Over the last 20 years, Lyme disease has grown to become the most common vector-borne disease affecting Americans. Spread in the eastern U.S. primarily by the bite of Ixodes scapularis, the black-legged tick, the disease affects an estimated 329,000 Americans per year. Originally confined to New England, it has since spread across much of the east coast and has become endemic in Virginia. Since 2010 the state has averaged 1200 cases per year, with 200 annually in the New River Health District (NRHD), the location of our study. Efforts to geographically model Lyme disease primarily focus on landscape and climatic variables. The disease depends highly on the survival of the tick vector, and white-footed mouse, the primary reservoir. Both depend on the existence of forest-herbaceous edge-habitats, as well as warm summer temperatures, mild winter lows, and summer wetness. While many studies have investigated the effect of forest fragmentation on Lyme, none have made use of high-resolution land cover data to do so at the peridomestic level. To fill this knowledge gap, we made use of the Virginia Geographic Information Network’s 1-meter land cover dataset and identified forest-herbaceous edge-habitats for the NRHD. We then calculated the density of these edge-habitats at 100, 200 and 300-meter radii, representing the peridomestic environment. We also calculated the density of <2-hectare forest patches at the same distance thresholds. To avoid confounding from climatic variation, we also calculated mean summer temperatures, total summer rainfall, and number of consecutive days below freezing of the prior winters. Adding to these data, elevation, terrain shape index, slope, and aspect, and including lags on each of our climatic variables, we created environmental niche models of Lyme in the NRHD. We did so using both Boosted Regression Trees (BRT) and Maximum Entropy (MaxEnt) modeling, the two most common niche modeling algorithms in the field today. We found that Lyme is strongly associated with higher density of developed-herbaceous edges within 100-meters from the home. Forest patch density was also significant at both 100-meter and 300-meter levels. This supports the notion that the fine scale peridomestic environment is significant to Lyme outcomes, and must be considered even if one were to account for fragmentation at a wider scale, as well as variations in climate and terrain. / M.S. / Lyme disease is the most common vector-borne disease in the United States today. Infecting about 330,000 Americans per year, the disease continues to spread geographically. Originally found only in New England, the disease is now common in Virginia. The New River Health District, where we did our study, sees over 200 cases per year. Lyme disease is mostly spread by the bite of the black-legged tick. As such we can predict where Lyme cases might be found if we understand the environmental needs of these ticks. The ticks themselves depend on warm summer temperatures, mild winter lows, and summer wetness. But they are also affected by forest fragmentation which drives up the population of white-footed mice, the tick’s primary host. The mice are particularly fond of the interface between forests and open fields. These edge habitats provide food and cover for the mice, and in turn support a large population of ticks. Many existing studies have demonstrated this link, but all have done so across broad scales such as counties or census tracts. To our knowledge, no such studies have investigated forest fragmentation near the home of known Lyme cases. To fill this gap in our knowledge, we made use of high-resolution forest cover data to identify forest-field edge habitats and small isolated forest patches. We then calculated the total density of both within 100, 200 and 300 meters of the homes of known Lyme cases, and compared these to values from non-cases using statistical modeling. We also included winter and summer temperatures, rainfall, elevation, slope, aspect, and terrain shape. We found that a large amount of forest-field edges within 100 meters of a home increases the risk of Lyme disease to residents of that home. The same can be said for isolated forest patches. Even after accounting for all other variables, this effect was still significant. This information can be used by health departments to predict which neighborhoods may be most at risk for Lyme. They can then increase surveillance in those areas, warn local doctors, or send out educational materials.

