Zucchini, Walter" sort="Zucchini, Walter" uniqKey="Zucchini W" first="Walter" last="Zucchini">Walter Zucchini</name><affiliation><nlm:aff id="I2">Institute for Statistics and Econometrics, Georg-August-University Göttingen, Platz der Göttinger Sieben 5, 37073 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Schomaker, Philipp" sort="Schomaker, Philipp" uniqKey="Schomaker P" first="Philipp" last="Schomaker">Philipp Schomaker</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Vor, Torsten" sort="Vor, Torsten" uniqKey="Vor T" first="Torsten" last="Vor">Torsten Vor</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author><author><name sortKey="Hagedorn, Peter" sort="Hagedorn, Peter" uniqKey="Hagedorn P" first="Peter" last="Hagedorn">Peter Hagedorn</name><affiliation><nlm:aff id="I3">Centre for Biological Safety, Robert Koch-Institut, Nordufer 20, 13353 Berlin, Germany</nlm:aff></affiliation></author><author><name sortKey="Niedrig, Matthias" sort="Niedrig, Matthias" uniqKey="Niedrig M" first="Matthias" last="Niedrig">Matthias Niedrig</name><affiliation><nlm:aff id="I3">Centre for Biological Safety, Robert Koch-Institut, Nordufer 20, 13353 Berlin, Germany</nlm:aff></affiliation></author><author><name sortKey="Ruhe, Ferdinand" sort="Ruhe, Ferdinand" uniqKey="Ruhe F" first="Ferdinand" last="Rühe">Ferdinand Rühe</name><affiliation><nlm:aff id="I1">Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Health Geographics</title><idno type="eISSN">1476-072X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Tick-borne encephalitis (TBE) virus can cause severe symptoms in humans. The incidence of this vector-borne pathogen in humans is characterised by spatial and temporal heterogeneity. To explain the variation in reported human TBE cases per county in southern Germany, we designed a time-lagged, spatially-explicit model that incorporates ecological, environmental, and climatic factors.</p></sec><sec><title>Results</title><p>We fitted a logistic regression model to the annual counts of reported human TBE cases in each of 140 counties over an eight year period. The model controlled for spatial autocorrelation and unexplained temporal variation. The occurrence of human TBE was found to be positively correlated with the proportions of broad-leafed, mixed and coniferous forest cover. An index of forest fragmentation was negatively correlated with TBE incidence, suggesting that infection risk is higher in fragmented landscapes. The results contradict previous evidence regarding the relevance of a specific spring-time temperature regime for TBE epidemiology. Hunting bag data of roe deer (<italic>Capreolus capreolus</italic>) in the previous year was positively correlated with human TBE incidence, and hunting bag density of red fox (<italic>Vulpes vulpes</italic>) and red deer (<italic>Cervus elaphus</italic>) in the previous year were negatively correlated with human TBE incidence.</p></sec><sec><title>Conclusions</title><p>Our approach suggests that a combination of landscape and climatic variables as well as host-species dynamics influence TBE infection risk in humans. The model was unable to explain some of the temporal variation, specifically the high counts in 2005 and 2006. Factors such as the exposure of humans to infected ticks and forest rodent population dynamics, for which we have no data, are likely to be explanatory factors. Such information is required to identify the determinants of TBE more reliably. Having records of TBE infection sites at a finer scale would also be necessary.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Pugliese, A" uniqKey="Pugliese A">A Pugliese</name></author><author><name sortKey="Beltramo, T" uniqKey="Beltramo T">T Beltramo</name></author><author><name sortKey="Torre, D" uniqKey="Torre D">D Torre</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gunther, G" uniqKey="Gunther G">G Günther</name></author><author><name sortKey="Haglund, M" uniqKey="Haglund M">M Haglund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Charrel, Rn" uniqKey="Charrel R">RN Charrel</name></author><author><name sortKey="Attoui, H" uniqKey="Attoui H">H Attoui</name></author><author><name sortKey="Butenko, Am" uniqKey="Butenko A">AM Butenko</name></author><author><name sortKey="Clegg, Jc" uniqKey="Clegg J">JC Clegg</name></author><author><name sortKey="Deubel, V" uniqKey="Deubel V">V Deubel</name></author><author><name sortKey="Frolova, Tv" uniqKey="Frolova T">TV Frolova</name></author><author><name sortKey="Gould, Ea" uniqKey="Gould E">EA Gould</name></author><author><name sortKey="Gritsun, Ts" uniqKey="Gritsun T">TS Gritsun</name></author><author><name sortKey="Heinz, Fx" uniqKey="Heinz F">FX Heinz</name></author><author><name sortKey="Labuda, M" uniqKey="Labuda M">M Labuda</name></author><author><name sortKey="Lashkevich, Va" uniqKey="Lashkevich V">VA Lashkevich</name></author><author><name sortKey="Loktev, V" uniqKey="Loktev V">V Loktev</name></author><author><name sortKey="Lundkvist, A" uniqKey="Lundkvist A">A Lundkvist</name></author><author><name sortKey="Lvov" uniqKey="Lvov">Lvov</name></author><author><name sortKey="Mandl, Cw" uniqKey="Mandl C">CW Mandl</name></author><author><name sortKey="Niedrig, M" uniqKey="Niedrig M">M Niedrig</name></author><author><name sortKey="Papa, A" uniqKey="Papa A">A Papa</name></author><author><name sortKey="Petrov, Vs" uniqKey="Petrov V">VS Petrov</name></author><author><name sortKey="Plyusin, A" uniqKey="Plyusin A">A Plyusin</name></author><author><name sortKey="Randolph, S" uniqKey="Randolph S">S Randolph</name></author><author><name sortKey="Suss, J" uniqKey="Suss J">J Süss</name></author><author><name sortKey="Zlobin, Vl" uniqKey="Zlobin V">VL Zlobin</name></author><author><name sortKey="De Lamballerie, X" uniqKey="De Lamballerie X">X de Lamballerie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gritsun, Ts" uniqKey="Gritsun T">TS Gritsun</name></author><author><name sortKey="Lashkevich, Va" uniqKey="Lashkevich V">VA Lashkevich</name></author><author><name sortKey="Gould, Ea" uniqKey="Gould E">EA Gould</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suss, J" uniqKey="Suss J">J Süss</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Holzmann, H" uniqKey="Holzmann H">H Holzmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kunze, U" uniqKey="Kunze U">U Kunze</name></author><author><name sortKey="Baumhackl, U" uniqKey="Baumhackl U">U Baumhackl</name></author><author><name sortKey="Bretschneider, R" uniqKey="Bretschneider R">R Bretschneider</name></author><author><name sortKey="Chmelik, V" uniqKey="Chmelik V">V Chmelik</name></author><author><name sortKey="Grubeck Loebenstein, B" uniqKey="Grubeck Loebenstein B">B Grubeck-Loebenstein</name></author><author><name sortKey="Haglund, M" uniqKey="Haglund M">M Haglund</name></author><author><name sortKey="Heinz, F" uniqKey="Heinz F">F Heinz</name></author><author><name sortKey="Kaiser, R" uniqKey="Kaiser R">R Kaiser</name></author><author><name sortKey="Kimmig, P" uniqKey="Kimmig P">P Kimmig</name></author><author><name sortKey="Kunz, C" uniqKey="Kunz C">C Kunz</name></author><author><name sortKey="Kunze, M" uniqKey="Kunze M">M Kunze</name></author><author><name sortKey="Mickiene, A" uniqKey="Mickiene A">A Mickiene</name></author><author><name sortKey="Misic Majerus, L" uniqKey="Misic Majerus L">L Misic-Majerus</name></author><author><name sortKey="Randolph, S" uniqKey="Randolph S">S Randolph</name></author><author><name sortKey="Rieke, B" uniqKey="Rieke B">B Rieke</name></author><author><name sortKey="Stefanoff, P" uniqKey="Stefanoff P">P Stefanoff</name></author><author><name sortKey="Suss, J" uniqKey="Suss J">J Süss</name></author><author><name sortKey="Wimmer, R" uniqKey="Wimmer R">R Wimmer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kaiser, R" uniqKey="Kaiser R">R Kaiser</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mickiene, A" uniqKey="Mickiene A">A Mickiene</name></author><author><name sortKey="Laiskonis, A" uniqKey="Laiskonis A">A Laiskonis</name></author><author><name sortKey="Gunther, G" uniqKey="Gunther G">G Günther</name></author><author><name sortKey="Vene, S" uniqKey="Vene S">S Vene</name></author><author><name sortKey="Lundkvist, A" uniqKey="Lundkvist A">A Lundkvist</name></author><author><name sortKey="Lindquist, L" uniqKey="Lindquist L">L Lindquist</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jones, E" uniqKey="Jones E">E Jones</name></author><author><name sortKey="Patel, Ng" uniqKey="Patel N">NG Patel</name></author><author><name sortKey="Levy, Ma" uniqKey="Levy M">MA Levy</name></author><author><name sortKey="Storeygard, A" uniqKey="Storeygard A">A Storeygard</name></author><author><name sortKey="Balk, D" uniqKey="Balk D">D Balk</name></author><author><name sortKey="Gittleman, Jl" uniqKey="Gittleman J">JL Gittleman</name></author><author><name sortKey="Daszak, P" uniqKey="Daszak P">P Daszak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Randolph, Se" uniqKey="Randolph S">SE Randolph</name></author><author><name sortKey="Sumilo, D" uniqKey="Sumilo D">D Sumilo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ostfeld, Rs" uniqKey="Ostfeld R">RS Ostfeld</name></author><author><name sortKey="Canham, Cd" uniqKey="Canham C">CD Canham</name></author><author><name sortKey="Oggenfuss, K" uniqKey="Oggenfuss K">K Oggenfuss</name></author><author><name sortKey="Winchcombe, Rj" uniqKey="Winchcombe R">RJ Winchcombe</name></author><author><name sortKey="Keesing, F" uniqKey="Keesing F">F Keesing</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Randolph, Se" uniqKey="Randolph S">SE Randolph</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vassalo, M" uniqKey="Vassalo M">M Vassalo</name></author><author><name sortKey="Perez Eid, C" uniqKey="Perez Eid C">C Perez-eid</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Labuda, M" uniqKey="Labuda M">M Labuda</name></author><author><name sortKey="Nuttal, Pa" uniqKey="Nuttal P">PA Nuttal</name></author><author><name sortKey="Kozuch, O" uniqKey="Kozuch O">O Kozuch</name></author><author><name sortKey="Eleckova, E" uniqKey="Eleckova E">E Eleckova</name></author><author><name sortKey="Zuffova, E" uniqKey="Zuffova E">E Zuffova</name></author><author><name sortKey="Sabo, A" uniqKey="Sabo A">A Sabo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Randolph, Se" uniqKey="Randolph S">SE Randolph</name></author><author><name sortKey="Gern, L" uniqKey="Gern L">L Gern</name></author><author><name sortKey="Nutall, Pa" uniqKey="Nutall P">PA Nutall</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hartemink, Na" uniqKey="Hartemink N">NA Hartemink</name></author><author><name sortKey="Randolph, Se" uniqKey="Randolph S">SE Randolph</name></author><author><name sortKey="Davis, Sa" uniqKey="Davis S">SA Davis</name></author><author><name sortKey="Heesterbeek" uniqKey="Heesterbeek">Heesterbeek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosa, R" uniqKey="Rosa R">R Rosà</name></author><author><name sortKey="Pugliese, A" uniqKey="Pugliese A">A Pugliese</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zeman, P" uniqKey="Zeman P">P Zeman</name></author><author><name sortKey="Benes, C" uniqKey="Benes C">C Benes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Randolph, Se" uniqKey="Randolph S">SE Randolph</name></author><author><name sortKey="Green, Rm" uniqKey="Green R">RM Green</name></author><author><name sortKey="Peacey, Mf" uniqKey="Peacey M">MF Peacey</name></author><author><name sortKey="Rogers, Dj" uniqKey="Rogers D">DJ Rogers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Racz, Gr" uniqKey="Racz G">GR Racz</name></author><author><name sortKey="Ban, E" uniqKey="Ban E">E Ban</name></author><author><name sortKey="Ferenczi, E" uniqKey="Ferenczi E">E Ferenczi</name></author><author><name sortKey="Berencsi, G" uniqKey="Berencsi G">G Berencsi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Allan, Bf" uniqKey="Allan B">BF Allan</name></author><author><name sortKey="Keesing, F" uniqKey="Keesing