BACKGROUND: The incidence of tick-borne diseases is increasing in Europe. Sub national information on tick
distribution, ecology and vector status is often lacking. However, precise location of infection risk can lead to better
targeted prevention measures, surveillance and control.
METHODS: In this context, the current paper compiled geolocated tick occurrences in Belgium, a country where
tick-borne disease has received little attention, in order to highlight the potential value of spatial approaches and
draw some recommendations for future research priorities.
RESULTS: Mapping of 89,289 ticks over 654 sites revealed that ticks such as Ixodes ricinus and Ixodes hexagonus are
largely present while Dermacentor reticulatus has a patchy distribution. Suspected hot spots of tick diversity might
favor pathogen exchanges and suspected hot spots of I. ricinus abundance might increase human-vector contact
locally. This underlines the necessity to map pathogens and ticks in detail. While I. ricinus is the main vector, I.
hexagonus is a vector and reservoir of Borrelia burgdorferi s.l., which is active the whole year and is also found in
urban settings. This and other nidiculous species bite humans less frequently, but seem to harbour pathogens. Their
role in maintaining a pathogenic cycle within the wildlife merits investigation as they might facilitate transmission
to humans if co-occurring with I. ricinus. Many micro-organisms are found abroad in tick species present in Belgium.
Most have not been recorded locally but have not been searched for. Some are transmitted directly at the time of
the bite, suggesting promotion of tick avoidance additionally to tick removal.
CONCLUSION: This countrywide approach to tick-borne diseases has helped delineate recommendations for future
research priorities necessary to design public health policies aimed at spatially integrating the major components of
the ecological cycle of tick-borne diseases. A systematic survey of tick species and associated pathogens is called for in
Europe, as well as better characterisation of species interaction in the ecology of tick-borne diseases, those being all tick
species, pathogens, hosts and other species which might play a role in tick-borne diseases complex ecosystems.