La maladie de Lyme est la maladie vectorielle la plus fréquente dans les pays tempérés et est en émergence dans plusieurs régions du monde. Plusieurs stratégies de prévention existent et comprennent des interventions qui visent les individus, comme le port de vêtements protecteurs, et d’autres qui sont implantées au niveau collectif, dont des interventions de contrôle des tiques dans l’environnement. L’efficacité de ces stratégies peut être influencée par divers facteurs, dont des facteurs sociaux tels que les connaissances, les perceptions et les comportements de la population ciblée. Elles peuvent également avoir des impacts parallèles non désirés, par exemple sur l’environnement et l’économie, et ces derniers peuvent s’opposer aux bénéfices des interventions jusqu’à remettre en cause la pertinence de leur mise en œuvre. Aussi, ces facteurs sociaux et les impacts des interventions sont susceptibles de varier selon la population ciblée et en fonction du contexte épidémiologique et social. L’objectif de cette thèse était donc d’étudier les principaux facteurs sociaux et enjeux d’importance à considérer pour évaluer l’efficacité et prioriser des interventions de prévention pour la maladie de Lyme dans deux populations exposées à des contextes différents, notamment en ce qui concerne leur situation épidémiologique, soient au Québec, où l’incidence de la maladie de Lyme est faible mais en émergence, et en Suisse, où elle est élevée et endémique depuis plus de trois décennies. L’approche choisie et le devis général de l’étude sont basés sur deux modèles théoriques principaux, soient le modèle des croyances relatives à la santé et celui de l’aide à la décision multicritère. Dans un premier temps, les facteurs associés à la perception du risque pour la maladie de Lyme, c’est-à-dire l’évaluation cognitive d’une personne face au risque auquel elle fait face, ont été étudiés. Les résultats suggèrent que les facteurs significatifs sont différents dans les deux régions à l’étude. Ensuite, l’impact des connaissances, de l’exposition, et des perceptions sur l’adoption de comportements préventifs individuels et sur l’acceptabilité des interventions de contrôle des tiques (acaricides, modifications de l’habitat, contrôle des cervidés) a été comparé. Les résultats suggèrent que l’impact des facteurs varierait en fonction du type du comportement et des interventions, mais que la perception de l’efficacité est un facteur commun fortement associé à ces deux aspects, et pourrait être un facteur-clé à cibler lors de campagnes de communication. Les résultats montrent également que les enjeux relatifs aux interventions de contrôle des tiques tels que perçus par la population générale seraient communs dans les deux contextes de l’étude, et partagés par les intervenants impliqués dans la prévention de la maladie de Lyme. Finalement, un modèle d’analyse multicritère a été développé à l’aide d’une approche participative pour le contexte du Québec puis adapté pour le contexte suisse et a permis d’évaluer et de prioriser les interventions préventives selon les différentes perspectives des intervenants. Les rangements produits par les modèles au Québec et en Suisse ont priorisé les interventions qui ciblent principalement les populations humaines, devant les interventions de contrôle des tiques. L’application de l’aide à la décision multicritère dans le contexte de la prévention de la maladie de Lyme a permis de développer un modèle décisionnel polyvalent et adaptable à différents contextes, dont la situation épidémiologique. Ces travaux démontrent que cette approche peut intégrer de façon rigoureuse et transparente les multiples perspectives des intervenants et les enjeux de la prévention relatifs à la santé publique, à la santé animale et environnementale, aux impacts sociaux, ainsi qu’aux considérations économiques, opérationnelles et stratégiques. L’utilisation de ces modèles en santé publique favoriserait l’adoption d’une approche « Une seule santé » pour la prévention de la maladie de Lyme et des zoonoses en général. Mots-clés : maladie de Lyme, prévention, facteurs sociaux, perception du risque, comportements préventifs, acceptabilité, priorisation des interventions, contrôle des tiques, aide à la décision multicritère, analyse multicritère, Québec, Suisse, « Une seule santé » / Lyme disease is the most common vector-borne disease in temperate countries and is emerging in many parts of the world. Several prevention strategies exist and include strategies at the individual level, such as wearing protective clothing, and at the population level, including tick