F">F Keesing</name></author><author><name sortKey="Ostfeld, Rs" uniqKey="Ostfeld R">RS Ostfeld</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jensen, Pm" uniqKey="Jensen P">PM Jensen</name></author><author><name sortKey="Hansen, H" uniqKey="Hansen H">H Hansen</name></author><author><name sortKey="Frandsen, F" uniqKey="Frandsen F">F Frandsen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gilbert, L" uniqKey="Gilbert L">L Gilbert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kiffner, C" uniqKey="Kiffner C">C Kiffner</name></author><author><name sortKey="Lodige, C" uniqKey="Lodige C">C Lödige</name></author><author><name sortKey="Alings, M" uniqKey="Alings M">M Alings</name></author><author><name sortKey="Vor, T" uniqKey="Vor T">T Vor</name></author><author><name sortKey="Ruhe, F" uniqKey="Ruhe F">F Rühe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vor, T" uniqKey="Vor T">T Vor</name></author><author><name sortKey="Kiffner, C" uniqKey="Kiffner C">C Kiffner</name></author><author><name sortKey="Niedrig, M" uniqKey="Niedrig M">M Niedrig</name></author><author><name sortKey="Hagedorn, P" uniqKey="Hagedorn P">P Hagedorn</name></author><author><name sortKey="Ruhe, F" uniqKey="Ruhe F">F Rühe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haemig, Pd" uniqKey="Haemig P">PD Haemig</name></author><author><name sortKey="Lithner, S" uniqKey="Lithner S">S Lithner</name></author><author><name sortKey="Sjostedt De Luna, S" uniqKey="Sjostedt De Luna S">S Sjöstedt de Luna</name></author><author><name sortKey="Lundkvist, " uniqKey="Lundkvist ">Å Lundkvist</name></author><author><name sortKey="Waldenstrom, J" uniqKey="Waldenstrom J">J Waldenström</name></author><author><name sortKey="Hansson, L" uniqKey="Hansson L">L Hansson</name></author><author><name sortKey="Arneborn, M" uniqKey="Arneborn M">M Arneborn</name></author><author><name sortKey="Olsen, B" uniqKey="Olsen B">B Olsen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dobson, Aj" uniqKey="Dobson A">AJ Dobson</name></author><author><name sortKey="Barnett, Ag" uniqKey="Barnett A">AG Barnett</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Haines Young, R" uniqKey="Haines Young R">R Haines-Young</name></author><author><name sortKey="Chopping, M" uniqKey="Chopping M">M Chopping</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hijmans, Rj" uniqKey="Hijmans R">RJ Hijmans</name></author><author><name sortKey="Cameron, Se" uniqKey="Cameron S">SE Cameron</name></author><author><name sortKey="Parra, Jl" uniqKey="Parra J">JL Parra</name></author><author><name sortKey="Jones, Pg" uniqKey="Jones P">PG Jones</name></author><author><name sortKey="Jarvis, A" uniqKey="Jarvis A">A Jarvis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rizzoli, A" uniqKey="Rizzoli A">A Rizzoli</name></author><author><name sortKey="Hauffe, Hc" uniqKey="Hauffe H">HC Hauffe</name></author><author><name sortKey="Tagliapietra, V" uniqKey="Tagliapietra V">V Tagliapietra</name></author><author><name sortKey="Neteler, M" uniqKey="Neteler M">M Neteler</name></author><author><name sortKey="Rosa, R" uniqKey="Rosa R">R Rosà</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sumilo, D" uniqKey="Sumilo D">D Sumilo</name></author><author><name sortKey="Asokliene, L" uniqKey="Asokliene L">L Asokliene</name></author><author><name sortKey="Bormane, A" uniqKey="Bormane A">A Bormane</name></author><author><name sortKey="Vasilenko, V" uniqKey="Vasilenko V">V Vasilenko</name></author><author><name sortKey="Golovljova, I" uniqKey="Golovljova I">I Golovljova</name></author><author><name sortKey="Randolph, Se" uniqKey="Randolph S">SE Randolph</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wimberly, Mc" uniqKey="Wimberly M">MC Wimberly</name></author><author><name sortKey="Baer, Ad" uniqKey="Baer A">AD Baer</name></author><author><name sortKey="Yabsley, Mj" uniqKey="Yabsley M">MJ Yabsley</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Mason, Ch" uniqKey="Mason C">CH Mason</name></author><author><name sortKey="Perreault, Wd" uniqKey="Perreault W">WD Perreault</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Estrada Pena, A" uniqKey="Estrada Pena A">A Estrada-Pena</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ginsberg, Hs" uniqKey="Ginsberg H">HS Ginsberg</name></author><author><name sortKey="Zhioua, E" uniqKey="Zhioua E">E Zhioua</name></author><author><name sortKey="Mitra, S" uniqKey="Mitra S">S Mitra</name></author><author><name sortKey="Fischer, J" uniqKey="Fischer J">J Fischer</name></author><author><name sortKey="Buckley, Pa" uniqKey="Buckley P">PA Buckley</name></author><author><name sortKey="Verret, F" uniqKey="Verret F">F Verret</name></author><author><name sortKey="Underwood, Hb" uniqKey="Underwood H">HB Underwood</name></author><author><name sortKey="Buckley, Fg" uniqKey="Buckley F">FG Buckley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Walker, Ar" uniqKey="Walker A">AR Walker</name></author><author><name sortKey="Alberdi, Mp" uniqKey="Alberdi M">MP Alberdi</name></author><author><name sortKey="Urquhart, Ka" uniqKey="Urquhart K">KA Urquhart</name></author><author><name sortKey="Rose, H" uniqKey="Rose H">H Rose</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ranta, E" uniqKey="Ranta E">E Ranta</name></author><author><name sortKey="Lindstrom, J" uniqKey="Lindstrom J">J Lindström</name></author><author><name sortKey="Linden, H" uniqKey="Linden H">H Lindén</name></author><author><name sortKey="Helle, P" uniqKey="Helle P">P Helle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="May, Rm" uniqKey="May R">RM May</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Linard, C" uniqKey="Linard C">C Linard</name></author><author><name sortKey="Lamarque, P" uniqKey="Lamarque P">P Lamarque</name></author><author><name sortKey="Heyman, P" uniqKey="Heyman P">P Heyman</name></author><author><name sortKey="Ducoffre, G" uniqKey="Ducoffre G">G Ducoffre</name></author><author><name sortKey="Luyasu, V" uniqKey="Luyasu V">V Luyasu</name></author><author><name sortKey="Tersago, K" uniqKey="Tersago K">K Tersago</name></author><author><name sortKey="Vanwambeke, So" uniqKey="Vanwambeke S">SO Vanwambeke</name></author><author><name sortKey="Lambin, Ef" uniqKey="Lambin E">EF Lambin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hudson, Pj" uniqKey="Hudson P">PJ Hudson</name></author><author><name sortKey="Rizzoli, A" uniqKey="Rizzoli A">A Rizzoli</name></author><author><name sortKey="Rosa, R" uniqKey="Rosa R">R Rosà</name></author><author><name sortKey="Chemini, C" uniqKey="Chemini C">C Chemini</name></author><author><name sortKey="Jones, Ld" uniqKey="Jones L">LD Jones</name></author><author><name sortKey="Gould, Ea" uniqKey="Gould E">EA Gould</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosa, R" uniqKey="Rosa R">R Rosà</name></author><author><name sortKey="Pugliese, A" uniqKey="Pugliese A">A Pugliese</name></author><author><name sortKey="Ghosh, M" uniqKey="Ghosh M">M Ghosh</name></author><author><name sortKey="Perkins, Se" uniqKey="Perkins S">SE Perkins</name></author><author><name sortKey="Rizzoli, A" uniqKey="Rizzoli A">A Rizzoli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kimmig, P" uniqKey="Kimmig P">P Kimmig</name></author><author><name sortKey="Oehme, R" uniqKey="Oehme R">R Oehme</name></author><author><name sortKey="Backe, H" uniqKey="Backe H">H Backe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sheldon, Bc" uniqKey="Sheldon B">BC Sheldon</name></author><author><name sortKey="Verhulst, S" uniqKey="Verhulst S">S Verhulst</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Randolph, Se" uniqKey="Randolph S">SE Randolph</name></author><author><name sortKey="Asokliene, L" uniqKey="Asokliene L">L Asokliene</name></author><author><name sortKey="Avsic Zupanc, T" uniqKey="Avsic Zupanc T">T Avsic-Zupanc</name></author><author><name sortKey="Bormane, A" uniqKey="Bormane A">A Bormane</name></author><author><name sortKey="Burri, C" uniqKey="Burri C">C Burri</name></author><author><name sortKey="Gern, L" uniqKey="Gern L">L Gern</name></author><author><name sortKey="Golovljova, I" uniqKey="Golovljova I">I Golovljova</name></author><author><name sortKey="Hubalek, Z" uniqKey="Hubalek Z">Z Hubalek</name></author><author><name sortKey="Knap, N" uniqKey="Knap N">N Knap</name></author><author><name sortKey="Kondrusik, M" uniqKey="Kondrusik M">M Kondrusik</name></author><author><name sortKey="Kupca, A" uniqKey="Kupca A">A Kupca</name></author><author><name sortKey="Pejcoch, M" uniqKey="Pejcoch M">M Pejcoch</name></author><author><name sortKey="Vasilenko, V" uniqKey="Vasilenko V">V Vasilenko</name></author><author><name sortKey="Zygutiene, M" uniqKey="Zygutiene M">M Zygutiene</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Health Geogr</journal-id><journal-title-group><journal-title>International Journal of Health Geographics</journal-title></journal-title-group><issn pub-type="epub">1476-072X</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20707897</article-id><article-id pub-id-type="pmc">2928184</article-id><article-id pub-id-type="publisher-id">1476-072X-9-42</article-id><article-id pub-id-type="doi">10.1186/1476-072X-9-42</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Determinants of tick-borne encephalitis in counties of southern Germany, 2001-2008</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Kiffner</surname><given-names>Christian</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>ckiffne@gwdg.de</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Zucchini</surname><given-names>Walter</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>wzucchi@uni-goettingen.de</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Schomaker</surname><given-names>Philipp</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>pschoma1@gwdg.de</email></contrib><contrib contrib-type="author" id="A4"><name><surname>Vor</surname><given-names>Torsten</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>tvor@gwdg.de</email></contrib><contrib contrib-type="author" id="A5"><name><surname>Hagedorn</surname><given-names>Peter</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>HagedornP@rki.de</email></contrib><contrib contrib-type="author" id="A6"><name><surname>Niedrig</surname><given-names>Matthias</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>niedrigm@rki.de</email></contrib><contrib contrib-type="author" id="A7"><name><surname>Rühe</surname><given-names>Ferdinand</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>fruehe@gwdg.de</email></contrib></contrib-group><aff id="I1"><label>1</label>Department of Forest Zoology and Forest Conservation incl. Wildlife Biology and Game Management, Büsgen-Institute, Georg-August-University Göttingen, Büsgenweg 3, 37077 Göttingen, Germany</aff><aff id="I2"><label>2</label>Institute for Statistics and Econometrics, Georg-August-University Göttingen, Platz der Göttinger Sieben 5, 37073 Göttingen, Germany</aff><aff id="I3"><label>3</label>Centre for Biological Safety, Robert Koch-Institut, Nordufer 20, 13353 Berlin, Germany</aff><pub-date pub-type="collection"><year>2010</year></pub-date><pub-date pub-type="epub"><day>13</day><month>8</month><year>2010</year></pub-date><volume>9</volume><fpage>42</fpage><lpage>42</lpage><history><date date-type="received"><day>6</day><month>4</month><year>2010</year></date><date date-type="accepted"><day>13</day><month>8</month><year>2010</year></date></history><permissions><copyright-statement>Copyright ©2010 Kiffner et al; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2010</copyright-year><copyright-holder>Kiffner et al; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://www.ij-healthgeographics.com/content/9/1/42"></self-uri><abstract><sec><title>Background</title><p>Tick-borne encephalitis (TBE) virus can cause severe symptoms in humans. The incidence of this vector-borne pathogen in humans is characterised by spatial and temporal heterogeneity. To explain the variation in reported human TBE cases per county in southern Germany, we designed a time-lagged, spatially-explicit model that incorporates ecological, environmental, and climatic factors.