Ticks - ecology, new hazards, and relevance for public health

Sammanfattning: Ticks and tick-borne diseases are ranking second only to mosquitoes as vectors of pathogens responsible for diseases in both humans and domestic animals. In the countries around the Baltic Sea, two medically important tick species are increasing both in range and abundance, and the public health threat posed by tick-borne diseases in this area is steadily growing. The aim of this thesis was to study the eco-epidemiological dynamics and mechanisms of ticks and bacterial tick-borne pathogens along the natural-urban gradient.Green spaces have become important intersections between humans, domestic animals, ticks, and tick-borne pathogens. Along the natural-urban gradient in Stockholm County, Sweden, we examined the impact of green space characteristics on tickabundance and pathogens prevalence. In this study all questing ticks were molecularly identified as Ixodes ricinus. Questing ticks were abundant in natural and seminatural habitats, but also present in urbanized parks. Important drivers of tickabundance included significant negative effects of local vegetation height and positiveeffects of mixed coniferous forests in the surrounding landscape.The prevalence of Borrelia burgdorferi sensu lato was 24% and that of Anaplasma phagocytophilum 7.5%. B. miyamotoi was found at a few sites with a prevalence of 0.9%. The dominant B. burgdorferi (s.l.) genospecies was B. afzelii. Tree stem density had a significant positive effect on B. burgdorferi (s.l.) prevalence. Broadleaved forests and total forest edge had significant positive effects on A. phagocytophilum prevalence, persisting even in highly urbanized areas. The tick-borne disease equine granulocytic anaplasmosis (EGA) significant increased from 2002 to 2015, with a yearly peak in late summer and early fall.The public health risk for tick-borne diseases in an urban green space was estimated from hazard data on tick abundances and pathogen prevalence combined with exposure data using residential population densities and green space visitor numbers. The results indicated a medium to high risk of tick-borne diseases at most sites. Structured interviews with visitors showed that even if visitors showed a high tick awareness and attempted to avoid ticks, most protective measures were only practiced during specific recreational activities.The findings from this doctoral project show a notable risk of encountering ticks and tick-borne pathogens along the entire natural-urban gradient, even in highly urbanized areas traditionally perceived as having a low risk. The information on the eco-epidemiological drivers of EGA is important also for the medical health field since the agent causing EGA is identical to the agent causing human disease. Despite ticks and their pathogens green spaces still continue to play a vital role in public health, but the omnipresent risk of tick-borne diseases highlights the need for public health initiatives to mitigate this risk.