control interventions in the environment. The effectiveness of these strategies can be influenced by various factors, including social factors such as knowledge, perceptions and behaviors of the target population, and by their potential impacts on various sectors such as on the environment and on the economy. Also, these social factors and impacts are likely to vary according to the epidemiological and social context of the target population. The objective of this thesis was to study the main social factors and issues of importance to consider for the prioritization of preventive interventions for Lyme disease in two populations living in different contexts, particularly with regard to their epidemiological situation, that is in Quebec, where the incidence of Lyme disease is low, but emerging, and Switzerland, where it is high and has been endemic for more than three decades. The approach and the design of this study were based on two main theoretical models, namely the Health Belief Model and the multicriteria decision analysis approach. Factors associated with risk perception, that is the cognitive assessment of a person facing a risk, for Lyme disease were studied initially in the target populations. The results suggest that factors significantly associated with a high level of risk perception are different in the two regions. Then, the impact of knowledge on Lyme disease, exposure, perceptions on the adoption of individual preventive behavior and on the acceptability of tick control interventions were compared. The data suggest that the impact of these factors varies according to the type of behavior and interventions, but that the perception of efficacy is a common factor strongly associated with both aspects, and could be targeted in communication campaigns. The results also show that issues related to tick control interventions as perceived by the participants are common in both contexts, and shared by the stakeholders involved in the prevention of Lyme disease. Finally, a multi-criteria analysis model was developed using a participatory approach for the Quebec context, adapted to the Swiss context and allowed to prioritize preventive interventions according to different stakeholder perspectives. Rankings produced by these models prioritized interventions that primarily target human populations in preference to tick control interventions. Applying the multi-criteria decision analysis approach in the context of Lyme disease prevention led to the development of a versatile decision model that can be adapted to different contexts, including the epidemiological situation. These studies show that this approach can offer a rigorous and transparent way to integrate the multiple perspectives of stakeholders and issues of prevention including those relating to public health, animal and environmental health, social impacts, as well as economic, operational and strategic considerations. Their use in public health practices could facilitate the adoption of a practical and applied “One health” approach to Lyme disease and other zoonosis prevention. Keywords: Lyme disease, prevention, social factors, risk perception, acceptability, prioritization of interventions, tick control, Multi-criteria decision analysis, MCDA, Quebec, Switzerland, "One health"

Indiana University-Purdue University Indianapolis (IUPUI) / The Lyme disease agent, Borrelia burgdorferi, has a complex system that allows it to thrive in the harsh and distinct environments of its tick vector and mammalian host. Although it has been known for some time that the Borrelia oxidative stress regulator protein (BosR) plays a necessary role in mammalian infectivity and functions as a transcriptional regulator of alternative sigma factor RpoS, very little is known about its mechanism of action, other than the suggestion that BosR activates rpoS transcription by binding to certain upstream regions of the gene. In our studies, we performed protein degradation assays and luciferase reporter assays for further understanding of BosR function. Our preliminary findings suggest that BosR is post-transcriptionally regulated by an unknown protease and may not need to bind to any rpoS upstream regions in order to activate transcription. We also describe the construction of luciferase reporter systems that will shed light on BosR’s mechanism of action. We postulate the provocative possibility that unlike its homologs Fur and PerR in other bacterial systems, BosR may not utilize a DNA-binding mechanism in order to fulfill its role as a transcriptional regulator to modulate virulence gene expression.