</p></sec><sec><title>Results</title><p>We fitted a logistic regression model to the annual counts of reported human TBE cases in each of 140 counties over an eight year period. The model controlled for spatial autocorrelation and unexplained temporal variation. The occurrence of human TBE was found to be positively correlated with the proportions of broad-leafed, mixed and coniferous forest cover. An index of forest fragmentation was negatively correlated with TBE incidence, suggesting that infection risk is higher in fragmented landscapes. The results contradict previous evidence regarding the relevance of a specific spring-time temperature regime for TBE epidemiology. Hunting bag data of roe deer (<italic>Capreolus capreolus</italic>) in the previous year was positively correlated with human TBE incidence, and hunting bag density of red fox (<italic>Vulpes vulpes</italic>) and red deer (<italic>Cervus elaphus</italic>) in the previous year were negatively correlated with human TBE incidence.</p></sec><sec><title>Conclusions</title><p>Our approach suggests that a combination of landscape and climatic variables as well as host-species dynamics influence TBE infection risk in humans. The model was unable to explain some of the temporal variation, specifically the high counts in 2005 and 2006. Factors such as the exposure of humans to infected ticks and forest rodent population dynamics, for which we have no data, are likely to be explanatory factors. Such information is required to identify the determinants of TBE more reliably. Having records of TBE infection sites at a finer scale would also be necessary.</p></sec></abstract></article-meta></front><body><sec><title>Background</title><p>Tick-borne encephalitis (TBE) is the most important flavivirus infection of the central nervous system in Europe and Russia. The annual number of cases is estimated to be as high as 10,000 in Russia and about 3,000 in European countries [<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B5">5</xref>]. Severe TBE infections caused by European virus strains typically take a biphasic course: After a short incubation period (usually 7-14 days, with extremes of 4-28 days), the first (viraemic) phase presents as an uncharacteristic influenza-like illness lasting 2-4 days (range 1-8 days) with fever, malaise, headache, myalgia, gastrointestinal symptoms, leukocytopenia, thrombocytopenia and elevated liver enzymes, and is often followed by a symptom-free interval of about one week (range 1-33 days). The second phase of TBE occurs in 20-30% of infected patients and is marked by four clinical features of different severity (meningitis, meningoencephalitis, meningoencephalomyelitis or meningoencephaloradiculitis) and the appearance of specific antibodies in the serum and cerebrospinal fluid. This is usually the time when patients with high fever and severe headache seek medical advice. The fatality rate in adult patients is less than 2%. However, severe courses of TBE infection with higher mortality and long-lasting sequelae, often affecting the patient's quality of life, are correlated with increased age [<xref ref-type="bibr" rid="B6">6</xref>-<xref ref-type="bibr" rid="B9">9</xref>].</p><p>As with most zoonotic diseases [<xref ref-type="bibr" rid="B10">10</xref>], TBE incidence in humans is characterised by considerable temporal (Figure <xref ref-type="fig" rid="F1">1</xref>) and spatial (Figure <xref ref-type="fig" rid="F2">2</xref>) heterogeneity [<xref ref-type="bibr" rid="B11">11</xref>]. The main determinant of infection risk is the density of infected ticks, i.e. the product of pathogen prevalence in the ticks and tick density [<xref ref-type="bibr" rid="B12">12</xref>]. <italic>Ixodes ricinus</italic>, the main vector of TBE virus (TBEV), has three distinct stages, larval, nymphal and adult ticks [<xref ref-type="bibr" rid="B13">13</xref>] whereas nymphs are responsible for the majority of tick bites in humans [<xref ref-type="bibr" rid="B14">14</xref>]. The <italic>prevalence </italic>of TBEV in (nymphal) ticks depends on a combination of factors; the basic reproduction number (R<sub>0</sub>) of TBEV, which crucially depends on the occurrence of non-viraemic virus transmission between ticks co-feeding, especially on forest rodents [<xref ref-type="bibr" rid="B15">15</xref>-<xref ref-type="bibr" rid="B17">17</xref>]. Furthermore, the persistence of TBEV depends on a threshold value between the density of competent (e.g. yellow-necked mice <italic>Apodemus flavicollis</italic>) and incompetent hosts (e.g. red deer <italic>Cervus elaphus</italic>) [<xref ref-type="bibr" rid="B18">18</xref>]. Possibly resulting from the species-specific reservoir competence, peaks in rodent populations in a given year are positively correlated with TBE incidence in humans in the succeeding year [<xref ref-type="bibr" rid="B19">19</xref>]. Co-feeding of larval and nymphal ticks on rodents critically depends on seasonal activity synchrony of these immature tick stages. Since Randolph et al.'s study [<xref ref-type="bibr" rid="B20">20</xref>], which related larval and nymphal synchrony to a certain temperature regime in autumn, subsequent research attention has been directed towards a specific temperature regime during spring time [<xref ref-type="bibr" rid="B11">11</xref>] causing the seasonal synchrony of immature ticks. Tick <italic>density </italic>in a given landscape is primarily determined by the availability of suitable forest habitat [<xref ref-type="bibr" rid="B21">21</xref>]. The findings of Allan et al. [<xref ref-type="bibr" rid="B22">22</xref>], relating to Lyme borreliosis risk, suggest that forest fragmentation might affect epidemiological risk. Tick density is further influenced by the abundance of host species such as roe (<italic>Capreolus capreolus</italic>) and red (<italic>Cervus elaphus</italic>) deer [<xref ref-type="bibr" rid="B23">23</xref>,<xref ref-type="bibr" rid="B24">24</xref>] which feed large numbers ticks in all stages of development [<xref ref-type="bibr" rid="B25">25</xref>,<xref ref-type="bibr" rid="B26">26</xref>]. Since estimates of wildlife population densities do not exist at the appropriate temporal and spatial resolution, we used hunting bag statistics as proxy for density. We also used hunting bag data of red fox (<italic>Vulpes vulpes</italic>), which was found to be positively correlated (with a time lag of one year) with TBE incidence in humans in Sweden [<xref ref-type="bibr" rid="B27">27</xref>]. The explanatory variables investigated in this paper include hunting bag data for red deer, roe deer and red fox, land cover, spring warming increase, and an index of forest fragmentation. Specifically we apply statistical tests, which take account of spatial correlation, to assess whether these factors are related to TBE incidence in humans.</p><fig id="F1" position="float"><label>Figure 1</label><caption><p><bold>Number of reported human TBE infections in Germany from 2001-2008</bold>. Data source: Robert-Koch Institut: SurvStat, <ext-link ext-link-type="uri" xlink:href="http://www3.rki.de/SurvStat">http://www3.rki.de/SurvStat</ext-link>. Accessed: 2/04/2009.</p></caption><graphic xlink:href="1476-072X-9-42-1"></graphic></fig><fig id="F2" position="float"><label>Figure 2</label><caption><p><bold>Spatial and temporal variation in reported numbers of human TBE infections from 2001-2008</bold>. The central map shows the distribution of TBE infection of entire Germany for the entire study period. Maps depicting the annual distribution of human TBE infections for the study area (States of Baden-Württemberg and Bavaria) are arranged clockwise around the central map. Data source: Robert-Koch Institut: SurvStat, <ext-link ext-link-type="uri" xlink:href="http://www3.rki.de/SurvStat">http://www3.rki.de/SurvStat</ext-link>. Accessed: 02/04/2009.</p></caption><graphic xlink:href="1476-072X-9-42-2"></graphic></fig></sec><sec sec-type="methods"><title>Methods</title><sec><title>Dependent variable</title><p>Annual symptomatic TBE infections in humans registered by the patients' place of permanent residence (county level) for the period 2001-2008 were obtained from the data base of the Robert Koch-Institut (SurvStat, <ext-link ext-link-type="uri" xlink:href="http://www3.rki.de/SurvStat">http://www3.rki.de/SurvStat</ext-link>, 11/02/2009). We included the human population size for each county and year (provided by the federal statistical bureau) in our model. For a given county in a given year we modelled <italic>p</italic>, the proportion of reported clinical TBE cases <italic>y </italic>out of <italic>n </italic>inhabitants, assuming that TBE incidence in humans and infection risk are closely correlated.</p></sec><sec><title>A model for the TBE-count data</title><p>Since our dependent variable consists of counts of successes (<italic>y</italic>) and failures (<italic>n-y</italic>) in <italic>n </italic>trials, we used a generalized linear model (GLM) with binomial error distribution, i.e. a logistic regression model [<xref ref-type="bibr" rid="B28">28</xref>]. The statistical package <italic>R </italic>[<xref ref-type="bibr" rid="B29">29</xref>] was used to estimate parameters of the model and to compute the test statistics. We model the probability that a person in a given county, and in a given year, is infected as a function of the explanatory variables.</p></sec><sec><title>Explanatory variables</title><sec><title>Forest type and forest cover</title><p>Information on forest type and forest cover for each county was obtained from the CORINE dataset with a spatial resolution of 100 meters [<xref ref-type="bibr" rid="B30">30</xref>]. We used the most recent available land cover information (year 2000) for all years, assuming that forest type and cover did not change substantially over this relatively short time period. For each county, we computed the proportion of coniferous, broad-leafed and mixed forest area.</p></sec><sec><title>Forest fragmentation</title><p>Given the relative coarse resolution of the CORINE dataset, we used the 'largest patch index' (largest forest patch/total forest area) to approximate the level of forest fragmentation for each county [<xref ref-type="bibr" rid="B31">31</xref>].</p></sec><sec><title>Spring warming</title><p>We extracted mean diurnal monthly interpolated temperatures from 30 arc s resolution climate surface maps based on the 1950-2000 period [<xref ref-type="bibr" rid="B32">32</xref>]. These data describe the spatial variation of temperatures which seems reasonable for our research question, given that temporal variation of temperatures is unlikely to explain the temporal variation of TBE incidence [<xref ref-type="bibr" rid="B33">33</xref>,<xref ref-type="bibr" rid="B34">34</xref>]. Data pre-processing included a validity check of the temperature data and a re-projection to the WGS84 cartographic system in GIS ArcView version 9 (ESRI, Redlands, CA, USA). Mean interpolated temperatures (in °C) were computed for each county, for the months of January, February, March and April. From these we computed the temperature increase in spring as the mean temperature increase between February and April corrected for the mean temperature of January [<xref ref-type="bibr" rid="B11">11</xref>].</p></sec><sec><title>Hunting bag data</title><p>We obtained annual hunting statistics of game species from wildlife authorities of both states (Baden-Württemberg and Bavaria) for the period 2000/2001-2007/2008. To deal with the unequal sizes of the 140 counties, we standardised the hunting bag counts by dividing them by area available for wildlife, the latter being approximated by the area covered by agriculture and forest. For Bavaria, hunting bag data on roe deer were not available for the period 2000/2001. Considering the minor temporal variation in roe deer hunting bags, we used the roe deer bag data of the period 2001/2002 also for the missing period. In Bavaria, roe deer hunting is based upon a three years management plan but hunting bags are approximately evenly realised among years. In Baden-Württemberg, roe deer hunting is based on yearly management plans. Management plans for carnivores are not in place.