{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T23:55:27Z","timestamp":1783641327767,"version":"3.55.0"},"reference-count":35,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,4]],"date-time":"2018-04-04T00:00:00Z","timestamp":1522800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health\/Fogarty International Center","award":["5R01-TW007248"],"award-info":[{"award-number":["5R01-TW007248"]}]},{"name":"National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland","award":["Task 6\/EMK\/2017"],"award-info":[{"award-number":["Task 6\/EMK\/2017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>During 1999\u20132012, 77% of the cases of tick-borne encephalitis (TBE) were recorded in two out of 16 Polish provinces. However, historical data, mostly from national serosurveys, suggest that the disease could be undetected in many areas. The aim of this study was to identify which routinely-measured meteorological, environmental, and socio-economic factors are associated to TBE human risk across Poland, with a particular focus on areas reporting few cases, but where serosurveys suggest higher incidence. We fitted a zero-inflated Poisson model using data on TBE incidence recorded in 108 NUTS-5 administrative units in high-risk areas over the period 1999\u20132012. Subsequently we applied the best fitting model to all Polish municipalities. Keeping the remaining variables constant, the predicted rate increased with the increase of air temperature over the previous 10\u201320 days, precipitation over the previous 20\u201330 days, in forestation, forest edge density, forest road density, and unemployment. The predicted rate decreased with increasing distance from forests. The map of predicted rates was consistent with the established risk areas. It predicted, however, high rates in provinces considered TBE-free. We recommend raising awareness among physicians working in the predicted high-risk areas and considering routine use of household animal surveys for risk mapping.<\/jats:p>","DOI":"10.3390\/ijerph15040677","type":"journal-article","created":{"date-parts":[[2018,4,4]],"date-time":"2018-04-04T12:42:57Z","timestamp":1522845777000},"page":"677","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["A Predictive Model Has Identified Tick-Borne Encephalitis High-Risk Areas in Regions Where No Cases Were Reported Previously, Poland, 1999\u20132012"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0087-0906","authenticated-orcid":false,"given":"Pawel","family":"Stefanoff","sequence":"first","affiliation":[{"name":"Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health\u2014National Institute of Hygiene, 00-791 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Rubikowska","sequence":"additional","affiliation":[{"name":"Department of Population Health Monitoring and Analysis, National Institute of Public Health\u2014National Institute of Hygiene, 00-791 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7329-6269","authenticated-orcid":false,"given":"Jakub","family":"Bratkowski","sequence":"additional","affiliation":[{"name":"Institute of Environmental Protection\u2014National Research Institute (IOS\u2014PIB), 00-548 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbigniew","family":"Ustrnul","sequence":"additional","affiliation":[{"name":"Department of Climatology, Jagiellonian University, 30-387 Krakow, Poland"},{"name":"Institute of Meteorology and Water Management, 30-215 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Vanwambeke","sequence":"additional","affiliation":[{"name":"Georges Lema\u00eetre Centre for Earth and Climate Research, Earth &amp; Life Institute, Universit\u00e9 Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6256-7809","authenticated-orcid":false,"given":"Magdalena","family":"Rosinska","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health\u2014National Institute of Hygiene, 00-791 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/QCO.0b013e32830ce74b","article-title":"Tick-borne encephalitis virus, ticks and humans: Short-term and long-term dynamics","volume":"21","author":"Randolph","year":"2008","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_2","first-page":"323","article-title":"Tick-borne encephalitis: From microfocus to human disease","volume":"Volume 1","author":"Mehlhorn","year":"2011","journal-title":"Progress in Parasitology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1016\/S0140-6736(08)60800-4","article-title":"Tick-borne encephalitis","volume":"371","author":"Lindquist","year":"2008","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Rizzoli, A., Hauffe, H.C., Tagliapietra, V., Neteler, M., and Ros\u00e0, R. (2009). Forest Structure and Roe Deer Abundance Predict Tick-Borne Encephalitis Risk in Italy. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0004336"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1603\/ME10180","article-title":"Microclimate and the Zoonotic Cycle of Tick-Borne Encephalitis Virus in Switzerland","volume":"48","author":"Burri","year":"2011","journal-title":"J. Med. Entomol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1476-072X-9-54","article-title":"Pathogenic landscapes: Interactions between land, people, disease vectors, and their animal hosts","volume":"9","author":"Lambin","year":"2010","journal-title":"Int. J. Health Geogr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ttbdis.2010.05.003","article-title":"Spatio-temporal variation of tick-borne encephalitis (TBE) incidence in the Czech Republic: Is the current explanation of the disease's rise satisfactory?","volume":"1","author":"Zeman","year":"2010","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_8","first-page":"179","article-title":"Changes of meteorological factors and tick-borne encephalitis incidence in the Czech Republic","volume":"58","author":"Daniel","year":"2009","journal-title":"Epidemiol. Mikrobiol. Imunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1089\/vbz.2009.0116","article-title":"Landscape Predictors of Tick-Borne Encephalitis in Latvia: Land Cover, Land Use, and Land Ownership","volume":"10","author":"Vanwambeke","year":"2010","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1186\/1756-3305-7-370","article-title":"Shaping zoonosis risk: Landscape ecology vs. landscape attractiveness for people, the case of tick-borne encephalitis in Sweden","volume":"7","author":"Zeimes","year":"2014","journal-title":"Parasit Vectors"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1002\/rmv.566","article-title":"Socio-economic factors in the differential upsurge of tick-borne encephalitis in central and Eastern Europe","volume":"18","author":"Bormane","year":"2008","journal-title":"Rev. Med. Virol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1476-072X-9-42","article-title":"Determinants of tick-borne encephalitis in counties of southern Germany, 2001\u20132008","volume":"9","author":"Kiffner","year":"2010","journal-title":"Int. J. Health Geogr."