Submitted by Cleide Dantas (cleidedantas@ufpa.br) on 2014-07-28T14:14:26Z No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_FrequenciaAnticorposAntiBorrelia.pdf: 513114 bytes, checksum: c4c606deec6650eaae49134f3922e92a (MD5) / Approved for entry into archive by Ana Rosa Silva (arosa@ufpa.br) on 2014-09-11T15:33:58Z (GMT) No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_FrequenciaAnticorposAntiBorrelia.pdf: 513114 bytes, checksum: c4c606deec6650eaae49134f3922e92a (MD5) / Made available in DSpace on 2014-09-11T15:33:58Z (GMT). No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_FrequenciaAnticorposAntiBorrelia.pdf: 513114 bytes, checksum: c4c606deec6650eaae49134f3922e92a (MD5) Previous issue date: 2006 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A Borreliose de Lyme é uma doença multissistêmica causada pela espiroqueta Borrelia burgdorferi latu sensu e transmitida por carrapatos ixodideos, acometendo seres humanos e animais domésticos, tendo como reservatórios naturais os animais silvestres, sendo ainda considerada uma zoonose de ampla distribuição geográfica. Foram coletadas 300 amostras sanguíneas de eqüinos aparentemente sadios, procedentes dos municípios de Ananideua, Belém, Benevides, Castanhal, Marituba e Santa Izabel do Pará da mesorregião metropolitana de Belém – Pará. O sangue foi coletado pela veia jugular e os soros foram analisados através do ensaio de imunoadsorção enzimática (ELISA) indireto no Laboratório de Doenças Parasitárias na Universidade Federal Rural do Rio de Janeiro. O objetivo do trabalho foi verificar a soroepidemiologia da Borrelia burgdorferi na mesorregião metropolitana de Belém. A freqüência de soropositividade foi de 26,67% (n=80), sendo 72 (24%) com título de 1:800, seis (2%) a 1:1600 e dois (0,6%) a 1:3200. A soropositividade entre os sexos foram valores aproximados sendo 13,67% nas fêmeas e 13% nos machos. A freqüência entre os animais de raças e mestiços foram 9% e 18%, respectivamente. Não houve diferença significativa de animais soropositivos quanto aos municípios, sexo, raça e faixa etária. A freqüência encontrada corrobora a hipótese da ocorrência de Borrelia sp. na região estudada. / Lyme borreliosis is a multisistemic disease caused by the spirochete Borrelia burgdorferi latu sensu and transmited by ixodide ticks, affecting both humans beings and domesticated animals and having wild animals as Its natural reservoirs, besides of being a zoonosis of wide geographic distribution. We picked 300 blood samples of apparently health horses from the cities of Ananideua, Belém, Benevides, Castanhal, Marituba and Santa Izabel of the Pará, all included in the metropolitan mesoregion of Belém – Pará. The samples were picked up by the jugular vein and the serum analised through indirect Enzyme-Linked Immunosorbent Assay (ELISA) in the Laboratory of Parasitic Diseases of the Federal Rural University of Rio de Janeiro. The aim of this work was to verify the serum epidemiology of Borrelia burgdorferi in the metropolitan mesorregion of Belém. The frequency of serum positivity was 26,67% (n=80), being 72 (24%) with title of 1:800, six (2%) with 1:1600 and two (0,6%) with 1:3200. The serum frequency by gender was approximately 13,67% of females and 13% of males. The thoroughbred and the half-breed animals had 9% and 18% of frequency, respectively. There was no significative difference in the serum positivity with regard to cities, gender, race and age. The frequency found corroborates the hypothesis of occurrence of Borrelia sp. in the studied region.

No description available.

La maladie de Lyme, ou borréliose de Lyme, est une infection bactérienne causée par le spirochète Borrelia burgdorferi sensu lato et transmise à l'hôte (homme, animal) par piqûre de tique du genre Ixodes. Cette maladie, caractérisée par un polymorphisme clinique important, est la maladie à transmission vectorielle la plus répandue dans l'hémisphère nord. Un traitement par antibiotiques permet une guérison rapide, mais si la maladie est diagnostiquée tardivement, certains symptômes persistent. Actuellement, aucun vaccin n'est commercialisé pour l'homme. Dans ce contexte, nous avons développé des approches protéomiques afin d'apporter de nouveaux éléments de compréhension du mécanisme d'interactions de la triade tique / bactérie / hôte. Ces travaux, visant particulièrement le développement de nouvelles stratégies vaccinales et diagnostiques, sont articulés autour de trois parties : - L'identification, suite à de nombreuses optimisations, d'une méthode d'analyse HPLC-UV et nanoLC-MS/MS, de protéines présentes dans des extraits de glandes salivaires de tiques et possédant une activité sur la réponse immunitaire innée cutanée. Ces développements ont mis en évidence une liste restreinte de protéines potentiellement bioactives. - La mise au point, sur un modèle murin, d'une méthode de détection d'une protéine de Borrelia burgdorferi, OspC, dans des biopsies cutanées par spectrométrie de masse ciblée LC-SRM. Cette étude a ouvert des perspectives quant au développement de nouveaux outils diagnostiques. - L'évaluation de la faisabilité de la détection de Borrelia burgdorferi directement à la surface de la peau par imagerie par spectrométrie de masse MALDI-MSI.