</p></sec><sec><title>Unexplained spatial and temporal variation</title><p>Spatial autocorrelation [<xref ref-type="bibr" rid="B35">35</xref>] was incorporated by using the proportion of TBE cases per inhabitant in the neighbouring counties as an explanatory variable in the model. To control for unexplained temporal variation, we included each year as fixed factor (with year 2001 as reference) in the model. Summary statistics of dependent and explanatory variables are provided in Table <xref ref-type="table" rid="T1">1</xref>.</p><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Summary statistics of dependent and explanatory variables for a model explaining the spatio-temporal variation of tick-borne encephalitis in southern Germany from 2001-2008</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Dependent variable</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Min.</th><th align="center">Max.</th></tr></thead><tbody><tr><td align="left">Number of reported TBE infections in humans</td><td align="center">1.95</td><td align="center">3.26</td><td align="center">0.00</td><td align="center">39.00</td></tr><tr><td align="left">County population size (in units of 10,000)</td><td align="center">16.54</td><td align="center">14.10</td><td align="center">2.86</td><td align="center">131.20</td></tr><tr><td align="left"><bold>Explanatory variables</bold></td><td></td><td></td><td></td><td></td></tr><tr><td align="left"><bold><italic>Proportion of forest cover/county</italic></bold></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Broad-leafed forest</td><td align="center">0.05</td><td align="center">0.06</td><td align="center">0</td><td align="center">0.28</td></tr><tr><td align="left">Coniferous forest</td><td align="center">0.18</td><td align="center">0.13</td><td align="center">0</td><td align="center">0.56</td></tr><tr><td align="left">Mixed forest cover</td><td align="center">0.09</td><td align="center">0.07</td><td align="center">0</td><td align="center">0.36</td></tr><tr><td align="left"><bold><italic>Forest fragmentation</italic></bold></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Connectivity (largest forest patch/entire forest cover)</td><td align="center">0.19</td><td align="center">0.14</td><td align="center">0</td><td align="center">0.74</td></tr><tr><td align="left"><bold><italic>Hunting bag in previous year per km<sup>2 </sup>hunting area</italic></bold></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Red deer <italic>Cervus elaphus</italic></td><td align="center">0.09</td><td align="center">0.30</td><td align="center">0</td><td align="center">6.77</td></tr><tr><td align="left">Roe deer <italic>Capreolus capreolus</italic></td><td align="center">4.46</td><td align="center">1.30</td><td align="center">0.76</td><td align="center">10.10</td></tr><tr><td align="left">Red fox <italic>Vulpes vulpes</italic></td><td align="center">2.17</td><td align="center">0.91</td><td align="center">0</td><td align="center">17.86</td></tr><tr><td align="left"><bold><italic>Climatic variables</italic></bold></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Spring warming: Temperature increase from February-April (°C) corrected for mean January temperature</td><td align="center">9.25</td><td align="center">1.39</td><td align="center">6.07</td><td align="center">12.59</td></tr><tr><td align="left"><bold><italic>Unexplained spatial variation</italic></bold></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Total human TBE cases in all neighbouring counties per inhabitants of those counties</td><td align="center">0.00013</td><td align="center">0.00014</td><td align="center">0</td><td align="center">0.00091</td></tr><tr><td align="left"><bold><italic>Unexplained temporal variation</italic></bold></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Each year was entered as a fixed factor in the model</td><td align="center">-/-</td><td align="center">-/-</td><td align="center">-/-</td><td align="center">-/-</td></tr></tbody></table><table-wrap-foot><p>Note that the hunting bag of roe deer in the counties of Bavaria is the average annual offtake of three years.</p></table-wrap-foot></table-wrap></sec></sec><sec><title>Modelling procedure</title><p>Before fitting a full model, we tested the effect of single covariates on the probability of TBE infections in humans after correcting for unexplained spatial and temporal variation (Table <xref ref-type="table" rid="T2">2</xref>). We tested for multicollinearity between the explanatory variables (Table <xref ref-type="table" rid="T3">3</xref>) by computing the condition number. For model checking the deviance residuals were computed and displayed using GRASS GIS [<xref ref-type="bibr" rid="B36">36</xref>].</p><table-wrap id="T2" position="float"><label>Table 2</label><caption><p>Relationships between single variables and the probability of tick-borne encephalitis infections in humans after correcting for spatial autocorrelation and unexplained temporal variation as tested by a logistic regression model</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Parameter</th><th align="center">Algebraic sign of coefficient estimate</th><th align="center">Significance level</th></tr></thead><tbody><tr><td align="left">Proportion broad-leafed forest</td><td align="center">-</td><td align="center">0.10</td></tr><tr><td align="left">Proportion coniferous forest</td><td align="center">+</td><td align="center">< 0.001</td></tr><tr><td align="left">Proportion mixed forest</td><td align="center">+</td><td align="center">< 0.001</td></tr><tr><td align="left">Connectivity</td><td align="center">+</td><td align="center">0.59</td></tr><tr><td align="left">Red deer hunting bag</td><td align="center">+</td><td align="center">< 0.01</td></tr><tr><td align="left">Roe deer hunting bag</td><td align="center">+</td><td align="center">< 0.001</td></tr><tr><td align="left">Red fox hunting bag</td><td align="center">-</td><td align="center">0.24</td></tr><tr><td align="left">Spring warming</td><td align="center">-</td><td align="center">< 0.001</td></tr></tbody></table></table-wrap><table-wrap id="T3" position="float"><label>Table 3</label><caption><p>Correlation matrix (Pearson product-moment correlation coefficient) between variables potentially explaining the probability of tick-borne encephalitis infections in humans in southern Germany</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Parameter</th><th align="center">Proportion broad-leafed forest</th><th align="center">Proportion coniferous forest</th><th align="center">Proportion mixed forest</th><th align="center">Largest forest patch index</th><th align="center">Red deer hunting bag</th><th align="center">Roe deer hunting bag</th><th align="center">Red fox hunting bag</th></tr></thead><tbody><tr><td align="left">Proportion coniferous forest</td><td align="center">-0.53</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Proportion mixed forest</td><td align="center">0.33</td><td align="center">-0.11</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Largest patch index</td><td align="center">-0.13</td><td align="center">0.17</td><td align="center">-0.15</td><td></td><td></td><td></td><td></td></tr><tr><td align="left">Red deer hunting bag</td><td align="center">-0.09</td><td align="center">0.27</td><td align="center">0.14</td><td align="center">-0.06</td><td></td><td></td><td></td></tr><tr><td align="left">Roe deer hunting bag</td><td align="center">-0.03</td><td align="center">0.06</td><td align="center">0.21</td><td align="center">-0.34</td><td align="center">-0.07</td><td></td><td></td></tr><tr><td align="left">Red fox hunting bag</td><td align="center">0.20</td><td align="center">-0.17</td><td align="center">0.13</td><td align="center">-0.17</td><td align="center">-0.06</td><td align="center">0.12</td><td></td></tr><tr><td align="left">Spring warming</td><td align="center">-0.44</td><td align="center">0.32</td><td align="center">-0.33</td><td align="center">-0.16</td><td align="center">0.16</td><td align="center">-0.02</td><td align="center">-0.38</td></tr></tbody></table></table-wrap></sec></sec><sec><title>Results</title><sec><title>Preliminary analyses</title><p>After correcting for unexplained spatial and temporal variation, five of the eight candidate variables were significantly (p < 0.05) related with TBE incidence in humans (Table <xref ref-type="table" rid="T2">2</xref>). The candidate variables showed rather weak correlations, resulting in a condition number of 6.5, which indicates that multicollinearity is not of concern [<xref ref-type="bibr" rid="B37">37</xref>]. The final model was fitted using all candidate variables.</p></sec><sec><title>Full model</title><p>The full model suggested that all candidate variables were significantly associated with TBE infection risk in humans (Table <xref ref-type="table" rid="T4">4</xref>). The proportion of forest cover was positively correlated with probability of TBE infection; the effect of coniferous forest cover was stronger than that of broad-leafed and mixed forest cover (Figure <xref ref-type="fig" rid="F3">3a-c</xref>). When tested on its own, the proportion of broad-leafed forest cover was not significant (Table <xref ref-type="table" rid="T2">2</xref>).</p><table-wrap id="T4" position="float"><label>Table 4</label><caption><p>Parameter estimates of variables derived from the full logistic regression model aiming at explaining the spatio-temporal variation in human tick-borne encephalitis infections in southern Germany from 2001-2008</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Parameter</th><th align="center">Estimate</th><th align="center">Standard error</th><th align="center">z-value</th></tr></thead><tbody><tr><td align="left">Intercept</td><td align="center">-11.94***</td><td align="center">0.32</td><td align="center">-37.30</td></tr><tr><td align="left">Proportion broad-leafed forest</td><td align="center">2.21***</td><td align="center">0.47</td><td align="center">4.71</td></tr><tr><td align="left">Proportion coniferous forest</td><td align="center">4.38***</td><td align="center">0.23</td><td align="center">18.69</td></tr><tr><td align="left">Proportion mixed forest</td><td align="center">3.21***</td><td align="center">0.32</td><td align="center">10.04</td></tr><tr><td align="left">Largest patch index</td><td align="center">-0.58**</td><td align="center">0.21</td><td align="center">-2.76</td></tr><tr><td align="left">Red deer hunting bag</td><td align="center">-0.27*</td><td align="center">0.11</td><td align="center">-2.74</td></tr><tr><td align="left">Roe deer hunting bag</td><td align="center">0.21***</td><td align="center">0.02</td><td align="center">10.42</td></tr><tr><td align="left">Red fox hunting bag</td><td align="center">-0.21***</td><td align="center">0.04</td><td align="center">-4.97</td></tr><tr><td align="left">Spring warming</td><td align="center">-0.14***</td><td align="center">0.02</td><td align="center">-6.09</td></tr><tr><td align="left">Spatial autocorrelation</td><td align="center">817.75***</td><td align="center">211.47</td><td align="center">3.87</td></tr><tr><td align="left">Year 2002</td><td align="center">-0.16</td><td align="center">0.10</td><td align="center">-1.63</td></tr><tr><td align="left">Year 2003</td><td align="center">-0.02</td><td align="center">0.10</td><td align="center">-0.18</td></tr><tr><td align="left">Year 2004</td><td align="center">-0.09</td><td align="center">0.09</td><td align="center">-0.98</td></tr><tr><td align="left">Year 2005</td><td align="center">0.42***</td><td align="center">0.08</td><td align="center">4.92</td></tr><tr><td align="left">Year 2006</td><td align="center">0.64***</td><td align="center">0.08</td><td align="center">7.81</td></tr><tr><td align="left">Year 2007</td><td align="center">-0.30**</td><td align="center">0.10</td><td align="center">-2.93</td></tr><tr><td align="left">Year 2008</td><td align="center">-0.01</td><td align="center">0.09</td><td align="center">-0.13</td></tr></tbody></table><table-wrap-foot><p>(***P-value < 0.001; **P-value < 0.01; *P-value < 0.05).