},{"key":"ref_13","first-page":"29","article-title":"Research on the ecology of ticks and tick-borne pathogens--methodological principles and caveats","volume":"3","author":"Gray","year":"2013","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1017\/S0031182099006083","article-title":"Seasonal synchrony: The key to tick-borne encephalitis foci identified by satellite data","volume":"121","author":"Randolph","year":"2000","journal-title":"Parasitology"},{"key":"ref_15","first-page":"293","article-title":"A serologic survey of the healthy population of Poland for encephalitis arboviruses in the years 1965\u20131967","volume":"22","author":"Wroblewska","year":"1968","journal-title":"Przegl. Epidemiol."},{"key":"ref_16","first-page":"123","article-title":"Occurrence of arbovirus antibodies in foresters in Poland in 1971\u20131972","volume":"22","author":"Wroblewska","year":"1973","journal-title":"Acta Microbiol. Pol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ijmm.2008.04.002","article-title":"Identification of new endemic tick-borne encephalitis foci in Poland\u2014A pilot seroprevalence study in selected regions","volume":"298","author":"Stefanoff","year":"2008","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_18","unstructured":"Stefanoff, P., Rogalska, J., Kaba, J., Nowicki, M., and Gut, W. (2008, January 19\u201321). Prevalence of anti-TBEV antibodies in goats as a tool to validate high-risk areas for tick-borne encephalitis in Poland. Proceedings of the The European Scientific Conference on Applied Infectious Disease Epidemiology, Berlin, Germany."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Stefanoff, P., Rogalska, J., Zajkowska, J., Czerska, M., Seroka, W., and Czarkowski, M.P. (2011). Surveillance of aseptic central nervous system infections in Poland: Is it meeting its objectives?. Eurosurveillance, 16.","DOI":"10.2807\/ese.16.29.19924-en"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1186\/1756-3305-6-180","article-title":"TBE Enhanced Surveillance Working Group. New endemic foci of tick-borne encephalitis (TBE) identified in districts where testing for TBE was not available before 2009 in Poland","volume":"6","author":"Stefanoff","year":"2013","journal-title":"Parasit Vectors"},{"key":"ref_21","unstructured":"Tveito, O.E., Wegehenkel, M., van der Wel, F., and Dobesch, H. (2008). The Use of Geographic Information Systems in Climatology and Meteorology, Office for Official Publications of the European Communities."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"D05109","DOI":"10.1029\/2008JD010100","article-title":"Comparison of six methods for the interpolation of daily, European climate data","volume":"113","author":"Hofstra","year":"2008","journal-title":"J. Geophys. Res: Atmos."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1017\/S1350482705001507","article-title":"Application of GIS for the development of climatological air temperature maps: An example from Poland","volume":"12","author":"Ustrnul","year":"2005","journal-title":"Meteorol. Appl."},{"key":"ref_24","first-page":"55","article-title":"The role of explanatory variables in spatial interpolation of selected climate elements","volume":"7","author":"Lupikasza","year":"2007","journal-title":"Ann. Geomat."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1756-3305-1-44","article-title":"Variable spikes in tick-borne encephalitis incidence in 2006 independent of variable tick abundance but related to weather","volume":"1","author":"Randolph","year":"2008","journal-title":"Parasit Vectors"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Stefanoff, P., Rosi\u0144ska, M., Samuels, S., White, D.J., Morse, D.L., and Randolph, S.E. (2012). A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Poland. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0045511"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1093\/ije\/dyi284","article-title":"Towards landscape design guidelines for reducing Lyme disease risk","volume":"35","author":"Jackson","year":"2006","journal-title":"Int. J. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.stamet.2013.02.001","article-title":"Markov regression models for count time series with excess zeros: A partial likelihood approach","volume":"14","author":"Yang","year":"2013","journal-title":"Stat. Methodol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s10493-015-9990-4","article-title":"Infections and mixed infections with the selected species of Borrelia burgdorferi sensu lato complex in Ixodes ricinus ticks collected in eastern Poland: A significant increase in the course of 5 years","volume":"68","author":"Sawczyn","year":"2016","journal-title":"Exp. Appl. Acarol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ttbdis.2015.10.001","article-title":"Prevalence of infection with Rickettsia helvetica in Ixodes ricinus ticks feeding on non-rickettsiemic rodent hosts in sylvatic habitats of west-central Poland","volume":"7","author":"Biernat","year":"2016","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1111\/j.1863-2378.2012.01517.x","article-title":"Virus detection in questing ticks is not a sensitive indicator for risk assessment of tick-borne encephalitis in humans","volume":"60","author":"Stefanoff","year":"2013","journal-title":"Zoonoses Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.ttbdis.2014.04.020","article-title":"Prevalence of tick-borne encephalitis virus in a highly urbanized and low risk area in Southern Poland","volume":"5","author":"Drelich","year":"2014","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.ttbdis.2016.12.011","article-title":"Local-scale spatio-temporal distribution of questing Ixodes ricinus L. (Acari: Ixodidae)-A case study from a riparian urban forest in Wroc\u0142aw, SW Poland","volume":"8","author":"Kiewra","year":"2017","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"54","DOI":"10.21101\/cejph.a3937","article-title":"Cross-border surveillance differences: Tick-borne encephalitis and lyme borreliosis in the Czech Republic and Poland, 1999-2008","volume":"22","author":"Stefanoff","year":"2014","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/S1438-4221(02)80002-9","article-title":"Predicting the risk of tick-borne diseases","volume":"291","author":"Randolph","year":"2002","journal-title":"Int. J. Med. Microbiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/4\/677\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:59:38Z","timestamp":1760194778000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/4\/677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,4]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4]]}},"alternative-id":["ijerph15040677"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15040677","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,4]]}}}