Nous avons étudié le rôle de l'immunité innée de la peau lors de la transmission des Borrelia (agent infectieux de la borréliose de Lyme) par son vecteur, une tique dure du genre Ixodes. Nous avons montré que la salive de tique et la protéine salivaire Salp15 inhibent la réaction inflammatoire (production de chimiokines et de peptides antimicrobiens) des kératinocytes induite par Borrelia. Cet effet anti- " alarmine " de la salive de tique contribue probablement à créer un environnement cutané local favorable à la transmission de Borrelia. Nous avons montré que Borrelia induit également au niveau des fibroblastes cutanés la transcription de nombreux gènes proinflammatoires. Nous avons observé un effet toxique direct de la salive de tique sur les fibroblastes cutanés : cet effet dose-dépendant est de nature protéique mais non lié à la protéine Salp15. Ces résultats indiquent que les fibroblastes jouent un rôle important dans l'inflammation cutanée induite par Borrelia.

Introduction This thesis concerns the mosquito-borne arbovirus Ross River (RR) virus. The main objectives were to determine the vector associations, the incidence, costs and natural history of disease, and behavioural and environmental risks for infection in tropical Queensland. 1. Literature review On the basis of the literature review there is strong evidence that Aedes vigilax, Ae. camptorhynchus and Culex annulirostris are important vectors in Australia. Aedes camptorhychus does not occur in Queensland. There is evidence that two peri-domestic container-breeding mosquitoes, Ae. notoscriptus and Ae. aegypti, may be vectors of the virus. The virus has been isolated from many other species but the role of most of these is unclear. It is unclear which vertebrate species are the major reservoirs for human infection. Studies are inconsistent with regard to the prevalence, duration and severity of symptoms and debility during RR virus disease. Nearly all epidemiological studies of RR virus have been descriptive. Therefore one can only surmise what the risks for human infection might be. Epidemiological studies to determine the associations between exposures and risk for disease do not exist. 2. Virus isolation from mosquitoes During 1996-1998 61,619 mosquitoes were processed for virus isolation. Thirty-three isolates of RR virus were made. The largest number (14) were from Ae. carmenti. The minimum infection rate (MIR) per 1,000 was 2.4. Isolates were also made from Ae. imprimens (1 isolate, MIR 10.3), Ae. kochi (2, 0.2), Ae. lineatus (1, 0.2), Ae. notoscriptus (1, 1.6), Ae. vigilax (1, 0.3), Cx. annulirostris (9, 0.3), Cx. vicinus (1, 4.0) and Mansonia septempunctata (3, 5.8). Ross River virus has been isolated from Cx. annulirostris, Ae. vigilax, Ae. notoscriputus and Ae. kochi but not from the other species. Ross River virus was not isolated from Ae. aegypti. Twenty-six isolates came from in or near a colony of 15,000 spectacled flying-fox, Pteropus conspicillatus. The proportion of RR virus positive pools from within 1 km. of this colony was significantly greater than elsewhere for all species combined and for Cx. annulirostris but not for Ae. carmenti. 3. The incidence and costs of Ross River virus disease Unpublished data on National, State and Territory notifications was collected. Crude incidence rates using census figures for denominator data were calculated. The same was done for the areas in which the other studies described in the thesis were carried out. An estimate of the cost of Ross River virus disease in Australia was made. During the period 1991-1998 of the States and Territories the Northern Territory (NT) had the highest and the Australian Capital Territory (ACT) the lowest notification incidences. These were 62-281 and 0-3 per 100,000 per annum, respectively. During this period the notification incidence for Queensland ranged from 70 to 149 per 100,000 per annum. For the local government areas of Cairns and Mareeba, where the majority of cases of RR virus disease for the studies described in this thesis were recruited, the notification incidences were between 74 and 267, and 28 and 200, respectively. On the basis of an average of 4,800 cases per annum in Australia the cost of serological testing and medical consultations were estimated at $443,520 and $105,600. Lost earnings were estimated at $1,798,560. The total cost for medical consultations, serological testing and lost earnings