</p></table-wrap-foot></table-wrap><fig id="F3" position="float"><label>Figure 3</label><caption><p><bold>Relative effects of significant variables of the final model explaining the variation of human TBE infections in southern Germany</bold>. The effect of single variables on the probability of TBE incidence was estimated by predicting the full model on the entire range of the target variable. Non-target variables entered the model prediction with their mean value and using the year 2001 as reference. For a definition of the variables shown in a) - j), see Table 1.</p></caption><graphic xlink:href="1476-072X-9-42-3"></graphic></fig><p>TBE risk was significantly negatively associated with the forest fragmentation index. This suggests that, taking all other variables as fixed, TBE risk in humans would decline if forest cover were more continuous (Figure <xref ref-type="fig" rid="F3">3d</xref>). Admittedly, we did not detect a significant relationship between the forest fragmentation index and TBE risk if tested without other explanatory variables (Table <xref ref-type="table" rid="T2">2</xref>).</p><p>Wildlife population densities (measured indirectly as described above) were significantly correlated with TBE risk in humans in the following year (Figure <xref ref-type="fig" rid="F3">3e-g</xref>). The correlation with roe deer density was positive but those with red fox and red deer were negative. Except in the case of red deer, all coefficients in the full model have the same sign as those in the corresponding restricted models. TBE risk was significantly correlated with temperature increase during the spring months (Figure <xref ref-type="fig" rid="F3">3h</xref>) both in the restricted and in the full model (Tables <xref ref-type="table" rid="T2">2</xref>, <xref ref-type="table" rid="T4">4</xref>). Unexpectedly, the correlation is negative.</p><p>There is strong evidence of spatial autocorrelation (Figure <xref ref-type="fig" rid="F3">3i</xref>) and, unfortunately, also of unexplained temporal heterogeneity. The incidence of TBE infections varied substantially from year to year (see Figure <xref ref-type="fig" rid="F1">1</xref>) peaking in 2005 and 2006. Of course we would have wished that the model could explain these peaks in terms of the explanatory variables considered here. As is evident in Table <xref ref-type="table" rid="T4">4</xref> we were unable to account for this temporal heterogeneity with the covariates available to us.</p><p>With the above limitations in mind, the model (Null deviance = 3580.0 on 1119 degrees of freedom; residual deviance = 2494.8 on 1101 degrees of freedom) explained a large fraction of the observed variance (Cox-Snell-R<sup>2 </sup>= 0.96, Nagelkerke's R<sup>2 </sup>= 0.65). A histogram of the deviance residuals of the model (Figure <xref ref-type="fig" rid="F4">4</xref>) indicates that the distribution of the residuals is somewhat skewed, which is due to the discrete nature of the response; about 40% of the observed counts are equal to zero, and almost 75% of them are two or less. The spatial distribution of the residuals (Figure <xref ref-type="fig" rid="F5">5</xref>) varied considerably from year to year. There was a slight tendency to underestimate the TBE incidence in counties with few reported cases (south central part of the study area) and to overestimate the incidence in counties with many reported cases (western, northern and eastern regions of the study area) (Figures <xref ref-type="fig" rid="F2">2</xref> and <xref ref-type="fig" rid="F5">5</xref>).</p><fig id="F4" position="float"><label>Figure 4</label><caption><p>Histogram of the residuals of the final model explaining the variation of human TBE infections in southern Germany.</p></caption><graphic xlink:href="1476-072X-9-42-4"></graphic></fig><fig id="F5" position="float"><label>Figure 5</label><caption><p>Spatial distribution of residuals derived from the negative binomial regression model on TBE infections in humans.</p></caption><graphic xlink:href="1476-072X-9-42-5"></graphic></fig></sec></sec><sec><title>Discussion</title><p>The model explaining TBE incidence in southern Germany contains eight variables (three related to forest cover, one related to forest fragmentation, three related to wildlife species population dynamics and one related to climatic conditions during spring time) plus one variable each to account for unobserved spatial and temporal variation. With one exception (spring warming) the results are broadly in line with previous research, highlighting the range of factors influencing TBE transmission dynamics and thus infection potential in humans [<xref ref-type="bibr" rid="B33">33</xref>,<xref ref-type="bibr" rid="B34">34</xref>,<xref ref-type="bibr" rid="B38">38</xref>]. The fact that the factor "year" had to be included in the model constitutes a failure of the model. Other factors, especially those taking account of human activities, would need to be considered to explain the remaining and substantial temporal heterogeneity. The admittedly incomplete model does, however, consider the influence of several explanatory variables simultaneously, rather than one variable or a few variables.</p><p>The proposed model suggests that the proportion of coniferous forests had a stronger effect on TBE risk for humans compared to other forest types. Results from field studies provide equivocal results concerning the epidemiological risk [densities of (infected) ticks] according to forest type, but generally broad-leafed forest is considered as a suitable habitat for ticks. In North American forests, black-legged ticks (<italic>Ixodes scapularis</italic>) are more abundant in deciduous than in coniferous woodlands [<xref ref-type="bibr" rid="B39">39</xref>]. In Scotland, tick densities were highest in coniferous forests compared to deciduous woodland and pastures [<xref ref-type="bibr" rid="B40">40</xref>]. In Denmark, no differences in <italic>Ixodes ricinus </italic>tick densities between spruce (conifer) forests and non spruce forests were found [<xref ref-type="bibr" rid="B23">23</xref>]. It is, however, unlikely that forest type itself accounts directly for tick density patterns. Potentially, forest type indirectly affects tick densities by providing appropriate moisture and host species for ticks or by sustaining more TBE competent reservoir species relative to incompetent ones [<xref ref-type="bibr" rid="B18">18</xref>,<xref ref-type="bibr" rid="B23">23</xref>,<xref ref-type="bibr" rid="B33">33</xref>], or forest types are unevenly frequented by humans.</p><p>In addition to forest extent, we hypothesized that forest fragmentation would enhance TBE risk either by increasing density of infected ticks [<xref ref-type="bibr" rid="B22">22</xref>] or by enhancing contact rates between humans and ticks. The effect of forest fragmentation was unclear. Despite showing weak correlations with other variables (Table <xref ref-type="table" rid="T3">3</xref>), which indicates that it is not confounded with other variables, the sign of the coefficient in the simple model was the opposite of that in the full model. Yet, removing this variable from the full model did not alter the signs of other coefficients.</p><p>Hunting bag densities of three game species were found to be significantly associated with TBE risk in humans. Since hunting bags are subject to management plans (deer) and/or influenced by hunting effort (red fox), these observations should be regarded cautiously [<xref ref-type="bibr" rid="B41">41</xref>]. Yet, "important ecological questions simply have to be addressed on the right scale - which often means an uncomfortable large scale - even if that means a certain degree of imprecision" [<xref ref-type="bibr" rid="B42">42</xref>]. There is growing empirical evidence that roe deer populations increase the epidemiological risk of ticks [<xref ref-type="bibr" rid="B23">23</xref>], Lyme disease risk [<xref ref-type="bibr" rid="B43">43</xref>] and TBE risk [[<xref ref-type="bibr" rid="B33">33</xref>], [<xref ref-type="bibr" rid="B44">44</xref>], this study]. Regarding the role of red deer in determining TBE risk, our results are inconclusive (changing signs simple model vs. full model) but do not necessarily contradict findings from Italy, where a non-significant effect was found between red deer and TBE incidence in humans [<xref ref-type="bibr" rid="B33">33</xref>].</p><p>The negative relationship found in this study between red fox hunting bags and human TBE cases in the succeeding year is in contrast to a study in TBE endemic areas in Sweden, where this relationship was found to be positive [<xref ref-type="bibr" rid="B27">27</xref>]. These contradictory findings will need to be clarified in future studies on the specific role of foxes in the epidemiology of TBEV.</p><p>Unfortunately, reliable data on forest rodent dynamics are not available at the appropriate temporal and spatial scale, and could thus not enter our model. Further attempts should be made to test the hypothesis that high rodent (especially <italic>Apodemus flavicollis</italic>) densities translate into high nymphal densities in the following year [<xref ref-type="bibr" rid="B45">45</xref>] and hence to elevate TBE incidence in humans [<xref ref-type="bibr" rid="B19">19</xref>]. Such a finding might be of use as an effective early warning system for public health.</p><p>Unexpectedly, the direction of the regression coefficient of the spring warming variable is not in line with the claimed importance of simultaneous activity of larval and nymphal ticks for TBE maintenance [<xref ref-type="bibr" rid="B11">11</xref>]. That theory suggests that fast warming in spring is required to allow nymphs (critical temperature ~7°C) and larvae (critical temperature ~10°C) to feed synchronously [<xref ref-type="bibr" rid="B16">16</xref>] and to transmit pathogens among the tick population [<xref ref-type="bibr" rid="B15">15</xref>]. However, it should be emphasised that spring warming has so far been used only to explain the distribution of TBE foci and not the variable incidence.</p><p>As in most epidemiological studies, we based our analysis on the assumption that TBE incidence is strongly correlated with the epidemiological risk of TBE (i.e. the density of infected nymphs). Although the model provides a reasonable fit, some potentially important factors were not investigated due to lack of data. Included here are differing virulence of TBE, variable exposure of humans to ticks, differing immune responses, demography and TBE immunisation coverage. E.g. Kimmig et al. [<xref ref-type="bibr" rid="B46">46</xref>] found discrepancies in spatial distribution of clinical TBE cases and prevalence of TBE antibodies in sera of persons at risk. In addition, demographic analyses indicate that men above the age of 35 years are disproportional represented (Figure <xref ref-type="fig" rid="F6">6</xref>) among the persons with clinical TBE symptoms, which might be related to higher exposure risk to ticks and/or to differing immune responses [<xref ref-type="bibr" rid="B47">47</xref>]. Furthermore, locations associated with the counts available to us are the patients' place of permanent residence, and not the place of infection. Although it is likely that most infections occur in the infected person's home county, exceptions in this respect are clearly a potential source of bias. Due to data availability this analysis is based on a rather coarse scale [cf. 42]. Counties do not necessarily represent homogenous units with respect to environmental and ecological conditions. Generally forests, animal communities and interpolated temperatures are very heterogeneous within a given county. Thus any analysis based on values that have been averaged over variable conditions cannot be expected to yield precise results. Consequential we strongly recommend recording the suspected places of TBE infection as accurately as possible i.e. at the resolution of the forest patch.