Sumilo Dana, Bormane Antra, Asokliene Loreta, Vasilenko Veera, Golovljova Irina, Avsic-Zupanc Tatjana, Hubalek Zdenek, Randolph Sarah E
Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK.
Rev Med Virol. 2008 Mar-Apr;18(2):81-95. doi: 10.1002/rmv.566.
Tick-borne encephalitis (TBE), the most serious widespread vector-borne disease of humans in Europe, increased from 2- to 30-fold in many Central and Eastern European countries from 1992 to 1993, coinciding with independence from Soviet rule. Unemployment and low income have been shown in Latvia to be statistically associated with high-risk behaviour involving harvest of wild foods from tick-infested forests, and also with not being vaccinated against TBE. Archival data for 1970--2005 record major changes in the agricultural and industrial sectors, and consequent changes in the abiotic and biotic environment and socio-economic conditions, which could have increased the abundance of infected ticks and the contact of humans with those ticks. For example, abandoned agricultural fields became suitable for rodent transmission hosts; use of pesticides and emissions of atmospheric industrial pollutants plummeted; wildlife hosts for ticks increased; tick populations appear to have responded; unemployment and inequality increased in all countries. These factors, by acting synergistically but differentially between and within each country, can explain the marked spatio-temporal heterogeneities in TBE epidemiology better than can climate change alone, which is too uniform across wide areas. Different degrees of socio-economic upheaval caused by political transition in Estonia, Latvia, Lithuania, Slovenia and the Czech Republic can apparently explain the marked variation in TBE upsurge. Causal linkage between national socio-economic conditions and epidemiology is strongly indicated by striking correlations across eight countries between the degree of upsurge of TBE and both poverty and household expenditure on food (R2 = 0.533 and 0.716, respectively).
蜱传脑炎（TBE）是欧洲最严重的广泛传播的人类媒介传播疾病，在1992年至1993年期间，许多中欧和东欧国家的发病率增长了2至30倍，这与从苏联统治下独立出来的时间相吻合。在拉脱维亚，失业和低收入在统计学上与涉及从蜱虫滋生的森林中采集野生食物的高风险行为相关，也与未接种TBE疫苗相关。1970 - 2005年的档案数据记录了农业和工业部门的重大变化，以及随之而来的非生物和生物环境及社会经济条件的变化，这些变化可能增加了受感染蜱虫的数量以及人类与这些蜱虫的接触。例如，废弃的农田变得适合啮齿动物作为传播宿主；农药使用量和大气工业污染物排放量大幅下降；蜱虫的野生动物宿主增加；蜱虫种群似乎对此有所反应；所有国家的失业率和不平等现象都有所增加。这些因素在每个国家内部和之间协同但有差异地起作用，比单独的气候变化能更好地解释TBE流行病学中明显的时空异质性，因为气候变化在广大区域过于均匀。爱沙尼亚、拉脱维亚、立陶宛、斯洛文尼亚和捷克共和国政治转型导致的不同程度的社会经济动荡显然可以解释TBE激增的显著差异。TBE激增程度与贫困和家庭食品支出之间在八个国家的显著相关性（分别为R2 = 0.533和0.716）有力地表明了国家社会经济条件与流行病学之间的因果联系。