will therefore be over $2 million in an average year. 4. The natural history of Ross River virus disease In 1998 incident cases of RR virus disease were ascertained. Fifty-seven eligible cases were recruited but only 47 could be reviewed on 3 occasions and data on these were analysed. Cases were followed for up to 197 days. Review included history, examination and the administration of the Clinical Health Assessment Questionnaire (CLINHAQ) and Short Form-36 (SF-36) . On initial review the 3 most common symptoms were arthralgia, joint stiffness and myalgia affecting 97.9, 89.4 and 59.6% of cases, respectively. The joint types most commonly affected by pain at the initial review were the ankles, wrists, interphalangeal joints of the fingers, knees and metacarpophalangeal joints. Objective signs of joint inflammation were rare. The prevalence of signs of inflammation decreased and the prevalence of normal joints on examination increased through the reviews. The prevalence of use of NSAIDs decreased through the reviews. On the basis of CLINHAQ items regarding work performance functioning at work improved through the course of the reviews. Linear regression with days since symptom onset as the independent variable was performed for some variables. The 8 dimensions of the SF-36 were standardized to the Queensland population and analyzed longitudinally . Analyses of the CLINHAQ functional disability index (FDI) and the visual analogue scales (VASs) for pain, global severity, fatigue, gastrointestinal complaints and sleep, and the depression and anxiety scales were also performed. The slopes of all fitted regressions except the SF-36 general health dimension were significantly different from zero. All measures of disease severity returned to normal by 8 months from onset, many in a shorter period. 5. Behavioural and environmental risks for infection Fifty-five incident cases of RR virus disease were recruited and formed the basis of a case-control study of behavioural and environmental risks. They were matched to 85 controls. In the year prior to symptom onset the only leisure exposure that significantly altered risk was camping [Odds ratio (OR) = 2.15; 95% confidence interval (CI) = 1.07-4.35]. No peri-domestic activities in the year prior to onset significantly altered disease risk. Leisure exposures were also assessed in a 3-week exposure period ending 4 days prior to symptom onset. None significantly altered risk. No peri-domestic activity in this period significantly altered risk and nor did exposure to vertebrates or mosquitoes. Containers and vegetation around the subject's dwelling did not significantly increase risk. The presence of ice cream containers and buckets was significantly protective when assessed by questionnaire, however this was also assessed by inspection and was found to increase risk though not significantly so. It was concluded that the former finding was due to differential misclassification of exposure status. The premise condition index (PCI) was measured. A low PCI for the subject's house was associated with a significantly increased risk (3-4 relative to 7-9 as reference category: OR = 3.15, 95% CI = 1.07-9.25). Window screening did not alter disease risk and air-conditioning in the house or the bedroom decreased risk but not significantly so. Use of protective measures, except bed nets, in the year prior to onset was found to decrease disease risk. Personal repellents, mosquito coils and citronella candles significantly decreased risk. A dose response was shown for the number of protective measures from personal repellents, aerosol and surface sprays, mosquito coils, citronella candles and mosquito "zappers" used in the year prior to symptom onset. Pet ownership and proximity of dwelling to horses did not significantly alter risk. A preference for light coloured clothing was significantly protective (0.37, 0.15-0.89). Stratification by gender, date of symptom onset and geographical area was performed. Stratification by geographical area included a coastal and tablelands stratum. There were differences between the stratum-specific odds ratios for camping in the year prior to symptom onset, the presence of bromeliads in the subject's garden and a preference for light coloured clothing. Multivariate analysis demonstrated confounding by use of personal repellents, mosquito coils and citronella candles. When modeled together these were found to cause confounding among themselves. They also caused significant confounding of camping, outdoor work and the presence of banana trees in the subject's yard. Multivariate analysis of the association between PCI and disease risk failed to demonstrate confounding by use of protective measures or time between symptom onset and review. 