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Final Report EDEN. Emerging diseases in a changing European environment. Integrated project. Sub-priority 63 : sustainable development, global change and ecosystems : Project n° 010284-2

Lancelot R.. 2012. Montpellier : CIRAD-BIOS, 291 p..

The challenge The number of emerging infectious disease (EID) events has been increasing in recent decades, many of them occurring in Europe. It has often been stated that climate change, and more generally environmental change, has been responsible for this increased EID incidence. Little scientific evidence was, however, available to support these statements as the biological and ecological mechanisms involved in disease emergence were poorly understood. In addition, the methodology and analysis chain needed to investigate disease upsurge had not been formally defined in the context of changing environment. Public-health agencies, therefore, had few tools to monitor environmental change, or assess/predict its possible effect on human health. Project objectives Vector-borne diseases, specifically those diseases caused by pathogens transmitted by arthropods (insects, ticks) or borne by rodents, were selected as EID models because they are highly sensitive to environmental changes. In this context, objectives were two-fold: 1. Assess the importance of environmental and socio-economic changes on emerging vector-borne diseases in Europe ant its surroundings, and develop quantitative, predictive models of disease emergence risk. 2. Identify and characterise the main ecosystems exposed to high risk of disease emergence at the European scale. viii CONTENTS Methodology Diseases were selected according to the vectors and hosts involved in their epidemiology: tick-borne encephalitis, haemorrhagic fever with renal syndrome (rodents), leishmaniasis (sandflies), West Nile and malaria (mosquitoes). Also, African sources of West Nile and Rift Valley fever viruses were studied to improve control for the benefit of African populations, and investigate the risk of introduction in Europe. EDEN has combined the understanding of disease epidemiology in a variety of environmental settings through a multidisciplinary approach to: _ Characterise the capacity of vectors and hosts to spread the selected diseases; _ Identify the drivers and develop predictive models for disease emergence; and _ Examine current and expected environment changes likely to favour disease emergence. Main results Methods have been developed to monitor climate and environmental changes, using the resulting indicators in disease modelling and developing tools for risk assessment, thereby enabling improved public health decision making at the national and European levels. A strong PhD network has been implemented, and many workshops and meetings have been held, including an international conference organised in Montpellier (France), May 2010. The EDEN information system is now internationally recognised and supported by the European center for disease prevention and control (ECDC). Besides the numerous publications and PhD theses released during EDEN, key scientific messages are: _ Disease emergence is a complex phenomenon that cannot be reduced to a single cause, and each EID is a special case. The causes may vary from place to place. _ Social, economic and behavioural changes may be more important than climate or environmental changes in explaining disease upsurges. _ Long-term, and high-quality, field and public-health data are essential to correctly identify the most important drivers of disease emergence. _ Quantitative predictive models are needed to develop useful early-warning tools. Last but not least, EDEN has allowed the development of a strong European research and expertise network. The list of EDEN partner institutes and corresponding members is given in on page 264, and the list of EDEN team leaders is given on page 265. Much more senior scientists and PhD students have been involved in EDEN activities....

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