</p><fig id="F6" position="float"><label>Figure 6</label><caption><p><bold>Distribution of reported TBE cases in Baden-Württemberg and Bavaria by age group and sex (m = male, f = female)</bold>. Data source: Robert-Koch Institut: SurvStat, <ext-link ext-link-type="uri" xlink:href="http://www3.rki.de/SurvStat">http://www3.rki.de/SurvStat</ext-link>. Accessed: 02/04/2009.</p></caption><graphic xlink:href="1476-072X-9-42-6"></graphic></fig></sec><sec><title>Conclusions</title><p>Our modelling approach focussed on ten biotic and abiotic factors possibly influencing the epidemiological risk of TBE. Except for the influence of spring warming, the results are in line with previously published findings. The presented approach might therefore be useful for predicting at least the potential direction, and approximate magnitude of TBE risk, as a function of ecological change (land cover change, wildlife population dynamics). To make further progress, a higher spatial resolution is needed in order to make more reliable interferences about the relationships between eco-environmental factors and TBE incidence. Moreover, neither this analysis nor the in-depth analyses of yearly temperature variability [<xref ref-type="bibr" rid="B33">33</xref>,<xref ref-type="bibr" rid="B34">34</xref>,<xref ref-type="bibr" rid="B48">48</xref>] could entirely explain the temporal dynamics of tick abundance and TBE in the past decade. This underlines previous notions that besides the epidemiological risk, the contact rate probability between infected ticks and humans is of crucial importance and should be incorporated in models for tick-borne diseases [<xref ref-type="bibr" rid="B11">11</xref>,<xref ref-type="bibr" rid="B43">43</xref>,<xref ref-type="bibr" rid="B48">48</xref>].</p></sec><sec><title>Competing interests</title><p>The authors declare that they have no competing interests.</p></sec><sec><title>Authors' contributions</title><p>CK designed the experiment, acquired the data, performed the statistical analysis, interpreted the results and wrote the manuscript. WZ designed the experiment, performed the statistical analysis, contributed to the interpretation of the results and the writing of the MS. PS performed the GIS analyses. FR acquired the data, contributed to the interpretation of the results and the writing of the MS. TV, PH and MN contributed to the interpretation of the results and the writing of the MS. All authors read and approved the final manuscript.</p></sec></body><back><sec><title>Acknowledgements</title><p>This study was funded by a research grant from the Federal Ministry of Education and Research (BMBF grant 1363120: Emerging arthropod-borne-viral infections in Germany: Pathogenesis, diagnostics and surveillance).The Bavarian State Ministry of Alimentation, Agriculture and Forestry and the Wildlife Research Unit of the State Baden-Württemberg kindly provided hunting bag data. Data on human population were kindly supplied by the German Federal Statistical Office. We sincerely thank F. Herschleb for assistance in digitalising hunting bag data and H. Reinecke for generating the map of the residuals. We thank four anonymous reviewers whose comments greatly improved previous drafts of this manuscript.</p></sec><ref-list><ref id="B1"><mixed-citation publication-type="journal"><name><surname>Pugliese</surname><given-names>A</given-names></name><name><surname>Beltramo</surname><given-names>T</given-names></name><name><surname>Torre</surname><given-names>D</given-names></name><article-title>Emerging and re-emerging viral infections in Europe</article-title><source>Cell Biochem Funct</source><year>2007</year><volume>25</volume><issue>1</issue><fpage>1</fpage><lpage>13</lpage><pub-id pub-id-type="doi">10.1002/cbf.1342</pub-id><pub-id pub-id-type="pmid">16944546</pub-id></mixed-citation></ref><ref id="B2"><mixed-citation publication-type="journal"><name><surname>Günther</surname><given-names>G</given-names></name><name><surname>Haglund</surname><given-names>M</given-names></name><article-title>Tick-borne encephalopathies: epidemiology, diagnosis, treatment and prevention</article-title><source>CNS Drugs</source><year>2005</year><volume>19</volume><issue>12</issue><fpage>1009</fpage><lpage>32</lpage><pub-id pub-id-type="doi">10.2165/00023210-200519120-00004</pub-id><pub-id pub-id-type="pmid">16332143</pub-id></mixed-citation></ref><ref id="B3"><mixed-citation publication-type="journal"><name><surname>Charrel</surname><given-names>RN</given-names></name><name><surname>Attoui</surname><given-names>H</given-names></name><name><surname>Butenko</surname><given-names>AM</given-names></name><name><surname>Clegg</surname><given-names>JC</given-names></name><name><surname>Deubel</surname><given-names>V</given-names></name><name><surname>Frolova</surname><given-names>TV</given-names></name><name><surname>Gould</surname><given-names>EA</given-names></name><name><surname>Gritsun</surname><given-names>TS</given-names></name><name><surname>Heinz</surname><given-names>FX</given-names></name><name><surname>Labuda</surname><given-names>M</given-names></name><name><surname>Lashkevich</surname><given-names>VA</given-names></name><name><surname>Loktev</surname><given-names>V</given-names></name><name><surname>Lundkvist</surname><given-names>A</given-names></name><name><surname>Lvov</surname></name><name><surname>Mandl</surname><given-names>CW</given-names></name><name><surname>Niedrig</surname><given-names>M</given-names></name><name><surname>Papa</surname><given-names>A</given-names></name><name><surname>Petrov</surname><given-names>VS</given-names></name><name><surname>Plyusin</surname><given-names>A</given-names></name><name><surname>Randolph</surname><given-names>S</given-names></name><name><surname>Süss</surname><given-names>J</given-names></name><name><surname>Zlobin</surname><given-names>VL</given-names></name><name><surname>de Lamballerie</surname><given-names>X</given-names></name><article-title>Tick-borne virus diseases of human interest in Europe</article-title><source>Clin Microbiol Infect</source><year>2004</year><volume>10</volume><issue>12</issue><fpage>1040</fpage><lpage>55</lpage><pub-id pub-id-type="doi">10.1111/j.1469-0691.2004.01022.x</pub-id><pub-id pub-id-type="pmid">15606630</pub-id></mixed-citation></ref><ref id="B4"><mixed-citation publication-type="journal"><name><surname>Gritsun</surname><given-names>TS</given-names></name><name><surname>Lashkevich</surname><given-names>VA</given-names></name><name><surname>Gould</surname><given-names>EA</given-names></name><article-title>Tick-borne encephalitis</article-title><source>Antiviral Res</source><year>2003</year><volume>57</volume><issue>1-2</issue><fpage>129</fpage><lpage>46</lpage><pub-id pub-id-type="doi">10.1016/S0166-3542(02)00206-1</pub-id><pub-id pub-id-type="pmid">12615309</pub-id></mixed-citation></ref><ref id="B5"><mixed-citation publication-type="journal"><name><surname>Süss</surname><given-names>J</given-names></name><article-title>Tick-borne encephalitis in Europe and beyond - the epidemiological situation as of 2007</article-title><source>Euro Surveill</source><year>2008</year><volume>13</volume><issue>26</issue><comment>pii=18916</comment></mixed-citation></ref><ref id="B6"><mixed-citation publication-type="journal"><name><surname>Holzmann</surname><given-names>H</given-names></name><article-title>Diagnosis of tick-borne encephalitis</article-title><source>Vaccine</source><year>2003</year><volume>21</volume><issue>Suppl 1</issue><fpage>S36</fpage><lpage>40</lpage><pub-id pub-id-type="doi">10.1016/S0264-410X(02)00819-8</pub-id><pub-id pub-id-type="pmid">12628812</pub-id></mixed-citation></ref><ref id="B7"><mixed-citation publication-type="journal"><name><surname>Kunze</surname><given-names>U</given-names></name><name><surname>Baumhackl</surname><given-names>U</given-names></name><name><surname>Bretschneider</surname><given-names>R</given-names></name><name><surname>Chmelik</surname><given-names>V</given-names></name><name><surname>Grubeck-Loebenstein</surname><given-names>B</given-names></name><name><surname>Haglund</surname><given-names>M</given-names></name><name><surname>Heinz</surname><given-names>F</given-names></name><name><surname>Kaiser</surname><given-names>R</given-names></name><name><surname>Kimmig</surname><given-names>P</given-names></name><name><surname>Kunz</surname><given-names>C</given-names></name><name><surname>Kunze</surname><given-names>M</given-names></name><name><surname>Mickiene</surname><given-names>A</given-names></name><name><surname>Misic-Majerus</surname><given-names>L</given-names></name><name><surname>Randolph</surname><given-names>S</given-names></name><name><surname>Rieke</surname><given-names>B</given-names></name><name><surname>Stefanoff</surname><given-names>P</given-names></name><name><surname>Süss</surname><given-names>J</given-names></name><name><surname>Wimmer</surname><given-names>R</given-names></name><collab>International Scientific Working Group on Tick-borne encephalitis</collab><article-title>The Golden Agers and Tick-borne encephalitis: Conference report and position paper of the International Scientific Working Group on Tick-borne encephalitis</article-title><source>Wiener Med Wochenschr</source><year>2005</year><volume>155</volume><issue>11-12</issue><fpage>289</fpage><lpage>94</lpage><pub-id pub-id-type="doi">10.1007/s10354-005-0178-0</pub-id></mixed-citation></ref><ref id="B8"><mixed-citation publication-type="journal"><name><surname>Kaiser</surname><given-names>R</given-names></name><article-title>Tick-borne encephalitis (TBE) in Germany and clinical course of the disease</article-title><source>Int J Med Microbiol</source><year>2002</year><volume>291</volume><issue>Suppl 33</issue><fpage>58</fpage><lpage>61</lpage><pub-id pub-id-type="doi">10.1016/S1438-4221(02)80012-1</pub-id><pub-id pub-id-type="pmid">12141760</pub-id></mixed-citation></ref><ref id="B9"><mixed-citation publication-type="journal"><name><surname>Mickiene</surname><given-names>A</given-names></name><name><surname>Laiskonis</surname><given-names>A</given-names></name><name><surname>Günther</surname><given-names>G</given-names></name><name><surname>Vene</surname><given-names>S</given-names></name><name><surname>Lundkvist</surname><given-names>A</given-names></name><name><surname>Lindquist</surname><given-names>L</given-names></name><article-title>Tickborne encephalitis in an area of high endemicity in Lithuania: disease severity and long-term prognosis</article-title><source>Clin Infect Dis</source><year>2002</year><volume>35</volume><issue>6</issue><fpage>650</fpage><lpage>658</lpage><pub-id pub-id-type="doi">10.1086/342059</pub-id><pub-id pub-id-type="pmid">12203160</pub-id></mixed-citation></ref><ref id="B10"><mixed-citation publication-type="journal"><name><surname>Jones</surname><given-names>E</given-names></name><name><surname>Patel</surname><given-names>NG</given-names></name><name><surname>Levy</surname><given-names>MA</given-names></name><name><surname>Storeygard</surname><given-names>A</given-names></name><name><surname>Balk</surname><given-names>D</given-names></name><name><surname>Gittleman</surname><given-names>JL</given-names></name><name><surname>Daszak</surname><given-names>P</given-names></name><article-title>Global trends in emerging infectious diseases</article-title><source>Nature</source><year>2008</year><volume>451</volume><fpage>990</fpage><lpage>994</lpage><pub-id pub-id-type="doi">10.1038/nature06536</pub-id><pub-id