Ticks and their epidemiological role in Slovakia: from the past till present.

In Slovakia, 22 tick species have been found to occur to date. Among them, and marginally and have been identified as the species of public health relevance. Ticks in Slovakia were found to harbour and transmit zoonotic and/or potentially zoonotic agents such as tick-borne encephalitis virus (TBEV), spirochaetes of the sensu lato (s.l.) complex, the relapsing fever sprirochaete , bacteria belonging to the orders Rickettsiales ( spp., , ), Legionellales () and Thiotrichales (), and spp. parasites (order Piroplasmida). is the principal vector of the largest variety of microorganisms including viruses, bacteria and piroplasms. TBEV, s.l., rickettsiae of the spotted fever group, and have been found to cause serious diseases in humans, whereas and pose lower or potential risk to humans Distribution of TBEV has a focal character. During the last few decades, new tick-borne encephalitis (TBE) foci and their spread to new areas have been registered and TBE incidence rates have increased. Moreover, Slovakia reports the highest rates of alimentary TBE infections among the European countries. Lyme borreliosis (LB) spirochaetes are spread throughout the distribution range of . Incidence rates of LB have shown a slightly increasing trend since 2010. Only a few sporadic cases of human rickettsiosis, anaplasmosis and babesiosis have been confirmed thus far in Slovakia. The latest large outbreaks of Q fever and tularaemia were recorded in 1993 and 1967, respectively. Since then, a few human cases of Q fever have been reported almost each year. Changes in the epidemiological characteristics and clinical forms of tularaemia have been observed during the last few decades. Global changes and development of modern molecular tools led to the discovery and identification of emerging or new tick-borne microorganisms and symbionts with unknown zoonotic potential. In this review, we provide a historical overview of research on ticks and tick-borne pathogens in Slovakia with the most important milestones and recent findings, and outline future directions in the investigation of ticks as ectoparasites and vectors of zoonotic agents and in the study of tick-borne diseases.