Favretto, Ar

GARCIA VOZMEDIANO, Aitor

Tomassone, L.

English

Institutional Research Information System University of Turin

18 October 2023AperTO - Archivio Istituzionale Open Access dell'Università di TorinoOriginal Citation:A One-Health approach to tackle tick-borne diseases: analysis of European surveillance initiativesTerms of use:Open Access(Article begins on next page)Anyone can freely access the full text of works made available as "Open Access". Works made availableunder a Creative Commons license can be used according to the terms and conditions of said license. Useof all other works requires consent of the right holder (author or publisher) if not exempted from copyrightprotection by the applicable law.Availability:This is the author's manuscriptThis version is available http://hdl.handle.net/2318/1679811 since 2018-10-31T11:32:43ZNEOH Final Conference, Bologna - September 10-12 2018Creating impact for One Health and Ecohealth: advancements in implementation, evaluation and governanceA One-Health approach to tackle tick-borne diseases: analysis of European surveillance initiativesA. Garcia-Vozmediano1, H. Sprong2, A.R. Favretto3, L. Tomassone1A.1Dept. Veterinary Sciences, University of Turin, Italy (laura.tomassone@unito.it); 2National Institute of Public Health and Environment (RIVM), The Netherlands; 3Department of Jurisprudence and Political, Economic and Social Sciences, University of Eastern Piedmont, ItalyIn Europe, Ixodid ticks are expanding their geographical range,but in some areas the awareness level on the risk of tick bitesand tick-borne diseases (TBD) is low, and no surveillanceactivities are in place.In order to identify ideal elements for disease monitoring andprevention, we are analysing TBD surveillance plans existing insome European countries where ticks and TBD are long since apublic health concern. As a starting point, we analyzed thesystem in place in The Netherlands, a country that hasimplemented a One Health (OH) approach to tackle zoonosesand has built a consultation structure for their monitoring andsignaling.We applied the semi-quantitative evaluation protocol developedby the Network for Evaluation of One Health (NEOH) to evaluatethe TBD surveillance system implemented in The Netherlands [1].The analysis was based on published literature and informationprovided by National Institute of Public Health and theEnvironment (RIVM).The incidence of TBD, in particular Lyme disease (LD), has beenincreasing in The Netherlands since the ‘90es. TBD are notconsidered as notifiable diseases in the country, however asurveillance system based on multiple projects has beenimplemented (Fig.1), including monitoring, research, educationand control activities. All actions are coordinated by RIVM, whichis in charge of the prevention and control of infectious diseases.As shown in Fig.2, the initiative has resulted in outputs (e.g.production of risk maps [2]), measurable outcomes (e.g.reduction in tick bites, stabilization in the number of LD cases [3])and on detection of unexpected outcomes (e.g. discovery of newpathogens such as the tick-borne encephalitis virus -TBEV).INTRODUCTIONMATERIALS AND METHODSRESULTS AND DISCUSSIONBibliographic references: [1] Rüegg et al., 2018. A Systems Approach to Evaluate One Health Initiatives. Front Vet Sci, 5:23. doi: 10.3389/fvets.2018.00023; [2] Swart et al.,2014. Predicting tick presence by environmental risk mapping. Front Public Health, 2:238. doi: 10.3389/fpubh.2014.00238; [3].Hofhuis et al., 2016. Decrease in tick biteconsultations and stabilization of early Lyme borreliosis in the Netherlands in 2014 after 15 years of continuous increase. BMC Public Health, 16:425. doi: 10.1186/s12889-016-3105-y; [4] RIVM, 2015. Signalling and risk assessment of emerging zoonoses a One Health approach in the Netherlands.https://www.rivm.nl/en/Topics/Z/Zoonotic_diseases/One_Health; [5] Antonise-Kamp et al., 2017. Prevention of tick bites: an evaluation of a smartphone app. BMC Infect Dis,17:744. doi: 10.1186/s12879-017-2836-4;Fig. 1. Visual representation of the TBD surveillance initiative in The Netherlands within its system.Relationships (arrows) are classified as governance (grey), membership (black), and causal interactions(blue). The red hexagon represents the initiative with arrows where it impacts the system. *TBD in petsand livestock are only partially considered by the initiative.Fig.2. The change pathway for the TBD surveillance system in The Netherlands: inputs from scienceand society to co-produce outputs taken up by society and the scientific community and disseminatedto result in first- and second- impacts and scientific progress.The surveillance system is characterized by a high degree of OHimplementation and a good balance of operational andinfrastructure support (Fig.3). Indeed, it is part of the nationalprogram for the control of zoonoses, which foresees a high levelof transdisciplinary and trans-sectoral collaboration betweenpublic, animal, and environmental health. Nevertheless, TBD arenot seen as a ‘veterinary’ concern, so data and expertise in theanimal domain are only partially considered (scarce informationon TBD in domestic animals).The initiative has demonstrated a high level of flexibility andadaption over the years. Although it is adequately supportedfrom a structural and financial point of view, the various project-based activities depend from different institutions and fundingsources. So, some actions may not sustainable in the long term,and reduced economic resources can affect the collaboration ofstakeholders and limit adaptive and generative learning. Datasharing is limited among the different projects/institutions, butcommunication flows (e.g. regular meetings among actors andwith stakeholders, on-line communication platforms [4]) enablean efficient sharing of information and support decision making.The active participation of stakeholders and citizen scienceactivities (e.g. the mobile phone app ‘Tekenbeet’ [5]) improvedthe surveillance.Fig.3. Spider diagram showing the                   degree of One Health implementation of the surveillance system on TBD in The NetherlandsCONCLUSIONSThe Dutch initiative represents a reference model for aneffective surveillance on TBD. Several of its operation andinfrastructure aspects could be adopted in other contexts,especially in areas of recent tick spread, where no surveillance iscarried out and the risk of TBD has to be assessed.

A One-Health approach to tackle tick-borne diseases: analysis of European surveillance initiatives

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A One-Health approach to tackle tick-borne diseases: analysis of European surveillance initiatives

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