6. Synthesis and conclusions The three research Chapters form a coherent body of public health research on the epidemiology (Chapters 5 and 6) and ecology (Chapters 4 and 7) of RR virus, and the natural history of RR virus disease (Chapter 6) in tropical Queensland. Conclusions are drawn from the research in the thesis. A set of priorities for future public health research on RR virus is suggested, and a pilot control program for Ross River virus disease in tropical Queensland is recommended.

Ticks are of global interest as the pathogens they spread can cause diseases that are of importance to both human health and economies. In Scotland, the most populous tick species is the sheep tick Ixodes ricinus, which is the vector of pathogens causing diseases such as Lyme borreliosis and Louping-ill. Recently, both the density and spread of I. ricinus ticks have grown across much of Europe, including Scotland, increasing disease risk. Due to the nature of the tick lifecycle they are particularly dependent on environmental factors, including temperature and habitat type. Because of this, the recent increase in tick-borne disease risk is believed to be linked to climate change. Many mathematical models have been used to explore the interactions between ticks and factors within their environments; this thesis begins by presenting a thorough review of previous modelling of tick and tick-borne pathogen dynamics, identifying current knowledge gaps. The main body of this thesis introduces an original mathematical modelling framework with the aim to further our understanding of the impact of climate change on tick-borne disease risk. This modelling framework takes into account how key environmental factors influence the I. ricinus lifecycle, and is used to create predictions of how I. ricinus density and disease risk will change across Scotland under future climate warming scenarios. These predictions are mapped using Geographical Information System software to give a clear spatial representation of the model predictions. It was found that as temperatures increase, so to do I. ricinus densities, as well as Louping-ill and Lyme borreliosis risk. These results give a strong indication of the disease risk implications of any changes to the Scottish environment, and so have the potential to inform policy-making. Additionally, the models identify areas of possible future research.

In this paper, I will show how applying a spatially explicit context to an existing environmental health surveillance framework is vital for more complete surveillance of disease, and for disease prevention and intervention strategies. As a case study to test the viability of a spatial approach to this existing framework, the risk of human exposure to Lyme disease will be estimated. This spatially explicit framework divides the surveillance process into three components: hazard surveillance, exposure surveillance, and outcome surveillance. The components will be used both collectively and individually, to assess exposure risk to infected ticks. By utilizing all surveillance components, I will identify different areas of risk which would not have been identified otherwise. Hazard surveillance uses maximum entropy modeling and geographically weighted regression analysis to create spatial models that predict the geographic distribution of ticks in Texas. Exposure surveillance uses GIS methods to estimate the risk of human exposures to infected ticks, resulting in a map that predicts the likelihood of human-tick interactions across Texas, using LandScan 2008TM population data. Lastly, outcome surveillance uses kernel density estimation-based methods to describe and analyze the spatial patterns of tick-borne diseases, which results in a continuous map that reflects disease rates based on population location. Data for this study was obtained from the Texas Department of Health Services and the University of North Texas Health Science Center. The data includes disease data on Lyme disease from 2004-2008, and the tick distribution estimates are based on field collections across Texas from 2004-2008.