pub-id-type="pmid">18288193</pub-id></mixed-citation></ref><ref id="B11"><mixed-citation publication-type="book"><name><surname>Randolph</surname><given-names>SE</given-names></name><name><surname>Sumilo</surname><given-names>D</given-names></name><person-group person-group-type="editor">Takken W, Knols B</person-group><article-title>Tick-borne encephalitis in Europe: dynamics of changing risk</article-title><source>Emerging Pests and Vector-borne Diseases in Europe</source><year>2007</year><publisher-name>Wageningen, University Publishers</publisher-name><fpage>187</fpage><lpage>206</lpage></mixed-citation></ref><ref id="B12"><mixed-citation publication-type="journal"><name><surname>Ostfeld</surname><given-names>RS</given-names></name><name><surname>Canham</surname><given-names>CD</given-names></name><name><surname>Oggenfuss</surname><given-names>K</given-names></name><name><surname>Winchcombe</surname><given-names>RJ</given-names></name><name><surname>Keesing</surname><given-names>F</given-names></name><article-title>Climate, deer, rodents, and acorns as determinants of variation in Lyme-disease risk</article-title><source>PLoS Biol</source><year>2006</year><volume>4</volume><issue>6</issue><fpage>e145</fpage><pub-id pub-id-type="doi">10.1371/journal.pbio.0040145</pub-id><pub-id pub-id-type="pmid">16669698</pub-id></mixed-citation></ref><ref id="B13"><mixed-citation publication-type="journal"><name><surname>Randolph</surname><given-names>SE</given-names></name><article-title>Tick ecology: processes and patterns behind the epidemiological risk posed by ixodid ticks as vectors</article-title><source>Parasitology</source><year>2004</year><volume>129</volume><issue>Suppl 1</issue><fpage>S37</fpage><lpage>S65</lpage><pub-id pub-id-type="doi">10.1017/S0031182004004925</pub-id><pub-id pub-id-type="pmid">15938504</pub-id></mixed-citation></ref><ref id="B14"><mixed-citation publication-type="journal"><name><surname>Vassalo</surname><given-names>M</given-names></name><name><surname>Perez-eid</surname><given-names>C</given-names></name><article-title>Comparative behavior of different life cycle stages of <italic>Ixodes ricinus </italic>(Acari: Ixodidae) to human-produced stimuli</article-title><source>J Med Entomol</source><year>2002</year><volume>39</volume><fpage>234</fpage><lpage>236</lpage><pub-id pub-id-type="doi">10.1603/0022-2585-39.1.234</pub-id><pub-id pub-id-type="pmid">11931263</pub-id></mixed-citation></ref><ref id="B15"><mixed-citation publication-type="journal"><name><surname>Labuda</surname><given-names>M</given-names></name><name><surname>Nuttal</surname><given-names>PA</given-names></name><name><surname>Kozuch</surname><given-names>O</given-names></name><name><surname>Eleckova</surname><given-names>E</given-names></name><name><surname>Zuffova</surname><given-names>E</given-names></name><name><surname>Sabo</surname><given-names>A</given-names></name><article-title>Non-viraemic transmission of tick-borne encephalitis virus: a mechanism for arbovirus survival in nature</article-title><source>Experientia</source><year>1993</year><volume>49</volume><fpage>802</fpage><lpage>805</lpage><pub-id pub-id-type="doi">10.1007/BF01923553</pub-id><pub-id pub-id-type="pmid">8405306</pub-id></mixed-citation></ref><ref id="B16"><mixed-citation publication-type="journal"><name><surname>Randolph</surname><given-names>SE</given-names></name><name><surname>Gern</surname><given-names>L</given-names></name><name><surname>Nutall</surname><given-names>PA</given-names></name><article-title>Co-feeding ticks: Epidemiological significance for tick-borne pathogen transmission</article-title><source>Parasitol Today</source><year>1996</year><volume>12</volume><issue>12</issue><fpage>472</fpage><lpage>479</lpage><pub-id pub-id-type="doi">10.1016/S0169-4758(96)10072-7</pub-id><pub-id pub-id-type="pmid">15275266</pub-id></mixed-citation></ref><ref id="B17"><mixed-citation publication-type="journal"><name><surname>Hartemink</surname><given-names>NA</given-names></name><name><surname>Randolph</surname><given-names>SE</given-names></name><name><surname>Davis</surname><given-names>SA</given-names></name><name><surname>Heesterbeek</surname></name><article-title>The basic reproduction number for complex disease systems: defining R<sub>0 </sub>for tick-borne infections</article-title><source>Am Nat</source><year>2008</year><volume>171</volume><issue>8</issue><fpage>743</fpage><lpage>754</lpage><pub-id pub-id-type="doi">10.1086/587530</pub-id><pub-id pub-id-type="pmid">18462128</pub-id></mixed-citation></ref><ref id="B18"><mixed-citation publication-type="journal"><name><surname>Rosà</surname><given-names>R</given-names></name><name><surname>Pugliese</surname><given-names>A</given-names></name><article-title>Effects of tick population dynamics and host densities on the persistence of tick-borne infections</article-title><source>Math Biosci</source><year>2007</year><volume>208</volume><fpage>216</fpage><lpage>240</lpage><pub-id pub-id-type="doi">10.1016/j.mbs.2006.10.002</pub-id><pub-id pub-id-type="pmid">17125804</pub-id></mixed-citation></ref><ref id="B19"><mixed-citation publication-type="journal"><name><surname>Zeman</surname><given-names>P</given-names></name><name><surname>Benes</surname><given-names>C</given-names></name><article-title>A tick-borne encephalitis ceiling has moved upwards during the last 30 years: possible impact of global warming?</article-title><source>Int J Med Microbiol</source><year>2004</year><volume>293</volume><issue>Suppl 37</issue><fpage>48</fpage><lpage>54</lpage><pub-id pub-id-type="pmid">15146984</pub-id></mixed-citation></ref><ref id="B20"><mixed-citation publication-type="journal"><name><surname>Randolph</surname><given-names>SE</given-names></name><name><surname>Green</surname><given-names>RM</given-names></name><name><surname>Peacey</surname><given-names>MF</given-names></name><name><surname>Rogers</surname><given-names>DJ</given-names></name><article-title>Seasonal synchrony: the key to tick-borne encephalitis foci identified by satellite data</article-title><source>Parasitology</source><year>2000</year><volume>121</volume><fpage>15</fpage><lpage>23</lpage><pub-id pub-id-type="doi">10.1017/S0031182099006083</pub-id><pub-id pub-id-type="pmid">11085221</pub-id></mixed-citation></ref><ref id="B21"><mixed-citation publication-type="journal"><name><surname>Racz</surname><given-names>GR</given-names></name><name><surname>Ban</surname><given-names>E</given-names></name><name><surname>Ferenczi</surname><given-names>E</given-names></name><name><surname>Berencsi</surname><given-names>G</given-names></name><article-title>A simple spatial model to explain the distribution of human tick-borne encephalitis cases in Hungary</article-title><source>Vector-Borne Zoonot</source><year>2006</year><volume>6</volume><fpage>369</fpage><lpage>378</lpage><pub-id pub-id-type="doi">10.1089/vbz.2006.6.369</pub-id></mixed-citation></ref><ref id="B22"><mixed-citation publication-type="journal"><name><surname>Allan</surname><given-names>BF</given-names></name><name><surname>Keesing</surname><given-names>F</given-names></name><name><surname>Ostfeld</surname><given-names>RS</given-names></name><article-title>Effect of forest fragmentation on lyme disease risk</article-title><source>Conserv Biol</source><year>2003</year><volume>17</volume><issue>1</issue><fpage>267</fpage><lpage>272</lpage><pub-id pub-id-type="doi">10.1046/j.1523-1739.2003.01260.x</pub-id></mixed-citation></ref><ref id="B23"><mixed-citation publication-type="journal"><name><surname>Jensen</surname><given-names>PM</given-names></name><name><surname>Hansen</surname><given-names>H</given-names></name><name><surname>Frandsen</surname><given-names>F</given-names></name><article-title>Spatial risk assessment for Lyme borreliosis in Denmark</article-title><source>Scand J Infect Dis</source><year>2000</year><volume>32</volume><fpage>545</fpage><lpage>550</lpage><pub-id pub-id-type="doi">10.1080/003655400458857</pub-id><pub-id pub-id-type="pmid">11055662</pub-id></mixed-citation></ref><ref id="B24"><mixed-citation publication-type="journal"><name><surname>Gilbert</surname><given-names>L</given-names></name><article-title>Altitudinal patterns of tick and host abundance: a potential role for climate change in regulating tick-borne diseases?</article-title><source>Oecologia</source><year>2010</year><volume>162</volume><fpage>217</fpage><lpage>225</lpage><pub-id pub-id-type="doi">10.1007/s00442-009-1430-x</pub-id><pub-id pub-id-type="pmid">19685082</pub-id></mixed-citation></ref><ref id="B25"><mixed-citation publication-type="journal"><name><surname>Kiffner</surname><given-names>C</given-names></name><name><surname>Lödige</surname><given-names>C</given-names></name><name><surname>Alings</surname><given-names>M</given-names></name><name><surname>Vor</surname><given-names>T</given-names></name><name><surname>Rühe</surname><given-names>F</given-names></name><article-title>Abundance estimation of Ixodes ticks (Acari: Ixodidae) on roe deer (<italic>Capreolus capreolus</italic>)</article-title><source>Exp Appl Acarol</source><year>2010</year><volume>52</volume><fpage>73</fpage><lpage>84</lpage><pub-id pub-id-type="doi">10.1007/s10493-010-9341-4</pub-id><pub-id pub-id-type="pmid">20204470</pub-id></mixed-citation></ref><ref id="B26"><mixed-citation publication-type="journal"><name><surname>Vor</surname><given-names>T</given-names></name><name><surname>Kiffner</surname><given-names>C</given-names></name><name><surname>Niedrig</surname><given-names>M</given-names></name><name><surname>Hagedorn</surname><given-names>P</given-names></name><name><surname>Rühe</surname><given-names>F</given-names></name><article-title>Tick burden on European roe deer (<italic>Capreolus capreolus </italic>L.)</article-title><source>Exp Appl Acarol</source><year>2010</year><volume>51</volume><fpage>405</fpage><lpage>417</lpage><pub-id pub-id-type="doi">10.1007/s10493-010-9337-0</pub-id><pub-id pub-id-type="pmid">20099011</pub-id></mixed-citation></ref><ref id="B27"><mixed-citation publication-type="journal"><name><surname>Haemig</surname><given-names>PD</given-names></name><name><surname>Lithner</surname><given-names>S</given-names></name><name><surname>Sjöstedt de Luna</surname><given-names>S</given-names></name><name><surname>Lundkvist</surname><given-names>Å</given-names></name><name><surname>Waldenström</surname><given-names>J</given-names></name><name><surname>Hansson</surname><given-names>L</given-names></name><name><surname>Arneborn</surname><given-names>M</given-names></name><name><surname>Olsen</surname><given-names>B</given-names></name><article-title>Red fox and tick-borne encephalitis (TBE) in humans: Can predators influence public health?</article-title><source>Scand J Infect Dis</source><year>2008</year><volume>40</volume><fpage>527</fpage><lpage>532</lpage><pub-id pub-id-type="doi">10.1080/00365540701805446</pub-id><pub-id pub-id-type="pmid">18584542</pub-id></mixed-citation></ref><ref id="B28"><mixed-citation publication-type="book"><name><surname>Dobson</surname><given-names>AJ</given-names></name><name><surname>Barnett</surname><given-names>AG</given-names></name><source>An introduction to generalized linear models</source><year>2008</year><publisher-name>Boca Raton, Chapman & Hall/CRC</publisher-name></mixed-citation></ref><ref id="B29"><mixed-citation publication-type="book"><collab>R Development Core Team</collab><source>R: A language and environment for statistical computing</source><year>2008</year><publisher-name>R Foundation for Statistical Computing, Vienna, Austria</publisher-name><ext-link ext-link-type="uri" xlink:href="http://www.R-project.org">http://www.R-project.org</ext-link></mixed-citation></ref><ref id="B30"><mixed-citation publication-type="book"><collab>Anonymous</collab><source>CORINE Land Cover</source><year>2004</year><publisher-name>Federal Environmental Agency, German Aeospace Center</publisher-name></mixed-citation></ref><ref id="B31"><mixed-citation publication-type="journal"><name><surname>Haines-Young</surname><given-names>R</given-names></name><name><surname>Chopping</surname><given-names>M</given-names></name><article-title>Quantifying landscape structure: a review of landscape indices and their application to forested landscapes</article-title><source>Prog Phys Rev</source><year>1996</year><volume>20</volume><fpage>418</fpage><lpage>445</lpage><pub-id pub-id-type="doi">10.1177/030913339602000403</pub-id></mixed-citation></ref><ref id="B32"><mixed-citation publication-type="journal"><name><surname>Hijmans</surname><given-names>RJ</given-names></name><name><surname>Cameron</surname><given-names>SE</given-names></name><name><surname>Parra</surname><given-names>JL</given-names></name><name><surname>Jones</surname><given-names>PG</given-names></name><name><surname>Jarvis</surname><given-names>A</given-names></name><article-title>Very high resolution interpolated climate surfaces for global land areas</article-title><source>Int J Climat</source><year>2005</year><volume>25</volume><fpage>1965</fpage><lpage>1978</lpage><pub-id pub-id-type="doi">10.1002/joc.1276</pub-id></mixed-citation></ref><ref id="B33"><mixed-citation publication-type="journal"><name><surname>Rizzoli</surname><given-names>A</given-names></name><name><surname>Hauffe</surname><given-names>HC</given-names></name><name><surname>Tagliapietra</surname><given-names>V</given-names></name><name><surname>Neteler</surname><given-names>M</given-names></name><name><surname>Rosà</surname><given-names>R</given-names></name><article-title>Forest structure and roe deer abundance predict tick-borne encephalitis risk in Italy</article-title><source>PloS ONE</source><year>2009</year><volume>4</volume><fpage>e4336</fpage><pub-id pub-id-type="doi">10.1371/journal.pone.0004336</pub-id><pub-id pub-id-type="pmid">19183811</pub-id></mixed-citation></ref><ref id="B34"><mixed-citation publication-type="journal"><name><surname>Sumilo</surname><given-names>D</given-names></name><name><surname>Asokliene</surname><given-names>L</given-names></name><name><surname>Bormane</surname><given-names>A</given-names></name><name><surname>Vasilenko</surname><given-names>V</given-names></name><name><surname>Golovljova</surname><given-names>I</given-names></name><name><surname>Randolph</surname><given-names>SE</given-names></name><article-title>Climate change cannot explain the upsurge of tick-borne encephalitis in the Baltics</article-title><source>PLoS ONE</source><year>2007</year><volume>6</volume><fpage>e500</fpage><pub-id pub-id-type="doi">10.1371/journal.pone.0000500</pub-id></mixed-citation></ref><ref id="B35"><mixed-citation publication-type="journal"><name><surname>Wimberly</surname><given-names>MC</given-names></name><name><surname>Baer</surname><given-names>AD</given-names></name><name><surname>Yabsley</surname><given-names>MJ</given-names></name><article-title>Enhanced spatial model for predicting the geographic distributions of tick-borne pathogens</article-title><source>Int J Health Geogr</source><year>2008</year><volume>7</volume><fpage>15</fpage><pub-id pub-id-type="doi">10.1186/1476-072X-7-15</pub-id><pub-id pub-id-type="pmid">18412972</pub-id></mixed-citation></ref><ref id="B36"><mixed-citation publication-type="book"><source>GRASS Development Team: Geographic Resources Analysis Support System (GRASS) Software,l 2010</source><publisher-name>Open Source Geospatial Foundation</publisher-name><ext-link ext-link-type="uri" xlink:href="http://grass.osgeo.org">http://grass.osgeo.org</ext-link></mixed-citation></ref><ref id="B37"><mixed-citation publication-type="journal"><name><surname>Mason</surname><given-names>CH</given-names></name><name><surname>Perreault</surname><given-names>WD</given-names></name><article-title>Collinearity power and interpretation of multiple regression analysis</article-title><source>J Marketing Res</source><year>1991</year><volume>28</volume><fpage>268</fpage><lpage>280</lpage><pub-id pub-id-type="doi">10.2307/3172863</pub-id></mixed-citation></ref><ref id="B38"><mixed-citation publication-type="journal"><name><surname>Estrada-Pena</surname><given-names>A</given-names></name><article-title>Tick-borne pathogens, transmission rates and climate change</article-title><source>Front Biosci</source><year>2009</year><volume>14</volume><fpage>2674</fpage><lpage>2780</lpage><pub-id pub-id-type="doi">10.2741/3405</pub-id><pub-id pub-id-type="pmid">19273227</pub-id></mixed-citation></ref><ref id="B39"><mixed-citation publication-type="journal"><name><surname>Ginsberg</surname><given-names>HS</given-names></name><name><surname>Zhioua</surname><given-names>E</given-names></name><name><surname>Mitra</surname><given-names>S</given-names></name><name><surname>Fischer</surname><given-names>J</given-names></name><name><surname>Buckley</surname><given-names>PA</given-names></name><name><surname>Verret</surname><given-names>F</given-names></name><name><surname>Underwood</surname><given-names>HB</given-names></name><name><surname>Buckley</surname><given-names>FG</given-names></name><article-title>Woodland type and spatial distribution of nymphal <italic>Ixodes scapularis </italic>(Acari : Ixodidae)</article-title><source>Environ Entomol</source><year>2004</year><volume>33</volume><issue>5</issue><fpage>1266</fpage><lpage>1273</lpage><pub-id pub-id-type="doi">10.1603/0046-225X-33.5.1266</pub-id></mixed-citation></ref><ref id="B40"><mixed-citation publication-type="journal"><name><surname>Walker</surname><given-names>AR</given-names></name><name><surname>Alberdi</surname><given-names>MP</given-names></name><name><surname>Urquhart</surname><given-names>KA</given-names></name><name><surname>Rose</surname><given-names>H</given-names></name><article-title>Risk factors in habitat of the tick <italic>Ixodes ricinus </italic>influencing human exposure to <italic>Ehrlichia phagocytophila </italic>bacteria</article-title><source>Med Vet Entomol</source><year>2001</year><volume>15</volume><fpage>40</fpage><lpage>49</lpage><pub-id pub-id-type="doi">10.1046/j.1365-2915.2001.00271.x</pub-id><pub-id pub-id-type="pmid">11297100</pub-id></mixed-citation></ref><ref id="B41"><mixed-citation publication-type="journal"><name><surname>Ranta</surname><given-names>E</given-names></name><name><surname>Lindström</surname><given-names>J</given-names></name><name><surname>Lindén</surname><given-names>H</given-names></name><name><surname>Helle</surname><given-names>P</given-names></name><article-title>How reliable are harvesting data for analyses of spatio-temporal population dynamics?</article-title><source>Oikos</source><year>2008</year><volume>117</volume><fpage>1461</fpage><lpage>1468</lpage><pub-id pub-id-type="doi">10.1111/j.0030-1299.2008.16879.x</pub-id></mixed-citation></ref><ref id="B42"><mixed-citation publication-type="journal"><name><surname>May</surname><given-names>RM</given-names></name><article-title>Crash test for the real</article-title><source>Nature</source><year>1999</year><volume>398</volume><fpage>371</fpage><lpage>372</lpage><pub-id pub-id-type="doi">10.1038/18769</pub-id></mixed-citation></ref><ref id="B43"><mixed-citation publication-type="journal"><name><surname>Linard</surname><given-names>C</given-names></name><name><surname>Lamarque</surname><given-names>P</given-names></name><name><surname>Heyman</surname><given-names>P</given-names></name><name><surname>Ducoffre</surname><given-names>G</given-names></name><name><surname>Luyasu</surname><given-names>V</given-names></name><name><surname>Tersago</surname><given-names>K</given-names></name><name><surname>Vanwambeke</surname><given-names>SO</given-names></name><name><surname>Lambin</surname><given-names>EF</given-names></name><article-title>Determinants of the geographic distribution of Puumala virus and Lyme borreliosis infections in Belgium</article-title><source>Int J Health Geogr</source><year>2007</year><volume>6</volume><fpage>15</fpage><pub-id pub-id-type="doi">10.1186/1476-072X-6-15</pub-id><pub-id pub-id-type="pmid">17474974</pub-id></mixed-citation></ref><ref id="B44"><mixed-citation publication-type="journal"><name><surname>Hudson</surname><given-names>PJ</given-names></name><name><surname>Rizzoli</surname><given-names>A</given-names></name><name><surname>Rosà</surname><given-names>R</given-names></name><name><surname>Chemini</surname><given-names>C</given-names></name><name><surname>Jones</surname><given-names>LD</given-names></name><name><surname>Gould</surname><given-names>EA</given-names></name><article-title>Tick-borne encephalitis virus in northern Italy: molecular analysis, relationships with density and seasonal dynamics of <italic>Ixodes ricinus</italic></article-title><source>Med Vet Entomol</source><year>2001</year><volume>15</volume><fpage>304</fpage><lpage>313</lpage><pub-id pub-id-type="doi">10.1046/j.0269-283x.2001.00317.x</pub-id><pub-id pub-id-type="pmid">11583449</pub-id></mixed-citation></ref><ref id="B45"><mixed-citation publication-type="other"><name><surname>Rosà</surname><given-names>R</given-names></name><name><surname>Pugliese</surname><given-names>A</given-names></name><name><surname>Ghosh</surname><given-names>M</given-names></name><name><surname>Perkins</surname><given-names>SE</given-names></name><name><surname>Rizzoli</surname><given-names>A</given-names></name><article-title>Temporal variation of <italic>Ixodes ricinus </italic>intensity on the rodent host <italic>Apodemus flavicollis </italic>in relation to local climate and host dynamics</article-title><source>Vector-Borne Zoonotic Dis</source><year>2007</year><fpage>285</fpage><lpage>295</lpage><pub-id pub-id-type="doi">10.1089/vbz.2006.0607</pub-id><pub-id pub-id-type="pmid">17760511</pub-id></mixed-citation></ref><ref id="B46"><mixed-citation publication-type="journal"><name><surname>Kimmig</surname><given-names>P</given-names></name><name><surname>Oehme</surname><given-names>R</given-names></name><name><surname>Backe</surname><given-names>H</given-names></name><article-title>Epidemiologie der Frühsommer-Meningoenzephalitis (FSME) und Lyme-Borreliose in Südwestdeutschland</article-title><source>Ellipse</source><year>1998</year><volume>14</volume><issue>4</issue><fpage>95</fpage><lpage>105</lpage></mixed-citation></ref><ref id="B47"><mixed-citation publication-type="journal"><name><surname>Sheldon</surname><given-names>BC</given-names></name><name><surname>Verhulst</surname><given-names>S</given-names></name><article-title>Ecological immunology: costly parasite defences and trade-offs in evolutionary ecology</article-title><source>TREE</source><year>1996</year><volume>11</volume><fpage>317</fpage><lpage>321</lpage></mixed-citation></ref><ref id="B48"><mixed-citation publication-type="journal"><name><surname>Randolph</surname><given-names>SE</given-names></name><name><surname>Asokliene</surname><given-names>L</given-names></name><name><surname>Avsic-Zupanc</surname><given-names>T</given-names></name><name><surname>Bormane</surname><given-names>A</given-names></name><name><surname>Burri</surname><given-names>C</given-names></name><name><surname>Gern</surname><given-names>L</given-names></name><name><surname>Golovljova</surname><given-names>I</given-names></name><name><surname>Hubalek</surname><given-names>Z</given-names></name><name><surname>Knap</surname><given-names>N</given-names></name><name><surname>Kondrusik</surname><given-names>M</given-names></name><name><surname>Kupca</surname><given-names>A</given-names></name><name><surname>Pejcoch</surname><given-names>M</given-names></name><name><surname>Vasilenko</surname><given-names>V</given-names></name><name><surname>Zygutiene</surname><given-names>M</given-names></name><article-title>Variable spikes in tick-borne encephalitis incidence in 2006 independent of variable tick abundance but related to weather</article-title><source>Parasites & Vectors</source><year>2008</year><volume>1</volume><fpage>44</fpage></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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